Interferon: Instructions for use, principle of operation and therapeutic effect. Interferon from colds Interferon Nasal Instructions

Interferon Alpha-2B Unlike Interferon Alfa-2a has arginine at position 23.

Interferon Alpha provides the following action:

The main properties of interferon alpha are used with a therapeutic target.

Interferon Alpha inhibits replication and transcription of viruses and chlamydia. It has an antiviral action, induced in cells a state of resistance to viral infections and modulating the response of the immune system, aimed at neutralizing viruses or the destruction of cell infected. The mechanism of antiviral action lies in the creation of protective mechanisms in non-infected virus cells. Binding to specific receptors on the cell surface, the alpha interferon changes the properties of the cell membrane, prevents the adhesion and penetration of the virus inside the cell, stimulates the specific enzymes, affects RNA and inhibits the synthesis of virus proteins. Suppresses the replication of viruses in an infected cell. Inhibits intracellular stages of the development of a variety of herpes I and II type. The antiviral activity of interferon alpha against hepatitis viruses is manifested in vitro in inhibiting the hepatitis Virus virus in in the human hepatoblastoma cell culture (HP 611) and the elimination of the hepatitis virus from the culture of human esbrobes. The listed properties of Interferon Alpha allow it to effectively participate in the elimination processes of the pathogen, prevent infection and possible complications.

Antiproliferative action Interferon Alpha is due to direct mechanisms causing changes in the cytoskeleton and cell membrane, regulating the differentiation and cellular metabolic processes, which, in turn, prevent cell proliferation, especially tumor. Induces the expression of some oncogens (MYC, SYS, RAS), which allows you to "normalize" the neoplastic transformation of cells and, thereby, inhibit tumor growth. In the tumor cells of the person treated with interferon alpha, the synthesis of DNA, RNA and protein significantly decreases. Interferon Alpha has an action on a number of human in vitro tumors and suppresses the growth of some xenotransplants of human tumors from "naked" mice. In vivo Antiproliferative activity of Interferon Alpha was studied on such tumors as a mothotic carcinoma of the breast and the adenocarcinoma of the blind and transverse guts, as well as the prostate gland. The degree of antiproliferative activity varies.

Thanks immunomodulatory activity Interferon Alpha, normalization of immune status. The immunomodulating effect is due to stimulating the activity of macrophages (phagocytic activity) and natural killer cells (NK cells). Stimulates the process of presentation of antigen by macrophages immunocompetent cells. Natural killer cells are involved in the immune response of the organism on tumor cells. Under the influence of interferon alpha in the body, the activity of T-helpers, cytotoxic T-lymphocytes, express antigens I and type II, as well as the intensity of differentiation of in-lymphocytes are enhanced. The activation of leukocytes ensures their active participation in the elimination of primary pathological foci and ensures the restoration of the products of secretory immunoglobulin A.

Interferon Alpha preparations can lead to the appearance of antibodies to interferon, which, as a result, reduces their therapeutic effect.

With the intravenous administration of interferon alpha (0.5-6 million me), the interferon in serum was recorded in a considerable volunteer in a matter of minutes and reached the maximum. However, with this method of administration, the interferon quickly disappeared from the blood: after 1.5-2 hours, only its traces (4-8 me / ml) were detected in serum.

After intramuscular or subcutaneous administration (0.5-3 million ME), the absorption rate from the place of administration is uneven, is carried out almost completely. The serum concentration of both healthy volunteers and patients with onco-scabers have individual differences. The maximum serum concentration is achieved after 4-8 h. T1 / h. It is maintained in a circulating line about 24 hours. In systemic blood flow, a% administered dose is distributed. After a single intramuscular administration of interferon alpha patients with metastatic cancer and chronic hepatitis in pharmacokinetic indicators are similar to those in healthy volunteers. Intramuscular administration of multiple (2 times a day for 14 days) Doses of interferon Alfa led to an increase in the interferon concentration in serum 2-2.5 times compared to such after a disposable dose.

With vaginal or rectal use, the alpha interferon is absorbed through the mucous membrane, enters the surrounding tissues into the lymphatic system, providing a systematic action. Also, due to partial fixation on the cells of the mucous membrane, the local action has a local action. Rectal use contributes to a longer circulation of interferon in the blood than with intravenous or intramuscular administration. Reducing the level of serum interferon 12 hours after the introduction determines the need for its re-administration.

The hematorecephalic barrier is a serious obstacle to penetrate the interferon into the spinal cord fluid, including the brain. This obstacle is overcome by the introduction of the drug directly into the cerebrospinal fluid (subdural).

The main way to eliminate alpha interferon is kidney catabolism. Hepatic metabolism and biliary excretions are less important paths of elimination. Partially interferon alpha is removed over the kidneys. Does not cumulative.

Parenteral - p / k, in / m, in / k:

Infectious diseases:

New formation of the lymphatic system and blood formation system:

Solid tumors:

Other diseases:

Suppositories (rectal, vaginal):

Apply in the complex treatment of various infectious inflammatory diseases of newborns (premature), children and adults (including pregnant women):

In the therapy of newborns (premature) children:

For the treatment of pregnant women:

For the treatment of sharp and chronic viral hepatitis B, C, D in children and adultsAs well as in the treatment of chronic viral hepatitis of a pronounced degree of activity and cirrhosis of the liver using plasmapheresis and hemosorption.

With infectious inflammatory diseases of the urogenital tract (In comprehensive therapy):

In addition, applied in therapy:

Inside:

Intranasal:

Conjunctivative:

Ointment is used to treat lesions of the skin and mucous membranes caused by human infection with herpes viruses, usually clinically manifested in the form of vesicular rashes. The primary reproduction of herpes virus occurs in the epithelium of the mucous membrane of the mouth, pharynx or genitals. Ointment is effective in treating:

Method of use and dose:

Parenteral - p / k, in / m, in / k (in the center and under the focus of the defeat):

Doses and the duration of reception are established individually taking into account the nosological form and severity of the disease and corrected in accordance with the patient's individual reaction.

For the preparation of a solution for subcutaneous and intramuscular administration, the powder is dissolved with sterile water for injections immediately before administration: in 1 ml with intramuscular administration and administration to a focus, in 5 ml with subconjunctive administration.

Preparations for parenteral administration should be visually checked for transparency before administration.

More often introduced in / m or p / k from 1 to 12 million me; The multiplicity of application varies from 3 times a week before daily destination.

Maximum doses (12 million meters or more) It is recommended to be introduced into / in drip slowly (in the flow), the necessary dose of the drug is bred in 50 ml of saline.

The most rational are intramuscular injections in doses from 3 to 5 million me with the duration of therapeutic courses in acute viral or bacterial infections within 5-10 days; With oncological diseases, treatment courses last for months and even years.

For supporting therapy appointed subcutaneously, the patient can enter the medicine itself, guided by the instruction of the doctor. Subcutaneous administration is especially recommended for patients with thrombocytopenia or patients with risk of bleeding. Patients with the number of platelets of Meneev mm ^ 3 should be changed intramuscular introduction to subcutaneous.

With certain diseases (for example, with pointed circularities), a combined systemic and local application of the solution of interferon alpha is possible.

