interferon-gamma 1B

Introduction

Tradename: Actimmune.

Indications

• reduction in frequency & severity of infections associated with chronic granulomatous disease
• osteopetrosis

Contraindications

• hypersensitivity to E. coli-derived products
• of no benefit for idiopathic pulmonary fibrosis

Caution:

• pre-exisiting heart disease
• seizure disorder
• CNS disturbances
• myelosuppression

Dosage

• < 0.5 m2 body area: 1.5 ug/kg SC 3 times/week
• > 0.5 m2 body area: 50 ug/m2 (1.5 million units/m2) SC 3 times/week
• acetaminophen may be used to prevent fever & headache

Injection: 100 ug (3 million units) (single use only)

Pharmacokinetics

• 89% bioavailability after IM or SC injection
• peak plasma concentrations
  • 4 hours after IM injection
  • 7 hours after SC injection
• 1/2life
  • 38 minutes after IV injection
  • 2.9 hours after IM injection
  • 5.9 hours after SC injection

Monitor

• BUN, serum creatinine
• complete blood count (CBC)
• urinalysis
• liver function tests every 3 months

Adverse effects

• common (> 10%)
  • fever/chills, headache, rash, fatigue, diarrhea, nausea/vomiting
• less common (1-10%)
  • abdominal pain, weight loss, myalgia, anorexia, depression, arthralgia, back pain
• other
  • focal segmental glomerulosclerosis
  • acute tubular necrosis (ATN)
  • proteinuria

Drug interactions

• other myelosuppressive agents
• may decrease cyt P450 levels, increasing levels of drugs metabolized by liver

• drug interaction(s) of methotrexate with biological response modifier

Mechanism of action

• clinical improvement was NOT associated with an increase in neutrophil bactericidal activity

More general terms

• biological response modifier
• interferon [IFN]-gamma
• pharmaceutical interferon

Additional terms

• chronic granulomatous disease