Alferon N

Read the Medication Guide available from your pharmacist before you start using this drug and each time you get a refill. Learn all preparation and usage instructions given by the manufacturer. If you have any questions, consult your doctor or pharmacist.

This medication is given by injection into a muscle or under the skin as directed by your doctor. Rotate the injection site each time you inject this medication to prevent soreness. It may also be given by injection into a vein or directly into a lesion, usually by a health care professional.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Do not shake the medication container (vial or syringe). Doing so may decrease the effectiveness of the drug. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely. Never reuse single-use syringes or needles. It is okay to reuse the multidose pen. It is best used in the evening before bedtime to reduce side effects.

Drink plenty of fluids while using this medication unless otherwise directed by your doctor.

Dosage is based on your medical condition and response to therapy. Do not change the dose or how often you use this medication without your doctor's approval. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each evening that you have a scheduled dose.

Different brands of interferon alfa can result in different amounts of medication in the blood. This medication comes in different forms (a powder in a vial, a solution in a vial, and a multidose pen). The way you inject this medication depends on the form you are using. Follow your doctor's directions carefully. Do not switch brands without your doctor's permission.

Injection site reactions (pain/swelling/redness), headache, tiredness, diarrhea, upset stomach, loss of appetite, back pain, dizziness, dry mouth, taste changes, nausea, or vomiting may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Flu-like symptoms such as fever, chills, and muscle aches may occur, especially when you first start this medication. These symptoms usually last about 1 day after the injection and improve or go away after a few weeks of continued use. You can reduce these side effects by injecting this medicine at bedtime and using a fever reducer/pain reliever such as acetaminophen before each dose. Consult your doctor or pharmacist for more information.

Tooth and gum problems may sometimes occur during treatment. Having a dry mouth can worsen this side effect. Prevent dry mouth by drinking plenty of water or using a saliva substitute. Brush your teeth well at least twice a day and have regular dental exams. If you experience vomiting during treatment, rinse your mouth afterwards to lessen the chance of tooth and gum problems.

Temporary hair loss may occur. Normal hair growth should return after treatment has ended.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: nausea/vomiting that doesn't stop, feeling too hot or cold (more than others around you), fast/irregular heartbeat, increased thirst/urination, menstrual changes (absent/delayed/irregular periods), numbness/tingling of hands/feet, swelling (especially of face/hands/feet), trouble sleeping, trouble walking, vision changes (such as blurred vision, partial loss of vision), easy bleeding/bruising, signs of infection (such as sore throat that doesn't go away, fever), stomach/abdominal pain, dark urine, black/tarry stools, yellowing eyes/skin.

Get medical help right away if any of these very serious side effects occur: chest pain, seizures, weakness on one side of the body, trouble speaking.

This drug may cause you to develop serious mental/mood changes that may get worse during treatment or after your last dose. Tell your doctor right away if you have symptoms such as confusion, depression, thoughts of suicide or hurting others, unusual irritability, or aggressive behavior. If this occurs, psychiatric therapy and monitoring is recommended during and after treatment with this medication.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

See also Warning section.

Before using interferon alfa, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as albumin), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood cell disorders (such as anemia, neutropenia, thrombocytopenia), blood clots, cancer, diabetes, eye problems, heart disease (such as angina, irregular heartbeat), high blood pressure, HIV infection, immune system diseases (such as lupus, psoriasis, rheumatoid arthritis), intestinal disease (such as colitis), kidney disease, liver disease (such as autoimmune hepatitis, decompensated liver disease), lung diseases (such as chronic obstructive pulmonary disease-COPD, asthma, pneumonia), mental/mood disorders (such as anxiety, depression), high blood triglyceride levels, pancreatitis, seizure disorder, thyroid disease, use/abuse of drugs/alcohol.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Tell your health care professional that you are using interferon alfa before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Children may be more sensitive to the side effects of this drug, especially mental/mood changes (such as severe depression, thoughts/attempts of suicide). Interferon and ribavirin may also slow down a child's rate of growth. Normal weight gain and rate of growth usually return after treatment is completed but the final adult height may be lower than expected. Monitor your child's height and weight periodically during treatment.

Older adults may be more sensitive to the effects of the drug, especially dizziness, mental/mood changes, and effects on the heart.

During pregnancy, interferon alfa should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Interferon alfa, when used in combination with ribavirin, must not be used during pregnancy by either the pregnant woman or her male partner. The combination may cause harm to an unborn baby. Reliable forms of birth control must be used whenever at least one sexual partner is using these medicines together. Female patients should continue using birth control for 9 months after stopping treatment. Male patients should continue using birth control for 6 months after stopping treatment. If you or your partner become pregnant, or if you think you or your partner may be pregnant, tell your doctor right away.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: barbiturates (such as phenobarbital), colchicine, drugs that may affect your immune system (such as cancer chemotherapy, aldesleukin, cyclosporine), hydroxyurea, telbivudine, theophyllines (such as aminophylline, theophylline).

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: nausea/vomiting that doesn't stop, chest pain, stomach/abdominal pain, dark urine.

Do not share this medication with others.

Lab and/or medical tests (such as blood counts, thyroid/kidney/liver function, triglyceride levels, eye exams) should be done before you start using this medication and while you are using it. Depending on your medical history, other tests (such as EKG) may be needed. Keep all medical and lab appointments. Consult your doctor for more details.

Do not change brands of interferon without checking with your doctor or pharmacist. Other interferons may not have the same effects on your disease.

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

Store in the refrigerator away from light and moisture. Do not freeze. Keep all medications away from children and pets. Consult the product instructions or your pharmacist for more storage details once this medication is mixed.

The multidose pen may be used for up to 4 weeks after the first injection. Do not leave this medication outside of the refrigerator for more than 48 hours. After 4 weeks of use, discard the pen, even if it still contains unused solution.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.