If the development of side effects on the administration of interferon alpha is noted with any administration method, a dose should be reduced (by 50%) or interrupt treatment before the disappearance of adverse reactions. If adverse reactions are developing against the background of a reduced dose or disease progresses, therapy should be abandoned.

Patients with a high pyrogenic reaction (39 ° C and higher) on the administration of interferon alpha is recommended simultaneous use of paracetamol or indomethacin.

Acute lymphoblastic leukemia in children:

In the period of remission after the end of inductive chemotherapy (at the 4-5th month of remission) - 1 million meters once a week for 6 months, then 1 time in 2 weeks within 24 months. Simultaneously conduct supporting chemotherapy.

Recommended initial dose - 3 million meters or per / m daily (within 2 months); supporting (after the normalization of the hemogram) million IM 3 times a week (6 months or more). Normalization of different hematological indicators usually occurs in 2 months from the start of therapy. In case of intolerance, the initial dose is reduced to 1.5 million meters three times a week. The minimum effective dose for the course of treatment is not established (

mE). Treatment duration: patients should receive treatment for 6 months, after which the doctor should decide whether to continue therapy (if there is a positive effect) or stop it (in its absence). Treatment was carried out until 20 months in a row. The optimal duration of therapy in the magnifying leukemia is not installed. The hemoglobin level, the amount of platelets, granulocytes and hairy cells in peripheral blood and in the bone marrow should be monitored during the entire period of treatment. If the improvement in hematological indicators is noted, the therapy should be continued until the laboratory indicators remain stable about 3 months. The resumption of therapy by Interferon Alpha in patients who were examined for some reasons for some reasons leads to an improvement in the state in more than 90% of cases. Preliminary splenectomy slows down the rate of development of the therapeutic effect of interferon alpha.

Non-Khodgkin Lymphoma Low Degree of Malignment:

When appropriate additionally to chemotherapy (with or without radiation therapy), the alpha interferon extensions the non-dedicated survival and survival without progression. Interferon Alpha should be prescribed as supportive therapy after standard chemotherapy (with radiotherapy or without it). Initial dose - 3 million meters (or 5 million me / m ^ 2) 3 times a week for at least 12 months. Treatment should be started as early as possible when improving the condition of the patient, usually after 4-6 weeks after chemat and radiation therapy. It can also be prescribed simultaneously with traditional chemotherapy schemes (for example, in combination with cyclophosphamide, prednisone, vincristine and doxorubicin), 3 million meters (or 5 million me / m ^ 2) p / c or per / m from 22 to 26 days Each 28-day cycle. In this case, the treatment of interferon alpha can be started simultaneously with chemotherapy.

Skin T-cell lymphoma (CCL):

Interferon Alpha can have the effect in patients with progressive skin T-cell lymphoma, including refractory to traditional therapy. Initial dose (in patients over 18 years old) - 3 million meters or per / m daily; The dose is increased within 12 weeks to the maximum dose of 18 million meters daily. It is recommended to increase the dose according to the following scheme: 1-3rd day - 3 million meters per day, 4-6th day - 9 million meters per day, 7-84 days - 18 million meters per day. The duration of treatment: patients should receive alpha interferon at least 8 weeks, preferably 12 weeks, after which the doctor should decide whether to continue therapy (if there is a positive effect) or stop it (in its absence). At the end of 3 months, they go to supportive treatment: 6-12 million IM 3 times a week. Treatment was carried out up to 40 months in a row. The optimal duration of treatment with interferon alpha with CTC is not installed. In patients who positively react to treatment, it must be continued at least 12 months to maximize the likelihood of achieving full remission and increase the likelihood of long-term remission. Approximately 40% of patients with the CTC of an objective antitumor effect cannot be achieved. Partial remission is usually observed within 3 months of treatment, and complete - within 6 months, although sometimes it takes 12 months of therapy to achieve the best effect.

Mushroom micaosis and Sesari syndrome:

Interferon Alfa induces clinical regression of an ulcers when introduced into a tissue at a dose of 1 or 2 million 3 times a week for 4 weeks. The plot or plots of administration should be treated with a cotton swab with alcohol. When the needle is introduced, it should be in the position of almost parallel skin surface. The alpha interferon is introduced into the surface layer of the dermis below the stain or ulcers, a thin needle is used (30 caliber) and 1 ml syringe. The deeper (subcutaneous) drug administration should be avoided. It is necessary to repeat this procedure 3 times a week for 4 weeks, a total of 12 injections to the lesion focus. After reaching the clinical effect, supporting therapy of 3 million meters once a week for 6-7 weeks is prescribed. Sometimes it is advisable to alternate an intramuscular administration of interferon alpha 3 million me and intraligative 2 million meters for 10 days. In patients with erythrodermic stage of mushroom-like Mikosa, with an increase in temperature, over 39 ° C and in case of exacerbation of the process, the administration of interferon alpha should be stopped.

Chronic myelolomicosis (HML):

Interferon Alpha is shown for the treatment of patients in the chronic stage of chronic myelolecosis, positive in the Philadelphia chromosome. It is possible to consider interferon alpha with a drug that is healing this disease is not yet clear. Studies showed a high probability of a positive response to therapy by Interferon Alpha in patients in the chronic phase of the disease, regardless of the previous therapy. In contrast to cytotoxic chemotherapy, Interferon Alpha can lead to a stable cytogenetic remission, which is ongoing more than 40 months. Treatment at a complete dose should be started as early as possible and continue to complete hematological remission. Initial dose (in patients over 18 years old) - 3 million meters (4-5 million me / m ^ 2) p / c or per / m daily, under the control of indicators of general blood analysis. This dose increases every week for 8-12 weeks to a maximum dose amounting to 9 million IU / day. The following scheme of a gradual increase in dose is recommended: 1-3rd day - 3 million meters per day, 4-6th day - 6 million meters per day, 7-84 days - 9 million meters per day. In patients sensitive to therapy, hematological response is observed in 2-3 months from the start of treatment. The minimum effective dose for the course of treatment is not established (

milli me). Duration of treatment: patients should receive alpha interferon at least 8 weeks, preferably 12 weeks, after which the doctor should decide whether to continue therapy (if there is an effect) or stop it (in the absence of hematological performance). In the presence of a clinical effect, the treatment continues until the total hematological remission is achieved, but not for no longer 18 months. All patients with full hematological remission should continue treatment for 9 million meters per day (optimal dose) or 9 million meters three times a week (minimum dose) in order to achieve cytogenetic remission as soon as possible. The optimal duration of the treatment of chronic myelolecosis interferon alpha is not established, although there are observations of cytogenetic remission lasting 2 years after the start of treatment. Efficiency, safety and optimal doses of interferon alpha for children with hML are not installed.

Thrombocytosis often accompanies chronic myelolomicosis and is the main sign of essential thrombocythemia. Clinically heavy thrombocytosis is manifested by a high frequency of severe thrombotic diathesis. Interferon Alpha in a few days reduces the number of platelets, reduces the frequency of accompanying thrombohemorrhagic complications and does not have leukeosogenic potential. Therefore, in the treatment of patients with excessive thrombocytosis in chronic myelolomicosis and other myeloproliferative diseases, it is recommended to use nonferon alpha therapy by interferon alpha.

