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interferon-gamma 1B

Tradename: Actimmune. Indications: - reduction in frequency & severity of infections associated with chronic granulomatous disease - osteopetrosis [5] Contraindications: 1) hypersensitivity to E. coli-derived products 2) of no benefit for idiopathic pulmonary fibrosis [4] Caution: 1) pre-exisiting heart disease 2) seizure disorder 3) CNS disturbances 4) myelosuppression Dosage: 1) < 0.5 m2 body area: 1.5 ug/kg SC 3 times/week 2) > 0.5 m2 body area: 50 ug/m2 (1.5 million units/m2) SC 3 times/week 3) acetaminophen may be used to prevent fever & headache Injection: 100 ug (3 million units) (single use only) Pharmacokinetics: 1) 89% bioavailability after IM or SC injection 2) peak plasma concentrations a) 4 hours after IM injection b) 7 hours after SC injection 3) 1/2life a) 38 minutes after IV injection b) 2.9 hours after IM injection c) 5.9 hours after SC injection Monitor: - BUN, serum creatinine - complete blood count (CBC) - urinalysis - liver function tests every 3 months Adverse effects: 1) common (> 10%) - fever/chills, headache, rash, fatigue, diarrhea, nausea/vomiting 2) less common (1-10%) - abdominal pain, weight loss, myalgia, anorexia, depression, arthralgia, back pain 3) other [2] - focal segmental glomerulosclerosis - acute tubular necrosis (ATN) - proteinuria Drug interactions: 1) other myelosuppressive agents 2) may decrease cyt P450 levels, increasing levels of drugs metabolized by liver Mechanism of action: - clinical improvement was NOT associated with an increase in neutrophil bactericidal activity

Related

chronic granulomatous disease

General

biological response modifier; immune factor; immunomodulator; biomodulator interferon [IFN]-gamma; interferon type 2; immune interferon (IFNG) pharmaceutical interferon

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  3. Department of Veterans Affairs, VA National Formulary
  4. FDA Medwatch http://www.fda.gov/medwatch/safety/2007/safety07.htm#Actimmune - King TE et al Effect of interferon gamma-1b on survival in patients with idiopathic pulmonary fibrosis (INSPIRE): a multicentre, randomised, placebo-controlled trial Lancet, Early Online Publication, 30 June 2009 doi:10.1016/S0140-6736(09)60551-1
  5. Deprecated Reference