Myleosuppressive agents -  because of possibility of interferon beta -1a to cause neutropenia, and lymphoma proper monitoring is required if administered concomittantly with mylosuppressive agents

Most serious adverse reactions were depression, suicidal ideation

Most commonly reported adverse reactions were-
asthenia,   flu -like symptoms, headache, injection site reactions, lymphoma, and pain

Adverse reactions-

Cardiovascular - vasodilation 2%

CNS - asthenia    20%, depression  15%, dizziness 12%  headache  50%

Dermatologic -  alpoecia 4%

GI - abdominal pain  6% 

Hypersensitivity to components in the formulation

Precautions/ warnings

Chronic progressive MS multiple sclerosis - safety and efficacy of interferon beta in chronic MS have not been evaluated

Depression - use with caution in patients suffering from depression, or mood disorders.
Suicidal attempts are known to occur. Advice patients to report any symptoms of depression

Injection site necrosis - has been reported

Anaphylaxis- anaphylaxis has been reported as a rare complicationof interferon beta use

Decreased peripheral blood counts - decreased peripheral blood counts in all cell lines, including rare pancytopenia and thrombocytopenia have been reported

Special risk patients- excercise caution when administering interferon beta -1a to patients with pre-existing seizure disorders. Seizures have been associated with the use of beta interferons

Cardiac disease - closely monitor ptients with cardiac disease such as angina, CHF or arrhythmias, for worsening of their condition during treatment taking interferon beta

Hepatic function impairment -  Very rarely, severe liver dysfunction leading to hepatic failure requiring liver transplant has been reported rarely in patients

Photosensitivity - caution patients to take protective measures against exposure to sun light or ultraviolet light

Pregnancy - no adequate and well documented studies in pregnant women. Weigh the potential benefit against potential hazards to the fetus before taking interferon beta

Lactation- It is not known whether interferon beta is excreted in breast milk. Decide whether to discontinue nursing or discontinue the drug taking into account the importance of the drug to the mother

Children- safety and efficacy in children younger than 18 years of have not established

Indication-
Multiple sclerosis

Dosage-
Dosages shown to be safe are 22 and 44 mcg injected subcutaneously 3 time per week.
Administer if possible at the same time preferably in the late afternoon or evening on the same
day 3 times, ( Monday, Wednesday , Friday ) at least 48 hrs apart ech week.

Generally start patients at 20% of the prescribed dose 3 times per and increased over  a
4-week period to the targeted dose either 22 or 44mcg 3 times per week

1. Instruction for self -injection  technique - instruct patients in the use of aspectic technique when administering interferon beta . Give appropiate instruction for reconstitution of the  product and self injection

2. Caution patients not to change the dosage or the schedule of administration without consulting  doctor

3. Disposal - caution patients against the re-use of needles or syringes and instruct them in
    safe disposal procedures

4. Injection site reactions- injection site reactions may occurat least one time during therapy.  In general these are transient and do not require discontinuationof the therapy

5. Flu-like symptoms- are common following initiation of therapy. Symptoms of flu syndrome  are most prominent at the initiation of therapy and decrease in frequency with continued  therapy

6. Depression/suicide - caution patients to report depression or suicidal ideation

7. Abortifacient potential - advice patients about the abortificient potential

8. Photosentiivity - advice patients to avoid prolonged exposure to sun light or ultraviolet light  since  interferon beta may cause photosentivity

Pregnancy -
No adequate and well documented studies in pregnant women. Weigh the potential
benefit against potential hazards to the fetus before taking interferon beta

Lactation-
It is not known whether interferon beta is excreted in breast milk. Decide whether to
discontinue nursing or discontinue the drug taking into account the importance of the drug to the mother

Children-
Safety and efficacy in children younger than 18 years of have not established