In the case of thrombocytosis in chronic myelolomicosis, the following dose increase scheme is recommended: 1-3rd day - 3 million meters per day, 4-6th day - 6 million meters per day, 7-84 days - 9 million Item per day. Treatment duration: patients should receive alpha interferon at least 8 weeks, preferably at least 12 weeks, after which the doctor should decide whether to continue treatment (if there is an effect) or stop it (in the absence of hematological indicators).

Thrombocytosis associated with myeloproliferative diseases:

In the case of thrombocytosis in myeloproliferative diseases (except chronic myelolecosis), the following dose increase circuit is recommended: 1-day day - 3 million meters per day, 4-30th day - 6 million meters per day. Duration of treatment: To maintain the number of platelets within the normal range, it is usually sufficiently well tolerated daily dose of 1-3 million meters 2-3 times a week. Each patient should, however, individually pick up the maximum portable dose.

Sarcoma Caposhi on the background of AIDS:

The optimal mode of dispensing Interferon Alpha for the treatment of Caposhi sarcoma amid AIDS is not installed. The probability that patients with sarcoma capos amicated by the background of AIDS positively respond to therapy, higher in the event that they have no opportunist infections, the symptoms of the group B (weight loss of more than 10%, the temperature is above 38c in the absence of a well-known focus of infection, night sweating), and the initial number of T4 lymphocytes exceeds 200 cells in 1 μl. Efficiency is demonstrated at a dose of 30 million me / m ^ 2 daily or 3 times a week, subcutaneously or intramuscularly.

V / m Introduction. Initial dose: Patients aged 18 and older Interferon Alfa should be introduced by the P / C or V / m in the timing, gradually bringing a daily dose of not less than 18 million meters, and if possible - up to 36 million meters. It is recommended to raise the dose according to the following scheme: 1-3rd day - 3 million meters per day, 4-6th day - 9 million meters per day, 7-9th day - 18 million meters per day, with tolerance increasing dose Napa to 36 million meters per day. Supporting dose: p / k or per / m 3 times a week in the maximum dose, transferred to patients, usually 9-18 million meters, but not exceeding 36 million meters. The frequency of remission in patients with sarcoma capos on the background of AIDS who received interferon alpha in a daily dose of 3 million meters was less than when pressed by the recommended doses. Duration: To determine the reaction to treatment, document the dynamics of the tumor. Patients should receive alpha interferon at least 10 weeks, preferably 12 weeks, after which the doctor should decide whether to continue therapy (if there is a positive effect) or stop it (in its absence). Treatment was carried out until 20 months in a row. Optimal duration of treatment with interferon alpha sarcoma Caposhi on the background of AIDS is not installed. In the presence of a clinical effect, treatment must be continued, at least before the disappearance of the tumor. Note: After the termination of therapy, Interferon Alpha Sarcoma Caposch often recurs.

In / in Introduction. Drip in dosable. IU / kV ^ m are introduced (30-minute infusion) daily within 5 days. Then the 9-day interval, after which the next 5-day treatment is followed. If the status stabilization is noted or the effect of the therapy has been reached, it is necessary to continue treatment until the complete remission of the tumor process is reached or the cancellation of treatment is not required due to severe concomitant infection or the development of severe undesirable phenomena. Supporting dose: See per / m Introduction.

In clinical studies, patients with HIV infection and sarcoma Caposh were obtained by interferon alpha in combination with Zidovudine. Most patients have tolerated the following treatment scheme: Alpha Interferon in a dose of 10 million me / m ^ 2 daily; Zidovudinmg every 4 hours. It should be individualized dispensing to each patient, taking into account portability and response to therapy.

Also in combination with cytostatics (recidencies, cyclophosphane) and glucocorticosteroids.

Kidnotection Cancer (kidney carcinoma):

In patients with a recurrent tumor or metastases, the best therapeutic effect was observed in the appointment of large doses of interferon alpha (36 million meters per day) as monotherapy or moderate doses of Interferon Alpha (18 million IM 3 times a week) in combination with vinblastine, compared With monotherapy with moderate doses of interferon 3 times a week. Optimal doses are not yet installed. In patients who received small doses of Interferon Alpha (2 million me / m ^ 2 of the body surface per day), no effect on treatment was observed. The combination of interferon alpha with vinblastine leads only to a slight increase in the frequency of light and moderate leukopenia and granulocyptopenia compared to monotherapy.

Monotherapy Interferon Alpha. Initial dose: p / k or per / m for 8-12 weeks, gradually bringing a daily dose to 18 million meters, and if possible - up to 36 million meters. Dose of 36 million mete. It is recommended to introduce intramuscularly. It is recommended to raise the dose according to the following scheme: 1-3rd day - 3 million meters per day, 4-6th day - 9 million meters per day, 7-9th day - 18 million meters per day, with tolerance increasing dose Napa to 36 million meters per day. Supporting dose: p / k or per / m 3 times a week in the maximum dose, portable patient, usual. IU, but not exceeding 36 million meters. The duration of treatment: patients should receive alpha interferon at least 8 weeks, preferably at least 12 weeks, after which the doctor should decide whether to continue therapy (if there is an effect) or stop it (in its absence). Treatment was carried out up to 16 months in a row. The optimal duration of treatment of the launched kidney-cellular carcinoma interferon alpha is not installed.

Interferon Alpha + Vinblastine. Interferon Alpha Treatment In combination with vinblastine gives the total frequency of remission of about 20%, slows down the progression of the disease and lengthens the overall survival of patients with the launched kidney cancer. In the first week, Interferon Alpha should be prescribed in a dose of 3 million meters or per / m 3 times a week, in the second week - 9 million II 3 times a week, then - by 18 million and 3 times a week. . During this period, Vinblastin should be administered intravenously according to the instructions of the manufacturer in a dose of 0.1 mg / kg of body weight once every 3 weeks. If the patient does not tolerate the dose of 18 million meters, the dose can be reduced to 9 million and 3 times a week. Duration of treatment: patients should receive alpha interferon at least 3 months, maximum - up to 12 months. In the case of complete remission, the treatment can be stopped 3 months after its offensive.

Multiple myeloma (generalized form of myeloma):

In addition to chemotherapy, the interferon alpha is assigned to P / C or V / m in Dozzell. IU (3-5 million me / m ^ 2) three times a week. Depending on individual tolerability, the dose can be increased weekly before reaching the maximum portable dose (9-18 million meters) three times a week. Supporting therapy: patients in the "Plateau" phase: Interferon Alpha is administered subcutaneously into dosilex. IU / M ^ 2 (up to 18 million meters) three times a week in the form of monotherapy. This mode should be maintained during an unlimited time, except when the disease develops too quickly or the intolerance to the drug patient appears.

Metastatic carcinoid tumors (endocrine tumors):

The effectiveness of interferon alpha is shown when appointing in doses of 3-4 million me / m ^ 2 subcutaneously, daily or every other day. It is recommended to begin the administration of interferon alpha with 2 million me / m ^ 2, then gradually increase the dose to 3.5.7 and 10 million me / m ^ 2 through a 2-week interval, depending on tolerability. Although the objective regression of the tumor does not occur, in 20% of patients there is a 50% reduction in the level of 5-hydroxyindolux acid in daily urine. In patients who received Interferon Alpha for 6 months (2 million me / m ^ 2 daily during the first 3 days, then an increase in dose to 5 million me / m ^ 2, subcutaneously three times a week), an objective improvement in the state was noted With long-term treatment.

