Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 500mcg/mL (single-dose prefilled syringe)
Polycythemia Vera
Indicated for treatment of polycythemia vera
Not currently on hydroxyurea
- Initial dose: 100 mcg SC q2Weeks
- Increase dose by 50 mcg q2Weeks (not to exceed 500 mcg/dose) until hematological parameters are stabilized (hematocrit [Hct] <45%, platelets [Plt] <400x 109/L, leukocytes <10x 109/L)
Transitioning from hydroxyurea
- Initial dose: 50 mcg SC q2Weeks in combination with hydroxyurea
- Increase dose by 50 mcg q2Weeks (not to exceed 500 mcg/dose) until hematological parameters are stabilized (HCT <45%, Plt <400 x 109/L, leukocytes <10 x 109/L)
- Weeks 3-12: Gradually taper off hydroxyurea by reducing total biweekly dose by 20-40% q2Weeks
- Week 13: Discontinue hydroxyurea
Dosage Modifications
Liver enzyme elevations
-
>5x to ≤20x ULN
- Decrease dose by 50 mcg; if no improvement, continue decreasing at biweekly intervals until ALT/AST <3x ULN if baseline was normal; 3x baseline if baseline was abnormal, and gamma-glutamyl transferase (GGT) recovers to <2.5x ULN if baseline was normal; or 2.5x baseline if baseline was abnormal
- If interrupted dose is 50 mcg, hold treatment until recovery
-
>20x ULN
- Interrupt treatment until ALT/AST <3x ULN if baseline was normal or 1.5x baseline if baseline was abnormal, and GGT <2.5x ULN if baseline was normal or 2x baseline if baseline was abnormal
- Consider permanent discontinuation if toxicity persists after 4 dose modifications
Elevated liver enzymes with elevated bilirubin, or other evidence of hepatic decompensation
- Any increase above baseline: Interrupt treatment until recovery; restart at 50 mcg lower than interrupted dose
- If interrupted dose is 50 mcg, hold treatment until recovery
- Consider permanent discontinuation if toxicity persists after 4 dose modifications
Cytopenia
-
Non-life-threatening
- Defined as hemoglobin (Hgb) <8 g/dL, platelet (PLT) count ≥25,000 to <50,000/mm3, or WBC ≥1,000 to <2,000/mm3
- Decrease dose by 50 mcg; if toxicity does not improve, continue decreasing at biweekly intervals until recovery of Hgb >10 g/dL, Plt count >75,000/mm3, and WBC >3,000/mm3
- If interrupted dose is 50 mcg, hold treatment until recovery
-
Life-threatening
- Defined as Hgb levels are life threatening, or urgent intervention needed, PLT count <25,000/mm3, or WBC <1,000/mm3
- Interrupt treatment until recovery of Hgb >10 g/dL, PLT count >75,000/mm3, and WBC >3,000/mm3
- Consider permanent discontinuation if toxicity persists after 4 dose modifications
Depression
- Mild, without suicidal ideation: Consider psychiatric consultation if persistent (>8 weeks)
- Moderate, without suicidal ideation: Consider dose reduction and psychiatric consultation
- Severe, or any severity with suicidal ideation: Discontinue therapy, recommend psychiatric consultation
Renal impairment
- eGFR ≥30 mL/min: No dose adjustment necessary
- eGFR <30 mL/min: Avoid use
Hepatic impairment
- Mild (Child-Pugh A): No dose adjustment necessary
- Moderate-to-severe (Child-Pugh B or C): Contraindicated
Dosing Considerations
Maintain 2-week dosing interval at which hematological stability is achieved for at least 1 year
After achievement of hematological stability for at least 1 year on a stable dose, dosing interval may be expanded to every 4 weeks
Monitor parameters
- Verify pregnancy in females of reproductive potential before initiating
- Perform complete blood cell (CBC) counts regularly, every 2 weeks during titration or dosage modification, and every 3-6 months during maintenance (once optimal dose is established)
- Monitor CBC more frequently if clinically indicated
- Phlebotomy as rescue treatment to normalize blood hyperviscosity may be necessary during titration
Safety and efficacy not established
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (181)
- abemaciclib
ropeginterferon alfa 2b, abemaciclib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- acalabrutinib
ropeginterferon alfa 2b, acalabrutinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- albendazole
ropeginterferon alfa 2b, albendazole. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- aldesleukin
ropeginterferon alfa 2b, aldesleukin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- alemtuzumab
ropeginterferon alfa 2b, alemtuzumab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- allopurinol
ropeginterferon alfa 2b, allopurinol. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- altretamine
ropeginterferon alfa 2b, altretamine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- arsenic trioxide
ropeginterferon alfa 2b, arsenic trioxide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- axicabtagene ciloleucel
ropeginterferon alfa 2b, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- azacitidine
ropeginterferon alfa 2b, azacitidine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- belinostat
ropeginterferon alfa 2b, belinostat. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- bendamustine
ropeginterferon alfa 2b, bendamustine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- bevacizumab
ropeginterferon alfa 2b, bevacizumab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- bexarotene
ropeginterferon alfa 2b, bexarotene. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- blinatumomab
ropeginterferon alfa 2b, blinatumomab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- bortezomib
ropeginterferon alfa 2b, bortezomib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- bosutinib
