Home Drug Guide Peginterferon Alfa-2b

Drug Guide

Generic Name

Peginterferon Alfa-2b

Brand Names Pegintron, Sylatron

Classification

Therapeutic: Immunomodulator, Antineoplastic agent

Pharmacological: Interferon (Type I)

FDA Approved Indications

  • Hairy Cell Leukemia
  • Melanoma (adjuvant therapy)
  • Chronic Hepatitis B (off-label)
  • Chronic Hepatitis C (off-label)

Mechanism of Action

Peginterferon Alfa-2b modulates the immune system by inducing antiviral proteins, inhibiting tumor cell proliferation, and enhancing the immune response against infected or malignant cells.

Dosage and Administration

Adult: Dose varies depending on indication; typically 180 mcg subcutaneously once weekly for hepatitis, adjusted based on response and tolerability.

Pediatric: Use depends on specific condition; consult detailed guidelines.

Geriatric: Use with caution; monitor for enhanced side effects.

Renal Impairment: Adjust dosing based on renal function; specifics depend on condition.

Hepatic Impairment: Use with caution; no specific dose adjustment provided, but monitor closely.

Pharmacokinetics

Absorption: Subcutaneous administration with peak serum levels in 24-48 hours.

Distribution: Widely distributed; high protein binding.

Metabolism: Metabolized via proteolytic enzymes to smaller peptides and amino acids.

Excretion: Primarily via renal route; dosage adjustments may be necessary in renal impairment.

Half Life: Approximately 4.7 hours.

Contraindications

  • Hypersensitivity to peginterferon alfa-2b or any component.
  • Autoimmune hepatitis.
  • Decompensated liver disease.

Precautions

  • History of autoimmune disease, psychiatric disorders, cardiac disease.
  • Monitoring for flu-like symptoms, depression, hematologic abnormalities is essential.
  • Pregnancy category C; use only if clearly needed; effective contraception advised during treatment and for some time after.

Adverse Reactions - Common

  • Flu-like symptoms (Very common)
  • Fatigue (Very common)
  • Myelosuppression (neutropenia, thrombocytopenia, anemia) (Common)
  • Injection site reactions (Common)

Adverse Reactions - Serious

  • Psychiatric symptoms (depression, suicidal ideation) (Uncommon)
  • Hepatotoxicity (liver failure) (Rare)
  • Autoimmune disorders (Rare)

Drug-Drug Interactions

  • Other myelosuppressants, hepatotoxic drugs, immunosuppressants

Drug-Food Interactions

  • No significant interactions reported

Drug-Herb Interactions

  • Limited data; caution advised with immune-modulating herbs.

Nursing Implications

Assessment: Monitor CBC, LFTs, and mental status regularly.

Diagnoses:

  • Risk for infection, risk for bleeding, risk for impaired skin integrity, altered nutrition.

Implementation: Administer as prescribed subcutaneously; educate patient on signs of adverse effects.

Evaluation: Assess for efficacy (viral load reduction, tumor response) and adverse reactions.

Patient/Family Teaching

  • Report flu-like symptoms, mood changes, signs of infection or bleeding promptly.
  • Adherence to schedule is critical.
  • Avoid live vaccines during therapy.

Special Considerations

Black Box Warnings:

  • Neuropsychiatric disorders, autoimmune disorders, ischemic events, and infectious disorders have been noted.

Genetic Factors: No specific genetic considerations specified.

Lab Test Interference: May elevate liver enzymes, affect blood counts.

Overdose Management

Signs/Symptoms: Flu-like symptoms, hematologic abnormalities, neuropsychiatric symptoms.

Treatment: Supportive care, supportive medications for symptoms, and monitoring; no specific antidote.

Storage and Handling

Storage: Store unopened vials refrigerated at 2°C to 8°C (36°F to 46°F). Protect from light.

Stability: Stable until the expiration date printed on the package.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.