In 10-25% of patients with a launched malignant melanoma, interferon alpha treatment led to objective regression of skin and visceral localization tumors. When using doses of less than 18 million and 3 times a week, the therapeutic effect was observed less often. In patients who responded to treatment, a longer survival period was noted than those who did not react. Initial dose: 18 million meters or per / m 3 times a week for 8-12 weeks. In some cases, at the beginning of treatment, interferon alpha is administered intravenously at a dose of 20 million me / m ^ 2 five times a week for 4 weeks. Supporting dose: Pomble. Me (or in the maximum portable dose) p / k or per / m 3 times a week. Duration: patients should receive alpha interferon at least 8 weeks, preferably at least 12 weeks, after which the doctor should decide whether to continue therapy (if there is a therapeutic effect) or stop it (in its absence). There is experience in treating patients for more than 2 years. The optimal duration of treatment of the launched melanoma is not installed.

Melanoma after surgical resection. Adjuvant therapy with small doses of interferon alpha increases the duration of time without relapse of the disease in patients without damage to lymph nodes and remote metastases after resection melanoma (tumor thickness\u003e 1.5 mm). Dose: 3 million meters 3 times a week P / C or V / m. The duration of treatment is 18 months, and treatment must be started no later than 6 weeks after surgery.

In combination with chemotherapy, Interferon Alpha is prescribed intravenously at a dose of 15 million me / m ^ 2 five times a week for 3 weeks, then p / k or per / m in a dose of 10 million me / m ^ 2 3 times a week, Prior to the termination of the progression of the disease or until the attending physician decides that there is no need to continue the introduction of the drug.

With basal cellular and flat-milk cancer, Keratoacanta Interferon Alpha is administered under the lesion center.

The interferon alpha administration site must be cleaned with a tampon with alcohol. Urban administration must be carried out in the base of the damaged section of the needle of small diameter (30 caliber) and 1 ml syringe. For sections of less than 2 cm ^ 2, 0.15 ml of a solution containing 1.5 million meters of interferon alpha 3 times a week for 3 weeks is introduced. Each cycle of therapy includes the introduction of 3 doses per week for 3 weeks. First, it is also possible at 1 million me 1 time per day daily within 10 days. The maximum total dose per week should not exceed 15 million meters.

With large surface and nodules-ulcerative basal cell damages (area from 2 to 10 cm ^ 2), the alpha interferon is introduced three times a week for 3 weeks at a dose of 0.5 million IU / cm ^ 2. Each damaged area is treated at a certain time.

Clinical status should be controlled periodically at the end of treatment. Clinical improvement is observed, as a rule, after 8 weeks from the start of treatment. At the end of the course, if necessary, cryodestructuring. If there are no improvements within 2-3 months, the introduction of interferon alpha should be stopped.

Pointed Condylomes (Pointed Condoomatiosis):

The location where the alpha interferon is to be introduced is carefully treated with alcoholic solution. Interferon alpha is needed to the base of the Condyloma, using thin needles (30 caliber). An isotonic solution of interferon alpha 10 million me / ml is used. 0.1 ml of a solution containing 1 million meters of interferon alpha is injected into the cloth 3 times a week for 3 weeks. The amount of damage should be calculated for the calculation of the overall simultaneously administered dose, which should not exceed 5 million IU. It is recommended to treat no more than 5 kondil at the same time. The maximum total dose should not exceed 15 million IU per week. Large lesions can be slipped by several injections (a total of 5 million meters per day). Each cycle of therapy includes the introduction of 3 doses per week for 3 weeks. It is also possible to additionally introduce 3 million meters three times a week P / C or V / M for 1-2 months.

Improvement usually occurs after 4-8 weeks from the beginning of the first course of treatment. If the effect of the first course of treatment is not noted, in the absence of contraindications, they repeat the course of therapy in the same dose as before.

Immediately after the first course of treatment, it is possible to start a second course in the same doses for the treatment of 5 additional areas of lesion in patients with from 6 to 10 kondil. Patients with more than 10 condylomes can receive a phased treatment, depending on the amount of Condyl.

In some cases, patients received interferon alpha in a dose of 1.5 million meters to the area of \u200b\u200blesion after the local application of 25% of the subofillotoxin. Treatment was carried out once a week for 3 weeks.

With the juvenile respiratory papillomatosis of the larynx, start the therapy after promptly removing with papillom. Recommended Dose Interferon Alpha: 3 million meters per week or per / m 3 times a week. For the result required at least 6 months of treatment. It is possible. ME for 1 kg of body weight daily in the campaign, then in the same dosage 3 times a week for 1 month. Doses can be adjusted depending on tolerability. The second and third courses are carried out with an interval of 2-6 months. Course dose of drugsln. Me.

With acute hepatitis B (lungs, medium-and-heavy and heavy forms), 1 million meters per day are prescribed for 5-6 days, then 1 million me / day are introduced for another 5 days. If necessary (after control biochemical blood tests), the treatment may be continued by 1 million me 2 times a week for 2 weeks. Course Dosamln. Me.

With chronic active hepatitis B (incl. Delta-positive chronic hepatitis B) The recommended dose - 4.5 million meters (3-5 million IU / M ^ 2) P / C or V / Mraz per week in For 4-6 months. The optimal dosing mode is not yet installed. If the number of virus affection markers (HBSAG) or HBEAG markers does not decrease after 1 month of treatment, then a dose should be increased (for example, DomNN. Every day), and the further correction of the dose is carried out depending on the tolerability of interferon alpha. In the absence of improvement in 3-4 months, the question of the feasibility of continuing therapy is solved individually

Children. In children with chronic hepatitis, the administration of Interferon Alpha in doses up to 10 million me / m ^ 2 is quite safe, but the effectiveness of this therapy has not been proven.

The effectiveness of interferon alpha in patients with chronic hepatitis B, simultaneously infected with the human immunodeficiency virus (HIV), has not been proven.

Chronic hepatitis Delta:

Interferon alpha is prescribed subcutaneously or intramuscularly in the initial dose of 5 million me / m ^ 2 daily or 10 million me / m ^ 2 3 times a week for 12 months. If necessary, the period of therapy can be extended. Doses can be adjusted depending on tolerability.

Chronic viral hepatitis C:

In case of chronic hepatitis C is prescribed 3-6 million meters or per / m 3 times a week, the duration of treatment is 12 weeks. Most patients respond to the therapy with a decrease in transaminase level 12 weeks from the start of treatment. If within 16 weeks from the start of therapy does not occur a decrease in the content of transaminase (alote), then the treatment should be discontinued. Some patients who did not respond to the introduction of the drug at a dose of 3 million meters every other day can be recommended an increase in dose to 6 million and 3 times a week. Supporting dose: To secure a complete remission to patients with a normalized level of alt in serum, a supporting dose of 3 million meters is required three times a week for another 3-18 months or more. Most cases of recurrence of the disease after adequate therapy occur no later than 4 months after the end of treatment. If a relapse occurs, the disease can be repeated in the same mode that was effective for the first time.