ropeginterferon alfa 2b, bosutinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppressionMyelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- brexucabtagene autoleucel
ropeginterferon alfa 2b, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- busulfan
ropeginterferon alfa 2b, busulfan. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- cabazitaxel
ropeginterferon alfa 2b, cabazitaxel. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- capecitabine
ropeginterferon alfa 2b, capecitabine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- carbamazepine
ropeginterferon alfa 2b, carbamazepine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- carboplatin
ropeginterferon alfa 2b, carboplatin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- carfilzomib
ropeginterferon alfa 2b, carfilzomib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- carmustine
ropeginterferon alfa 2b, carmustine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- chlorambucil
ropeginterferon alfa 2b, chlorambucil. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- chloramphenicol
ropeginterferon alfa 2b, chloramphenicol. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- cidofovir
ropeginterferon alfa 2b, cidofovir. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- ciltacabtagene autoleucel
ropeginterferon alfa 2b, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- cisplatin
ropeginterferon alfa 2b, cisplatin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- cladribine
ropeginterferon alfa 2b, cladribine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- clofarabine
ropeginterferon alfa 2b, clofarabine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- clozapine
ropeginterferon alfa 2b, clozapine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- colchicine
ropeginterferon alfa 2b, colchicine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- cyclophosphamide
ropeginterferon alfa 2b, cyclophosphamide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- cytarabine
ropeginterferon alfa 2b, cytarabine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- dacarbazine
ropeginterferon alfa 2b, dacarbazine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- dactinomycin
ropeginterferon alfa 2b, dactinomycin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- dasatinib
ropeginterferon alfa 2b, dasatinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- daunorubicin
ropeginterferon alfa 2b, daunorubicin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- decitabine
ropeginterferon alfa 2b, decitabine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- desflurane
ropeginterferon alfa 2b and desflurane both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- desvenlafaxine
ropeginterferon alfa 2b and desvenlafaxine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- deutetrabenazine
ropeginterferon alfa 2b and deutetrabenazine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- dexchlorpheniramine
ropeginterferon alfa 2b and dexchlorpheniramine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- dexmedetomidine
ropeginterferon alfa 2b and dexmedetomidine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- dexrazoxane
ropeginterferon alfa 2b, dexrazoxane. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- dichloralphenazone
ropeginterferon alfa 2b and dichloralphenazone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- dichlorphenamide
ropeginterferon alfa 2b and dichlorphenamide both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- difelikefalin
ropeginterferon alfa 2b and difelikefalin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- difenoxin hcl
ropeginterferon alfa 2b and difenoxin hcl both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- dinutuximab
ropeginterferon alfa 2b, dinutuximab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- diphenoxylate hcl
ropeginterferon alfa 2b and diphenoxylate hcl both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- docetaxel
ropeginterferon alfa 2b, docetaxel. Either increases levels of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- doxorubicin
ropeginterferon alfa 2b, doxorubicin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- doxorubicin liposomal
ropeginterferon alfa 2b, doxorubicin liposomal. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- dronabinol
ropeginterferon alfa 2b and dronabinol both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- droperidol
ropeginterferon alfa 2b and droperidol both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- duloxetine
ropeginterferon alfa 2b and duloxetine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- efavirenz
ropeginterferon alfa 2b and efavirenz both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- entacapone
ropeginterferon alfa 2b and entacapone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- epirubicin
ropeginterferon alfa 2b, epirubicin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- eribulin
ropeginterferon alfa 2b, eribulin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- escitalopram
ropeginterferon alfa 2b, escitalopram. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- estramustine
ropeginterferon alfa 2b, estramustine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- ethosuximide
ropeginterferon alfa 2b and ethosuximide both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- ethotoin
ropeginterferon alfa 2b and ethotoin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- etoposide
ropeginterferon alfa 2b, etoposide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- everolimus
