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Precautions and Warnings With Peginterferon Alfa-2b

Your healthcare provider needs to know if you have certain medical conditions, such as diabetes or lung problems, before you can begin treatment with peginterferon alfa-2b. Other warnings and precautions on using this drug safely include letting your healthcare provider know if you are using any other medications or if you are pregnant or breastfeeding.

What Should I Tell My Healthcare Provider?

Talk to your healthcare provider prior to using peginterferon alfa-2b (PegIntron®, Sylatron®) if you have:
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Peginterferon Alfa-2b Precautions and Warnings

Some warnings and precautions to be aware of prior to using this medicine include the following:
  • Probably the most important thing to be aware of before starting this medication is that interferon medications, including peginterferon alfa-2b, may increase the risk for depression or other psychiatric problems. Make sure your healthcare provider knows if you have depression or another mood disorder (such as bipolar disorder or manic depression) or if your depression seems to get worse while you are using this drug.
  • Being on peginterferon alfa-2b feels like having a constant case of the flu, as it usually causes side effects such as fatigue, muscle aches, and fever. This is normal and expected, although highly unpleasant.
  • In studies, peginterferon alfa-2b appeared to increase the risk for heart problems, such as heart attacks or irregular heart rhythms (arrhythmias). If you develop heart problems, you will probably need to stop using this medication permanently.
  • Peginterferon alfa-2b can cause a variety of problems in the eye, including damage to the retina, which can lead to blindness. Let your healthcare provider know immediately if you develop any vision changes, such as blurred vision. You will need eye exams before you start this medication and periodically thereafter.
  • There have been reports of strokes in people using peginterferon alfa-2b or other similar medications. Some of these cases occurred in people who were not otherwise at risk for a stroke. However, there is no clear link between peginterferon alfa-2b and strokes at this time.
  • Peginterferon alfa-2b can cause low blood cell counts, increasing the risk for dangerous infections or serious bleeding. You will need periodic blood tests to make sure your blood cell counts are not dropping too low.
  • There have been cases of this medication worsening preexisting autoimmune disorders, or even causing them, such as:
    • Rheumatoid arthritis
    • Psoriasis
    • Thyroiditis
    • Interstitial nephritis
    • Thrombotic thrombocytopenic purpura
    • Idiopathic thrombocytopenic purpura
    • Lupus.
  • This drug often causes poor growth in children. Often, but not always, growth catches up after treatment is finished. It should be noted that peginterferon alfa-2b is approved only for treating hepatitis C in children and not for treating metastatic melanoma.
  • There have been reports of colitis in people using peginterferon alfa-2b. Let your healthcare provider know right away if you have symptoms of this problem, such as:
    • Bloody diarrhea
    • Abdominal (stomach) pain
    • Fever.
  • There have been reports of pancreatitis (inflammation of the pancreas), which may be quite dangerous, in people using peginterferon alfa-2b. Let your healthcare provider know immediately if you have any signs of this condition, such as:
    • Severe abdominal (stomach) pain
    • Nausea and vomiting
    • Loss of appetite.
  • Peginterferon alfa-2b can cause or worsen serious lung problems. Make sure your healthcare provider knows if you have any lung problems before starting treatment.
  • This drug can sometimes cause liver failure. Your liver will need to be closely monitored during treatment.
  • This medication can worsen kidney function, particularly in people who already have kidney disease. Your kidney function may need to be monitored during treatment.
  • In rare cases, peginterferon alfa-2b can cause serious allergic reactions.
  • Various dental problems have been reported with peginterferon alfa-2b. Make sure to brush your teeth at least twice a day and see your dentist regularly while using this medicine.
  • This product can affect thyroid function, sometimes unpredictably. It is recommended that your healthcare provider check your thyroid function, using a simple blood test, before you start this medication and periodically thereafter.
  • Peginterferon alfa-2b might cause diabetes. Your healthcare provider may want to check your blood sugar levels periodically.
  • Peginterferon alfa-2b is a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Make sure to talk with your healthcare provider about the risks and benefits of using this medicine when pregnant (see PegIntron and Pregnancy or Sylatron and Pregnancy). Keep in mind that when used to treat hepatitis C, peginterferon alfa-2b is usually combined with ribavirin (Rebetol®), a medication that should never be used during pregnancy.
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Peginterferon Alfa-2b Drug Information

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