With mite encephalitis (including under meningeal form), 1-3 million meters are introduced 2 times a day for 10 days. Then go to supporting therapy for 1-3 million meters every 2 days 5 times.

With multiple sclerosis, the interferon alpha is prescribed 1 million me: with a pyramid syndrome 3 times a day, with a cerebulic syndrome 1-2 times a day for 10 days, followed by the introduction of 1 million ME 1 time per week for 5-6 months. The total number of interferon alpha embossed ME.

Surface bladder cancer:

For a crawling cancer, doses are recommended from 30 to 50 million meters weekly, internally within 8-12 weeks; For carcinoma in situ, it is recommended to use instillations (mln. me) weekly for 12 weeks, then 1 time per month; The maximum duration of therapy is 1 year.

Intravel administration of Interferon Alpha: Patients must refrain from taking fluid for 8 hours before administration of the drug Interferon Alpha in order to create an optimal concentration of the drug in the bladder. The bubble should be emptied before the administration of the drug. The solution is introduced with a sterile syringe through the catheter to the urinary bubble cavity, where the drug must be present within 2 hours. During this time, the patient should change the pose every 15 minutes in order to create a larger area of \u200b\u200bcontact with the bladder mucous membrane. After 2 hours the patient empties the bladder.

Recommended doses to patients with residual diseases of the disease - 50 million meters intraperitoneally, if interferon alpha is used for monotherapy. Dissolve interferon alpha powder in 250 ml of sodium chloride solution. A solution of 1750 ml of dialysate is added and inserted through the catheter to the abdominal cavity. Instillation is carried out within 1 hour. The procedure is repeated weekly for 16 weeks.

With stromal keratitis and keratimo-chiclitis, subconjunctive injections of interferon alpha in a dose of 60 thousand meters are prescribed in a volume of 0.5 ml daily or every other day, depending on the severity of the process. Injections are carried out under local anesthesia with 0.5% Dicain solution. The course of treatment is from 15 to 25 injections or 1-2 million me.

Suppositories. Rectal and vaginal application.

The schemes for using interferon alpha in candles are largely determined by specific clinical cases.

Newborn children (including over 34 weeks premature age) apply 2 times a day after 12 o'clock. The course of treatment is 5 days.

Premature children with gestational age less than 34 weeks are prescribed 3 times a day after 8 hours. The course of treatment is 5 days.

Recommended number of courses in various infectious inflammatory diseases in newborn children, including prematurely: ARVI - 1 course, pneumonia (bacteriakurs, viral - 1 year, chlamydia - 1 year), sepsiscurs, meningitkurs, Herpetic infection - 2nd courses, enterovirus infectionChurs , cytomegalovirus infectioncars, mycoplasmosis. The break between the courses is 5 days.

For the treatment of pregnant women with infectious-inflammatory pathology from 28 to 34 weeks, gestation is used by 0.3-0.6 million meters per day with a 12-hour interval every other day. From 35 to 40 week, gestation is used by 0.6 - 1 million meters per day with 12-hour intervals daily. The course of treatment is 5 days. Total 7 courses for 12 weeks. Break between 7 days courses. The duration of treatment is determined by the dynamics of clinical and laboratory indicators.

Doses for children over 7 years old and adults (for children under 7 years old doses are about twice below):

In the complex therapy of intestinal dysbacteriosis:

In comprehensive therapy of intestinal dysbacteriosis, the interferon alpha in candles is assigned to 0.6 - 1 million meters per day with a 12-hour interval for 10 days, then in a supporting dose of 0.6 - 1 million meters per week for a month.

In the complex therapy of juvenile rheumatoid arthritis:

In comprehensive therapy of juvenile rheumatoid arthritis, 0.6 - 1 million meters are assigned to two receptions every day with a 12-hour interval within 10 days. Further 3 times a week every day at 0.6 - 1 million meters per day with a 12-hour interval for 6 months.

In therapy of various forms of epidemic vapotitis:

In therapy of various forms of epidemic vapotitis, the interferon alpha in candles is prescribed daily at 0.6 - 1 million meters per day with a 12-hour interval within 5 days.

When treating the localized form of diphtheria:

In the treatment of a localized form of diphtheria, the interferon alpha is used daily by 0.6 - 1 million meters per day with a 12-hour interval within 5 days.

In the complex therapy of sharp and chronic viral hepatitis B, C, D:

Interferon alpha in candles is assigned to 1 million meters per day in two receptions every day with a 12-hour interval within 10 days. Further 3 times a week every other day 1 million meters per day in two receptions with a 12-hour interval; with acute hepatitis for 1 month; In chronic hepattems. The duration of treatment is determined by the dynamics of clinical and laboratory indicators. Sick chronic hepatitis with a pronounced degree of activity and cirrhosis of the liver before carrying out plasmapheresis and / or hemosorption, the application of 1 million meters per day in two receptions is shown daily with a 12-hour interval within 14 days.

In the complex therapy of herpetic infection, chlamydia, ureaplasmosis, toxoplasmosis, cytomegalovirus infection:

In complex therapy of herpetic infection, chlamydia, ureaplazmosis, toxoplasmosis, cytomegalovirus infection is used by 0.6 - 1 million meters per day in two receptions every day with a 12-hour interval for 10 days, then 3 times a week in a day of 0, 6 - 1 million meters per day in two receptions with a 12-hour interval within 1-12 months. The duration of treatment is determined by the dynamics of clinical and laboratory indicators.

Infectious inflammatory diseases of the urogenital tract in women:

0.25 or 0.5 million meters depending on the severity of the disease vagnantly 2 times a day daily for 10 days. With protracted forms 3 times a week in a day of 0.25 or 0.5 million meters within 1-3 months.

In the complex therapy of prostatites of various etiology:

In the complex therapy of prostatites of various etiologies, Interferon Alpha in Candle is prescribed rectally daily by 0.5 - 1 million meters twice a day with a 12-hour interval within 10 days. The need for repeated curls is determined by the dynamics of clinical and laboratory indicators.

In the complex treatment of glomerulonephritis associated with viral hepatitis B, herpesvirus and cytomegalovirus infections:

In the complex treatment of glomerulonephritis associated with viral hepatitis B, herpesvirus and cytomegalovirus infections, it is recommended to use a daily 0.6 - 1 million meters per day in two receptions with a 12-hour interval within 10 days, then within a week - every other day 0.6 - 1 million meters per day with a 12-hour interval, then within a week - in a day of 0.3 - 0.6 million meters per night, after 0.3 - 0.6 million . Me for the night 2 times a week for 6-7 weeks, and further - 3 weeks of 0.3 - 0.6 million meters per night once a week. The total course is 3 months.

With pyelonephritis, the interferon alpha in candles is assigned to 0.6 - 1 million meters per day each day with a 12-hour interval within 7 days. Next, 2 times a week of 0.6 - 1 million meters per day for 4 weeks. With a severe course, the course is at least 6-8 weeks.

In the complex therapy of the meningeal form of tick-borne encephalitis:

In the complex therapy of the meningeal mold of the tick-borne encephalitis, Interferon Alpha in Candlelight is recommended to be used daily by 0.6 - 1 million meters per day with a 12-hour interval for 7 days. The subsequent administration is carried out at 0.6 - 1 million meters per day at the interval of 12 hours at 10, 13, 16, 19 days from the moment of primary purpose.