ropeginterferon alfa 2b, everolimus. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- flibanserin
ropeginterferon alfa 2b and flibanserin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- floxuridine
ropeginterferon alfa 2b, floxuridine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- flucytosine
ropeginterferon alfa 2b, flucytosine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- fludarabine
ropeginterferon alfa 2b, fludarabine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- fluorouracil
ropeginterferon alfa 2b, fluorouracil. Either increases levels of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- fosphenytoin
ropeginterferon alfa 2b and fosphenytoin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- gabapentin
ropeginterferon alfa 2b and gabapentin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- gabapentin enacarbil
ropeginterferon alfa 2b and gabapentin enacarbil both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- ganciclovir
ropeginterferon alfa 2b, ganciclovir. Either increases levels of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- guanfacine
ropeginterferon alfa 2b and guanfacine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- haloperidol
ropeginterferon alfa 2b, haloperidol. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- hydroxyurea
ropeginterferon alfa 2b, hydroxyurea. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- ibritumomab tiuxetan
ropeginterferon alfa 2b, ibritumomab tiuxetan. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- ibrutinib
ropeginterferon alfa 2b, ibrutinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- idarubicin
ropeginterferon alfa 2b, idarubicin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- idecabtagene vicleucel
ropeginterferon alfa 2b, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- ifosfamide
ropeginterferon alfa 2b, ifosfamide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- imatinib
ropeginterferon alfa 2b, imatinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- interferon alfa 2b
ropeginterferon alfa 2b, interferon alfa 2b. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- interferon beta 1a
ropeginterferon alfa 2b, interferon beta 1a. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- interferon beta 1b
ropeginterferon alfa 2b, interferon beta 1b. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- interferon gamma 1b
ropeginterferon alfa 2b, interferon gamma 1b. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- irinotecan
ropeginterferon alfa 2b, irinotecan. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- isoflurane
ropeginterferon alfa 2b and isoflurane both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- ixabepilone
ropeginterferon alfa 2b, ixabepilone. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- ketamine
ropeginterferon alfa 2b and ketamine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- lenalidomide
ropeginterferon alfa 2b, lenalidomide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- levetiracetam
ropeginterferon alfa 2b, levetiracetam. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- linezolid
ropeginterferon alfa 2b, linezolid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- lisocabtagene maraleucel
ropeginterferon alfa 2b, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- lithium
ropeginterferon alfa 2b and lithium both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- lomustine
ropeginterferon alfa 2b, lomustine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- maprotiline
ropeginterferon alfa 2b and maprotiline both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- mebendazole
ropeginterferon alfa 2b, mebendazole. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- mechlorethamine
ropeginterferon alfa 2b, mechlorethamine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- meclizine
ropeginterferon alfa 2b and meclizine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- melphalan
ropeginterferon alfa 2b, melphalan. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- mercaptopurine
ropeginterferon alfa 2b, mercaptopurine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- methadone
ropeginterferon alfa 2b and methadone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- methimazole
ropeginterferon alfa 2b, methimazole. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- methohexital
ropeginterferon alfa 2b and methohexital both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- methotrexate
ropeginterferon alfa 2b, methotrexate. Either increases levels of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- methsuximide
ropeginterferon alfa 2b and methsuximide both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- metyrosine
ropeginterferon alfa 2b and metyrosine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- mirtazapine
ropeginterferon alfa 2b and mirtazapine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- mitomycin
ropeginterferon alfa 2b, mitomycin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- mitoxantrone
ropeginterferon alfa 2b, mitoxantrone. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- morphine
ropeginterferon alfa 2b and morphine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- nabilone
ropeginterferon alfa 2b and nabilone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- nefazodone
ropeginterferon alfa 2b and nefazodone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- nelarabine
