Drug Information TableImmunomodulators – interferon beta-1a (Avonex, Rebif); beta-1b (Betaseron)

Therapeutic Use Administration

• Beta-1a: multiple sclerosis (relapsing-remitting type)

• Beta-1b: multiple sclerosis (relapsing and relapsing-remitting types)

• Beta-1a (Avonex): Give IM weekly

• Beta-1a (Rebif): Give SC daily for 3 days each week ◦Administer late in day ◦Allow 48 hours between injections

• Beta-1b: (Betaseron): Give SC every other day

• Beta-1b: Use within hours after reconstituting

Side/Adverse Effects Interventions Patient Instructions

• Flu-like symptoms (these decrease with prolonged treatment)

• Begin with low dose and titrate to higher doses to prevent adverse effects

• Medicate with acetaminophen or other prescribed NSAID if symptoms are expected

• Instruct patient to pre-medicate with prescribed NSAID if flu-like symptoms occur

• Myelosuppression (all blood cell types)

• Monitor CBC before treatment begins and periodically thereafter

• Instruct patient to notify provider for easy bruising, bleeding, fatigue

• Liver toxicity • Monitor liver function tests before treatment begins and periodically thereafter

• Instruct patient to report abdominal tenderness, anorexia, jaundice to provider

• Pain, redness at subcutaneous injection site

• Monitor for injection site reactions

• Instruct patient to rotate injection sites, use cool compress prior to injection and warm, moist compress following injection

• Instruct patient to report skin ulceration to provider

Contraindications Precautions Interactions

• Previous allergy to interferon beta, human albumin or mannitol

• Suicidal tendencies• Pre-existing or history of liver

disorder• Alcohol abuse• Children younger than 18 years• Seizures• Mental health disorders• Thyroid disorders

• Any drug which suppresses the immune system (e.g. prednisone) may increase risk for myelosuppression