With hemorrhagic fever with renal syndrome and secondary cell immunodeficiency states:

In a hemorrhagic fever with renal syndrome and secondary cell immunodeficiency states, they are prescribed in a daily dose 4 times a day with a break of 6 hours or 0.6 million meters 2 times a day with a break of 8 hours. Course treatment 7-14 days.

For the prevention and correction of postoperative purulent-septic complications:

For the prevention and correction of postoperative purulent-septic complications, interferon alpha in candles is prescribed daily by 0.6 - 1 million meters with a 12-hour interval for 5 days, starting from the second postoperative day.

30 minutes before meals. Immediately before use, 1-2 ml of distilled or cooled boiled water is added to the contents of the vial. When shaking for 1-5 min, a homogeneous white suspension should be formed.

Acute hepatitis in: Adults and school-age children - 1 million meters 2 times a day, for children 3-7 years old - 0.5 million meters 1 time per day for 10 days, if necessary (after control biochemical blood tests) and more, until complete recovery .

Chronic hepatitis B. (in active and inactive replicative forms associated with glomerulonephritis): School children and adults - 1 million meters, children 3-7 years old - 0.5 million meters within 10 days 2 times a day and then for 1 month a day 1 time per day at night.

When conducting specific immunotherapy It is accepted in the morning hours according to the following scheme: 0.5 million meters daily within 10 days, and then 0.5 million meters every other day (term dose 10 million meters). Total treatment for 30 days.

Locally. Intranasal. Conjunctivative. Externally.

For local use, the contents of the ampoule 1 million ME are dissolved in 1 ml of sterile isotonic sodium chloride solution. In the case of storage of the drug solution, observing the aseptics rules, transfer the contents of the ampoule to the sterile bottle and store the solution in the refrigerator at 4-10 & degs no more than 12 hours.

For the treatment of influenza and ORVI in the first hours of the disease, they are injected into each nasal stroke of 3-4 drops each email for 3-4 hours, then 4-5 times a day for 3-4 days. For the prevention of influenza and ARVI - 5 drops 2 times a day (while the danger of infection is preserved).

In conjunctivitis and surface keratitis, in the acute stage of the disease, they bury 2-3 drops into each eye 3-10 times a day in combination with symptomatic treatment. As the inflammatory process, the number of bundles reduce the drains per day. The course of treatment, if necessary - up to 30 days.

Herpety lesions of the skin and mucous membranes. The treatment of interferon alpha ointment is beginning with the appearance of the first signs of herpes lesions of the skin and mucous membranes and in the first 2-3 days of the recurrence of herpes of various localization with the advent of erythema, swelling, bubbles, burning. Ointment is applied by a thin layer on the lesions and gently rub 3-4 times a day, the duration of treatment. When the ointment is drying on a hydrogel basis (10-15 minutes) a protective polymer film is formed.

Influenza and ORVI: Ointments are applied by a thin layer on the mucous membrane of the nasal strokes 2 times a day (in the morning and evening) during the entire period of the disease, for the prevention of influenza and other virus infections - for 2 weeks, then 2-3 times a week for 1 month.

Papillomavirus infection: Ointment is applied to the foci of lesion 2-4 times a day, the duration of treatment varies from 5 to 30 sutuk.

There are no reports of overdose, however, the re-introduction of large doses of interferon may be accompanied by deep lethargy, lethargy, prostration and a coma. Such patients should be hospitalized to observe and conduct relevant supportive activities. With proper careful care, the previous condition in patients with severe side reactions to Interferon Alpha is restored a few days after the cessation of treatment. In clinical studies, the coma was registered in 0.4% of cancer patients.

Contraindications:

With caution - arrhythmias, post-infarction cardiosclerosis, myelodepression, pregnancy.

Application during pregnancy and lactation:

During pregnancy, the alpha interferon is prescribed only on condition that the expected effect for the mother exceeds the risk to the fetus. It is allowed to use in the second half of pregnancy. Women of childbearing age at all time of treatment should be used by reliable methods of contraception. Although animal experiments do not indicate the teratogenicity of Interferon Alpha, it is impossible to exclude the possibility that its use during pregnancy can harm the fetus. When macakam-cutters in the early and middle time of pregnancy was administered doses, significantly superior to the recommended clinic, they had an increase in the number of miscarriages.

The possibility of excretion of interferon alpha components with milk is not excluded. Due to the potential risk of impact on the fetus through the milk, Interferon Alpha recommend not to prescribe nursing mothers or refuse feeding during therapy, taking into account the need for treatment for a woman.

In the parenteral use of interferon Alpha, side effects are observed significantly more often than with other ways of administration (in the form of candles, under local application).

Influencing syndrome: fever, chills, muscle and headaches, joint pain, sweating, weakness, fatigue. These phenomena are reversible and disappear usually 72 hours after stopping the reception or reduction of the dose.

From the CNS: dizziness, ataxia, anxiety, irritability, depression, increased excitability, drowsiness, insomnia, weakening of attention, confusion of consciousness, somnoleps, violation of cerebral circulation, tremor, neuropathy, paresthesia.

From the side of the senses: paralysis of glasses, impairment of vision, ischemic retinopathy.

From the gastrointestinal bodies: anorexia, nausea, vomiting, hypersion, dry mouth, violation of taste, heartburn, increased peristalistic, abdominal pain, diarrhea, constipation, meteorism, body weight loss; Stomatitis, recurrence of ulcerative disease, bleeding from the gastrointestinal tract; Increasing the activity of "liver" transaminases, alkaline phosphatase, lactate dehydrogenase, hyperbilirubinemia. The increase in serum transaminases (ALT, AST) is described in a number of patients who did not have virus hepatitis, as well as in patients with chronic hepatitis V. It coincided with the disappearance of viral DNA polymerase. With a decrease in the dose or temporary cessation of treatment, laboratory indicators are normalized.

From the side of the cardiovascular system: arterial hyper-or hypotension, orthostatic hypotension, arrhythmia, tachycardia, cardialia, ischemic disorders, shortness of breath (especially in patients with the pathology of the cardiovascular system).

From the oral formation organs: Mielodepression, leo and thrombocytopenia, reduced hematocrit, anemia (more often found with doses of more than 10 million meters); An increase in prothrombin and partial thromboplastin time, nasal bleeding.

From the urogenital system: proteinuria, increasing urea, hypercreaticinemia, hyperuricemia; Reduced Libodo.

Skin: Alopecia; Allergic reactions: skin rash, skin hyperemia, itching, dry skin, urticaria; Furunculosis, herpety rash, bubble deprived.

Local reactions: inflammation at the injection site; When smoking the lesion, the local inflammatory response; Under nasal application - Chihanye, a disturbance of the outflow of the secret from the nose, rhinitis, nasal bleeding; In case of accidental, ointment in the eyes is hyperemia of conjunctiva, edema of conjunctiva, conjunctival infection. Under the local application of interferon alpha on the mucous membrane of the eye, there is a conjunctival infection, hyperemia of the mucous eye, single follicles, edema of the lower vessel conjunctiva.

With sharply pronounced local and general adverse reactions, the administration of interferon alpha should be stopped.