ropeginterferon alfa 2b, nelarabine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- nilotinib
ropeginterferon alfa 2b, nilotinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- nitrous oxide
ropeginterferon alfa 2b and nitrous oxide both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- obinutuzumab
ropeginterferon alfa 2b, obinutuzumab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- olaparib
ropeginterferon alfa 2b, olaparib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- opium tincture
ropeginterferon alfa 2b and opium tincture both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- oxaliplatin
ropeginterferon alfa 2b, oxaliplatin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- oxybutynin
ropeginterferon alfa 2b and oxybutynin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- paclitaxel
ropeginterferon alfa 2b, paclitaxel. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- palbociclib
ropeginterferon alfa 2b, palbociclib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- pazopanib
ropeginterferon alfa 2b, pazopanib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- peginterferon alfa 2a
ropeginterferon alfa 2b, peginterferon alfa 2a. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- pemetrexed
ropeginterferon alfa 2b, pemetrexed. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- pentostatin
ropeginterferon alfa 2b, pentostatin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- perampanel
ropeginterferon alfa 2b and perampanel both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- pheniramine
ropeginterferon alfa 2b and pheniramine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- phenobarbital
ropeginterferon alfa 2b and phenobarbital both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- phenytoin
ropeginterferon alfa 2b and phenytoin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- ponatinib
ropeginterferon alfa 2b, ponatinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- primaquine
ropeginterferon alfa 2b, primaquine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- primidone
ropeginterferon alfa 2b and primidone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- procarbazine
ropeginterferon alfa 2b, procarbazine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- propofol
ropeginterferon alfa 2b and propofol both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- propylthiouracil
ropeginterferon alfa 2b, propylthiouracil. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- pyrimethamine
ropeginterferon alfa 2b, pyrimethamine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- rituximab
ropeginterferon alfa 2b, rituximab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- ruxolitinib
ropeginterferon alfa 2b, ruxolitinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- scopolamine
ropeginterferon alfa 2b and scopolamine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- sevoflurane
ropeginterferon alfa 2b and sevoflurane both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- sirolimus
ropeginterferon alfa 2b, sirolimus. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- sodium oxybate
ropeginterferon alfa 2b and sodium oxybate both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- sorafenib
ropeginterferon alfa 2b, sorafenib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- streptozocin
ropeginterferon alfa 2b, streptozocin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- sulfasalazine
ropeginterferon alfa 2b, sulfasalazine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- sunitinib
ropeginterferon alfa 2b, sunitinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tacrolimus
ropeginterferon alfa 2b, tacrolimus. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tedizolid
ropeginterferon alfa 2b, tedizolid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- temazepam
ropeginterferon alfa 2b and temazepam both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- temozolomide
ropeginterferon alfa 2b, temozolomide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- teniposide
ropeginterferon alfa 2b, teniposide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tetrabenazine
ropeginterferon alfa 2b and tetrabenazine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- thalidomide
ropeginterferon alfa 2b, thalidomide. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- theophylline
ropeginterferon alfa 2b and theophylline both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- thioguanine
ropeginterferon alfa 2b, thioguanine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- thiotepa
ropeginterferon alfa 2b, thiotepa. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tisagenlecleucel
ropeginterferon alfa 2b, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- tizanidine
ropeginterferon alfa 2b and tizanidine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- tofacitinib
ropeginterferon alfa 2b, tofacitinib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tolcapone
ropeginterferon alfa 2b and tolcapone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- topotecan
ropeginterferon alfa 2b, topotecan. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tositumomab
ropeginterferon alfa 2b, tositumomab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- trabectedin
ropeginterferon alfa 2b, trabectedin. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- trastuzumab
ropeginterferon alfa 2b, trastuzumab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- trimethobenzamide
ropeginterferon alfa 2b and trimethobenzamide both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- valerian
ropeginterferon alfa 2b and valerian both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- vilazodone
ropeginterferon alfa 2b and vilazodone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- vinblastine
ropeginterferon alfa 2b, vinblastine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- vincristine
ropeginterferon alfa 2b, vincristine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- vinorelbine
ropeginterferon alfa 2b, vinorelbine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- vorinostat
ropeginterferon alfa 2b, vorinostat. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- ziconotide
ropeginterferon alfa 2b and ziconotide both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- zidovudine
ropeginterferon alfa 2b, zidovudine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
Monitor Closely (30)
- alfentanil
ropeginterferon alfa 2b will increase the level or effect of alfentanil by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- amphotericin B cholesteryl sulfate
ropeginterferon alfa 2b will increase the level or effect of amphotericin B cholesteryl sulfate by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- amphotericin B deoxycholate
ropeginterferon alfa 2b will increase the level or effect of amphotericin B deoxycholate by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- amphotericin B liposomal
ropeginterferon alfa 2b will increase the level or effect of amphotericin B liposomal by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- amphotericin B phospholipid complex
ropeginterferon alfa 2b will increase the level or effect of amphotericin B phospholipid complex by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- clonidine
ropeginterferon alfa 2b will increase the level or effect of clonidine by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- cyclosporine
ropeginterferon alfa 2b will increase the level or effect of cyclosporine by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- dihydroergotamine
ropeginterferon alfa 2b will increase the level or effect of dihydroergotamine by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- dihydroergotamine inhaled
ropeginterferon alfa 2b will increase the level or effect of dihydroergotamine inhaled by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- disopyramide
ropeginterferon alfa 2b will increase the level or effect of disopyramide by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- divalproex sodium
ropeginterferon alfa 2b will increase the level or effect of divalproex sodium by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- ergotamine
ropeginterferon alfa 2b will increase the level or effect of ergotamine by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- fentanyl
ropeginterferon alfa 2b will increase the level or effect of fentanyl by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- fentanyl intranasal
ropeginterferon alfa 2b will increase the level or effect of fentanyl intranasal by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- fentanyl iontophoretic transdermal system
ropeginterferon alfa 2b will increase the level or effect of fentanyl iontophoretic transdermal system by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- fentanyl transdermal
ropeginterferon alfa 2b will increase the level or effect of fentanyl transdermal by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- fentanyl transmucosal
ropeginterferon alfa 2b will increase the level or effect of fentanyl transmucosal by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- isavuconazonium sulfate
ropeginterferon alfa 2b and isavuconazonium sulfate both decrease immunosuppressive effects; risk of infection. Use Caution/Monitor.
- levothyroxine
ropeginterferon alfa 2b will increase the level or effect of levothyroxine by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- midazolam
ropeginterferon alfa 2b will increase the level or effect of midazolam by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- minoxidil
ropeginterferon alfa 2b will increase the level or effect of minoxidil by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- pimozide
ropeginterferon alfa 2b will increase the level or effect of pimozide by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- prazosin
ropeginterferon alfa 2b will increase the level or effect of prazosin by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- quinidine
ropeginterferon alfa 2b will increase the level or effect of quinidine by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- repaglinide
ropeginterferon alfa 2b will increase the level or effect of repaglinide by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- thioridazine
ropeginterferon alfa 2b will increase the level or effect of thioridazine by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- triazolam
ropeginterferon alfa 2b will increase the level or effect of triazolam by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- ublituximab
ublituximab and ropeginterferon alfa 2b both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered
- valproic acid
ropeginterferon alfa 2b will increase the level or effect of valproic acid by Other (see comment). Use Caution/Monitor. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Therefore, monitor patients who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index from toxicities to such drugs.
- warfarin
ropeginterferon alfa 2b increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.