The following data on the side effects of Interferon Alpha are based on the experience of treating patients with the most different malignant diseases, often refractors to the previous treatment and located in late stages, as well as patients with chronic hepatitis in and chronic hepatitis C:

Most oncological patients received doses, significantly exceeding the recommended at present. This, possibly, explains the higher frequency and the severity of adverse reactions in this group of patients compared with hepatitis in patients in which adverse reactions were usually transient, so after 1-2 weeks after the start of treatment, patients returned to the initial state. Enhanced hair loss can continue for several weeks.

O6 symptoms. Often - flu-like syndrome (lethargy, temperature rise, chills, loss of appetite, muscle and headaches, joint pain and sweating). These acute side effects usually weaken or eliminate with the simultaneous purpose of paracetamol or indomethacin, and their severity during treatment or when a dose of interferon Alpha has a downward tendency, although drowsiness, weakness and lethargy may occur when continuing therapy.

Gastrointestinal tract. Often - about two thirds of oncological patients - anorexia, half - nausea. Quite often - vomiting, changing taste sensations, dry mouth, weight loss, diarrhea, as well as weak or moderate abdominal pain. Rarely - constipation, meteorism, strengthening of peristaltic and heartburn, aggravation of ulcerative disease, gastrointestinal bleeding, not threatening life, severe liver function.

Changes in the liver function. Sometimes it is an increase in the level of amalate, alkaline phosphatase, LDH and bilirubin, which, as a rule, do not require a dose correction. Rarely change in the activity of transaminase during hepatitis B, which usually indicates the improvement of the clinical state of the patient.

Central nervous system. Sometimes - systemic and non-systemic dizziness, impairment of vision, deterioration of the mental state, forgetfulness, depression, drowsiness, confusion of consciousness, violation of behavior (anxiety, nervousness) and sleep disorders. Rarely - strong drowsiness, convulsions, coma, violations of cerebral circulation, temporary impotence and ischemic retinopathy, as well as suicidal behavior (in the latter case, the drug must be canceled).

Peripheral nervous system. Sometimes - paresthesia, numbness of limbs, neuropathy, itching and tremor.

Cardiovascular and respiratory system. Quite often - approximately one fifth of oncological patients - transient arterial hypo- and hypertension, swelling, cyanosis, arrhythmia, heartbeat and chest pain. Rarely - cough and small shortness of breath, pulmonary edema, pneumonia, congestive heart failure, heart stop and respiratory stop, myocardial infarction. In patients with hepatitis in cardiovascular disorders, very rarely observed.

Leather, her appendages and mucous membranes. Quite often - the fifth part of the patients is a light or moderate hair loss, reversible after the cessation of treatment. Rarely - exacerbation of herpetic races on the lips, rash, itching, dry skin and mucous membranes, discharge from the nose and nasal bleeding, exacerbation or manifestation of psoriasis.

Kidney and urinary paths. Rarely - deterioration of the kidney function, acute renal failure (mainly in cancer patients with such risk factors as kidney diseases or simultaneous treatment with nephrotoxic drugs), electrolyte disorders, especially with anorexia or dehydration of the body, proteinuria, increasing the content of cell elements in urine sediment , raising the urea nitrogen level in the blood, as well as creatinine and uric acid in serum.

Blood-formation system. Quite often - transient leukopenia (rarely requiring dose reduction), in patients in a state of myelosuppression - thrombocytopenia, decrease in hemoglobin levels. Sometimes - thrombocytopenia in patients without myelosuppression. Rarely - reduction of hemoglobin and hematocrit. The return of severe hematological disorders to the initial level was usually observed 7-10 days after the cessation of the treatment of Interferon Alpha.

Others. Rarely - hyperglycemia, reactions at the injection site, autoimmune pathology (vasculitis, arthritis, hemolytic anemia, lupus-like syndrome), violation of the function of the thyroid gland. Very rarely - asymptomatic hypocalcemia. In Makak Reshov, who were prescribed the doses of Interferon Alpha, significantly exceeding the recommended for the clinic, transient disorders of the menstrual cycle were observed, including the elongation of the menstruation period. The significance of this data for a person is not established.

Antibodies to interferon. In some patients, after the administration of drugs containing homologous protein, neutralizing antibody proteins can be formed. Therefore, it is likely that the antibodies to all interferons, both natural and recombinant will be found in a certain part of the patients. In some diseases (cancer, a systemic red lupus, a deprive) antibodies to the leukocyte interferon of a person can spontaneously occur in patients who had previously never received interferons. In the experiment on mice, relative immunogenicity of lyophilized interferon alpha increases with time, if you store the drug at 25 ox. In clinical studies in which the lyophilized alpha interferon was used, which was kept at 25 ° C, neutralizing antibodies to the interferon were detected approximately in one fifth of the patients. Inspection on the fact that with any of the clinical indications, the presence of such antibodies may adversely affect the patient's response to the alpha interferon, is not available. When storing the lyophilized interferon alpha at a temperature of 4C (recommended storage conditions), increasing immunogenicity is not observed.

Special instructions and precautions:

Injection:

The solution for interferon alpha injection should be administered under the supervision of a physician who has experience in treating appropriate indications. Patients should be informed not only about the benefits of this therapy, but also about possible adverse reactions.

When severe side effects appear, the dose is reduced by 50% or temporarily stop therapy. The severity of adverse reactions is removed when taking the drug immediately before bedtime.

With a light and moderate violation of the functions of the kidneys, liver or bone marrow, they must be carefully monitored.

Prior to the start of therapy, Interferon Alpha should be held a clinical analysis and a biochemical study of blood (the amount of erythrocyte, platelets and leukocytes with leukocyte formula, electrolytes, calcium, transaminase, including alanine substransferase, whey bilirubin, albumin, general protein, creatinine). It is necessary to periodically repeat analyzes in the treatment process.

With exceptional caution, interferon alpha in patients with severe myelosuppression should be used, since the alpha interferon depresses the bone marrow, causing the drop in the number of leukocytes (especially granulocytes), the number of platelets and, less commonly, the level of hemoglobin. This can lead to an increased risk of infection or bleeding. It is necessary to closely monitor these. Particular attention should be paid to patients with coagulation impairment (for example, if the history was thrombophlebitis, pulmonary arteries embolism). In the case of violations of laboratory indicators, including leukopenia, thrombocytopenia, it is possible to briefly reduce the dose without correction of the overall treatment regimen (quickly disappear after a dose reduction). When thrombocytopenia, with the number of platelets less than 50,000 / μl, the interferon alpha should be administered to P / K.

The level of thyrotropic hormone (TSH) should not exceed the norm at the time of the start of therapy. If the patient during the period of therapy interferon alpha is noted a change in the level of thyroid hormones, it is necessary to more thoroughly explore the condition and the function of the thyroid gland. In patients with hepatitis C, receiving treatment, there may sometimes be disturbed by the function of the thyroid gland, expressed in hypo-or hyperthyroidism.

For patients receiving treatment for viral hepatitis, it is recommended to carry out a blood test to 1, 2, 4, 8, 12, 16 weeks of treatment and then monthly until the end of therapy. If, on the background of the administration of Interferon Alpha, the level of Alt is noted, then the treatment should be continued if there are no signs of hepatic insufficiency. With raising the level of transaminases (the so-called cytolytic crisis), it is necessary to investigate the propromblea content (prothrombin time), Alt, alkaline phosphatase, serum albumin and bilirubin every 2 weeks. When the level of albumin or promotine is reduced, it is necessary to immediately stop the administration of interferon alpha.