Minor (0)
Adverse Effects
>10%
Influenza-like illness (59%)
Arthralgia (47%)
Fatigue (47%)
Pruritus (45%)
Nasopharyngitis (43%)
Musculoskeletal pain (41%)
Headache (39%)
Diarrhea (33%)
Hyperhidrosis (29%)
Nausea (28%)
Upper respiratory tract infection (27%)
Local administration site reactions (26%)
Dizziness (22%)
Abdominal pain (20%)
Depression (20%)
Sleep disorder (20%)
Leukopenia (18%)
Decreased appetite (18%)
Alopecia (16%)
Edema (16%)
Hypertension (16%)
Muscle spasms (16%)
Neutropenia (16%)
Rash (16%)
Transaminase elevations (16%)
Urinary tract infection (16%)
Thrombocytopenia (12%)
Vertigo (12%)
1-10%
Atrial fibrillation (<10%)
Warnings
Black Box Warnings
Risk of serious disorders
- Interferon alfa products may cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders
- Closely monitor patients with periodic clinical and laboratory evaluations
- Withdraw therapy in patients with persistently severe or worsening signs or symptoms of these conditions; in many, but not all cases, these disorders resolve after stopping therapy
Contraindications
Presence or history of severe psychiatric disorders, particularly severe depression, suicidal ideation, or suicide attempt
Hypersensitivity to interferons including interferon alfa-2b or any inactive ingredients
Moderate or severe (Child-Pugh B or C) hepatic impairment
History or presence of active serious or untreated autoimmune disease
Immunosuppressed transplant recipients
Cautions
Endocrine toxicity has occurred; do not use in patients with active serious or untreated endocrine disorders associated with autoimmune disease; evaluate thyroid function in patients who develop symptoms suggestive of thyroid disease during therapy; discontinue in patients who develop endocrine disorders that cannot be adequately managed during treatment
Cardiovascular toxicity (eg, cardiomyopathy, myocardial infarction, atrial fibrillation, coronary artery ischemia) reported; closely monitor for cardiovascular toxicity during therapy; avoid use with severe or unstable cardiovascular disease, (eg, uncontrolled hypertension, congestive heart failure (NYHA class ≥2), serious cardiac arrhythmia, significant coronary artery stenosis, unstable angina) or recent stroke or myocardial infarction
Decreased peripheral blood counts have occurred; these toxicities may include thrombocytopenia (increasing the risk of bleeding), anemia, and leukopenia (increasing the risk of infection)
Hypersensitivity reactions may occur; may include serious, acute hypersensitivity reactions (eg, urticaria, angioedema, bronchoconstriction, anaphylaxis); if such reactions occur, discontinue therapy and institute appropriate medical therapy immediately
Pancreatitis reported; symptoms may include nausea, vomiting, upper abdominal pain, bloating, and fever; may experience elevated lipase, amylase, WBC, or altered renal/hepatic function; interrupt treatment in patients with possible pancreatitis and evaluate promptly; consider discontinuation with confirmed pancreatitis
Fatal and serious ulcerative or hemorrhagic/ischemic colitis have occurred; symptoms may include abdominal pain, bloody diarrhea, and fever; discontinue if signs or symptoms develop; colitis may resolve within 1-3 weeks of stopping treatment
Pulmonary toxicities may occur; toxicity may manifest as dyspnea, pulmonary infiltrates, pneumonia, bronchiolitis obliterans, interstitial pneumonitis, pulmonary hypertension, and sarcoidosis; discontinue if pulmonary infiltrates or pulmonary function impairment
Ophthalmologic toxicity reported; advise patients to have eye examinations before and during treatment; evaluate eye symptoms promptly and discontinue if new or worsening eye disorders,especifically in those patients with a retinopathy-associated disease such as diabetes mellitus or hypertension
Hyperlipidemia, hypertriglyceridemia, or dyslipidemia occurred; monitor serum triglycerides before treatment and intermittently during therapy and manage when elevated
Hepatotoxicity may occur; these toxicities may include increases in serum ALT, AST, GGT and bilirubin; monitor liver enzymes and hepatic function at baseline and during treatment. Reduce dose or discontinue depending on severity; discontinue in patients who develop evidence of hepatic decompensation (eg, jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, variceal hemorrhage) during treatment
Renal toxicity reported; monitor serum creatinine at baseline and during therapy; avoid use in patients with eGFR <30 mL/min; discontinue if severe renal impairment develops
Dental and periodontal toxicity may occur; these toxicities may include dental and periodontal disorders; advise patients on good oral hygiene and to have regular dental examinations
Dermatologic toxicities (eg, skin rash, pruritus, alopecia, erythema, psoriasis, xeroderma, dermatitis, acneiform hyperkeratosis, hyperhidrosis) reported; consider discontinuing if clinically significant dermatologic toxicity
Advise patients to avoid driving or using machinery if they experience dizziness, somnolence, or hallucination
May cause fetal harm when administered to pregnant females
Depression and suicide
- Life-threatening or fatal neuropsychiatric reactions have occurred
- These reactions may occur in patients with and without previous psychiatric illness
- Other CNS effects, including suicidal ideation, attempted suicide, aggression, bipolar disorder, mania, and confusion have been observed with other interferon alfa products
- Contraindicated with history of severe psychiatric disorders, particularly severe depression, suicidal ideation, or suicide attempt
- Closely monitor for any symptoms of psychiatric disorders and consider psychiatric consultation and treatment if such symptoms emerge
- If psychiatric symptoms worsen, discontinue therapy
Drug interaction overview
-
Drugs metabolized by CYP450
- Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates
- Monitor patients on ropeginterferon alfa who are receiving concomitant drugs that are CYP450 substrates with a narrow therapeutic index to inform if dosage modification for these concomitant drugs is necessary
-
Myelosuppressive agents
- Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression
- Myelosuppressive agents can produce additive myelosuppression
-
Narcotics, hypnotics, or sedatives
- Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity
- Narcotics, hypnotics, or sedatives can produce additive neuropsychiatric side effects
Pregnancy & Lactation
Pregnancy
Insufficient human data are available on use in pregnant females to identify a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
Animal studies assessing reproductive toxicity have not been conducted
Based on mechanism of action and the role of interferon alfa in pregnancy and fetal development, fetal harm may occur and should be assumed to have abortifacient potential when administered to pregnant females
Verify pregnancy in females of reproductive potential before initiating
Disease-associated maternal and/or embryofetal risk
- Untreated polycythemia vera during pregnancy is associated with adverse maternal outcomes such as thrombosis and hemorrhage
- Adverse pregnancy outcomes associated with polycythemia vera include increased risk for miscarriage
Contraception
- Females of reproductive potential: Use effective contraception during treatment and for at least 8 weeks after final dose
Infertility
- Based on its mechanism of action, therapy can cause disruption of the menstrual cycle
- No animal fertility studies have been conducted
Lactation
There are no data on presence in human or animal milk, effects on breastfed children, or effects on milk production
Advise females not to breastfeed during treatment and for 8 weeks after final dose
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Long-acting pegylated interferon alfa-2b
Alfa interferons bind to and activates the human type 1 interferon receptor; signal transduction is initially mediated by the Janus kinase-2 gene (JAK2); polycythemia vera is caused by a JAK2 V617F mutation, that permanently turns of signaling at affected cytokine receptors; this results in overproduction of RBCs by the bone marrow
Absorption
Steady-state reached by 2-5 days
Peak plasma concentration: 4.4-31 ng/mL
Minimal plasma concentration: 1.4-12 ng/mL
AUC:1,011-7,809 ng·hr/mL
Absorption rate: 0.12 day-1
Distribution
Vd: 4.8 L
Elimination
Half-life: 7 days
Clearance 1.7-2.5 L/hr
Administration
SC Administration
SC administration only
Proper training on storage, preparation, and administration technique should be provided
If a patient or caregiver is not an appropriate candidate for any reason, then administer by a healthcare professional
Remove prefilled syringe from refrigerator and allow it to reach room temperature of 15-25ºC (59-77ºF) for 15-30 min
Visually inspect prefilled syringe for particulate matter and discoloration before administration (discard if solution is cloudy, discolored, contains particulate matter or if the syringe shows any sign of damage)
Choose 1 of the following injection sites: Lower stomach (abdomen) area, at least 2 inches away from the belly button, or top of thighs
Rotate injection site for each injection; do not inject into skin that is irritated, red, bruised, infected, or scarred
Uncap needle and tap on the body of the syringe to move any air bubbles to the top; remove the excess air
Depending on prescribed dose, the amount of dose in the syringe may need to be adjusted by discarding some of the medication
Pinch the chosen injection site, insert needle at a 45- to 90-degree angle into pinched skin, then release pinched skin
Inject by slowly pressing on the plunger all the way until it stops
After all the liquid medicine is injected, remove the needle from the skin
Discard used syringe with the needle still attached, into an FDA-cleared sharps disposal container; do not recap needle
Storage
Refrigerate at 2-8°C (36-46°F) in the original carton to protect from light
Do not freeze
Keep away from heat
Images
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.