In the treatment of patients with myeloma disease, a periodic study of the kidney function is carried out.

A thorough periodic psycho-neurological examination of all patients is recommended. In rare cases, the patients receiving Interferon Alpha were noted suicidal attempts (development of depression); In such cases, therapy should be discontinued. In case of elderly patients receiving high doses, side effects from the CNS, the patient should be carefully examined and, if necessary, interrupt treatment. They are recorded both with the introduction of standard doses and with high doses therapy.

In patients after transplantation (for example, kidney or bone marrow), drug immunosuppression may be less efficient, since interferons have a stimulating effect on the immune system.

In the presence of clinical symptoms of hyperglycemia, control of blood glucose levels and appropriate observation is necessary. Sick diabetes mellitus may require a dose correction of sugar drugs and insulin.

With special care to use interferon-alpha with allergic and autoimmune diseases (including a history). Pronounced allergic reactions (urticaria, angioedema swelling, bronchospasm, anaphylactic shock) on the introduction of interferon alpha is rare. If an allergic reaction develops, immediately stop the administration of the drug and begin the appropriate therapy. Transient spindles on the skin are not contraindicated to continue the administration of interferon alpha.

Caution is prescribed to patients with cardiovascular diseases - arrhythmias can develop. All such patients are recommended to control the ECG.

Caution should be prescribed to patients with chronic obstructive lung diseases.

In the cholestatic version of acute hepatitis B or with a developing hepatic coma interferon alpha is ineffective. The interferon alpha is not prescribed by the sick autoimmune hepatitis, persons who received immunosuppressive therapy after transplantation, since the administration of interferon alpha can worsen the liver function in these patients.

Treatment begins as early as possible, with the improvement of the patient's condition after the chemovered and radiation therapy (after 4-6 weeks).

The temperature reaction may be a reaction to the administration of interferon alpha, however, it is necessary to exclude all possible causes of fever. To relieve or reduce the severity of flu-like symptoms, the simultaneous purpose of paracetamol in the daily dose to 1 g or indomethacin is recommended

In the treatment of renal carcinoma, it is recommended to combine with vinblastine.

Patients with psoriatic rashes need to compare the risk with benefit from therapy.

Patients with sarcoma capos due to HIV infection interferon alpha is shown only if there are no heavy visceral disorders.

Alfheron alpha in solution for injection in newborns is particularly premature, and children under 2 years old are not recommended. In some ready-to-use drugs Interferon Alpha (Syringe-Ampoule) contains benzyl alcohol as a preservative, which, according to reports, can lead to persistent disorders in the neuropsychic sphere and polyorgan deficiency. The benzyl alcohol contained as a filler in the ready-to-use solution can penetrate the placenta (it should be considered when prescribed during pregnancy).

The experience of using Interferon Alpha in patients under the age of 18 is limited. Therefore, when appointing Interferon Alpha, children should determine whether the positive effect will prevail over undesirable phenomena.

Interferon may disrupt the reproductive function. In research studies, the interferon disrupts the menstrual cycle. In women who received leukocyte interferon, a decrease in the level of estrogen and progesterone in serum was recorded. Men reproductive age should be informed about possible unwanted phenomena.

Caution is prescribed to patients engaged in potentially hazardous activities that require speeds of motor and mental reactions. Interferon Alpha may have an effect on the reaction rate, affecting the execution of certain operations.

During the therapy, the use of ethanol should be excluded.

The frequency of use of natural interferon alpha drugs is correlated with the frequency of application of recombinant interferon as 1: 100. However, when using recombinant, and not natural interferons, the appearance of patients with neutralizing anti-IFN antibodies are recorded in the blood serum, which can significantly reduce the clinical efficacy of the drug.

The drug is not suitable for use if: the integrity of the packaging is broken; lacking labeling; expired expiration.

The bottle with a solution for injections containing 18 million meters of 3 ml is designed for reusable use (in one patient). All other dosage forms are designed for one-time application. Before dialing a dose, the bottle cover by 18 million should be wiped with a disinfectant. On the bottle label it is necessary to record the date of the first dose set. With each new dose set from a multi-modular bottle, you should use new sterile syringe and needle. The needles used cannot be reused in a multi-modular bottle. Multi-modular bottles of 18 million should be used within 30 days after the first doseset.

Interferon Alpha in Candle (Suppositories):

To treat a wide range of infectious inflammatory diseases, the interferon alpha in candles can be used as part of combined therapy with antibacterial drugs, glucocorticoids, immunosuppressive drugs, interferon inductors.

There are data on the effectiveness of the use of interferon alpha in candles in complex therapy and the prevention of the following diseases and states: herpes, chlamydia, ureaplasmosis, toxoplasmosis, cytomegalovirus infection in adults and children over 1 year; juvenile rheumatoid arthritis; meningeal shape of tick-borne encephalitis; prostatites of different etiology; purulent-septic postoperative complications, virus-mass glomerulonephritis, pyelonephritis.

Alpha Interferon Ointment:

It is necessary to avoid falling ointment into the eyes.

You can not enter any drugs simultaneously with Interferon Alpha.

For additional dilution, it is possible to use an isotonic solution of sodium chloride, ringer solution.

Interferon Alpha may disrupt oxidative metabolic processes, reducing the activity of hepatic microsomal enzymes of the cytochrome P450 system. This should be taken into account while simultaneously appointing medicines that are metabolized by this path (cimetidine, phenytoin, warfarin, theophylline, diazepam, propranolol).

Interferon Alpha can enhance the neurotoxic, hematotoxic or cardiotoxic effect of drugs that have appointed earlier or simultaneously with them.

When conducting therapy with interferon alpha narcotic, sleeping pills, sedatives should be prescribed with caution.

Care should be taken when appointed together with interferon alpha drugs with a myelosuppressive action. Sienergism of side effects (in relation to the number of leukocytes) is described when the interferon alpha and zidovudine is jointly appointed. In patients who received these drugs at the same time, the frequency of development of neutropenia was higher than that of Zidovudine only.

Paracetamol and Indomethacin are successfully used to relieve flu-like syndrome, which is found when using Interferon Alpha. The recommended paracetamol dose is 20 minutes before the introduction of Alpha interferon. The maximum dose of paracetamol is 1 g 4 times a day.

Interferon alpha in candles can be used as part of combined therapy with antibacterial drugs, GKS, Imunodepressants, interferon inductors for the treatment of a wide range of infectious inflammatory diseases. For the treatment of urogenital diseases, the most effective in combination with antimicrobial drugs, incl. antibiotics, inductors of interferon.

List B. Store in a dry, light-protected place, at a temperature of 2-10 ° C and not lower than 0 & degs. Freezing do not allow.

Transportation by all types of indoor transport at a temperature not higher than 10 & degs.

Keep out of the reach of children.

Shelf life is specified on the package. The preparation with an expired application is not subject to use.

The syringe knob with the inserted cartridge can be stored at room temperature (up to 25 ° C) within 30 days.

Conditions for leave from pharmacies - according to the doctor's prescription.

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