Rebetron

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Rebetron, |Rebetron
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Rebetron

Generic Name: interferon alfa-2b and ribavirin (in ter FEE ron AL fa 2b and rye beh VIE rin)
Brand Names: Rebetron

What are interferon alfa-2b and ribavirin?

Interferon alfa-2b is a protein. Interferons are released in the body in response to viral infections. Interferons are important for fighting viruses in the body, for regulating reproduction of cells, and for regulating the immune system.

Ribavirin is an antiviral medication. The exact way that it works is unknown.

Interferon alfa-2b and ribavirin are used together to treat chronic hepatitis C in patients with compensated liver disease who have not previously been treated with alfa interferon or who have relapsed following alfa interferon therapy.

Interferon alfa-2b and ribavirin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about interferon alfa-2b and ribavirin?

Interferon alfa-2b and ribavirin is in the FDA pregnancy category X. This means that it is known to cause birth defects in an unborn baby. Interferon alfa-2b and ribavirin should not be used by women who are pregnant or by male partners of pregnant women. Extreme care must be taken to avoid pregnancy during treatment with interferon alfa-2b and ribavirin and for 6 months following the completion of treatment in women taking this medication and women partners of men being treated with this medication. Women who could become pregnant during treatment and men must use two reliable forms of birth control during treatment and during the 6-month period following treatment. Notify your doctor immediately if pregnancy occurs.

Interferon alfa-2b and ribavirin may cause anemia, which is a decrease in the number of red blood cells in the body. This can be dangerous, especially for patients who already have heart or circulatory problems. Your doctor will want to check your red blood cell count before starting and periodically during treatment. Talk to your doctor before taking this medication if you have or have ever had any heart or circulatory problems.

Call your doctor or seek emergency medical attention if you develop symptoms of depression or are contemplating suicide; become unusually irritable, anxious (nervous), or aggressive; or experience other mood or behavior changes. In some cases, interferon alfa-2b and ribavirin has caused serious mood or behavioral problems.

What should I discuss with my healthcare provider before taking interferon alfa-2b and ribavirin?

Do not use interferon alfa-2b and ribavirin without first talking to your doctor if you have had an allergic reaction to ribavirin or an alfa interferon in the past or if you are allergic to E. coli derived products.

Before taking interferon alfa-2b and ribavirin, tell your doctor if you have

  • blood problems such as anemia, thalassemia, sickle-cell anemia, and others;

  • bone marrow suppression (low red or white blood cells or platelets);

  • high blood pressure, history of a heart attack, or other heart problems;

  • a history of depression, suicidal thoughts, anxiety, drug or alcohol abuse, or another mental illness;

  • had an organ transplant and are taking medicine that keeps your body from rejecting the transplanted organ;

  • lung or breathing problems;

  • kidney problems;
  • liver problems (except hepatitis C infection);

  • diabetes;

  • thyroid problems;

  • autoimmune disorder;

  • psoriasis;

  • an active infection;

  • eye problems;

  • a seizure disorder; or

  • pancreatitis.

You may not be able to take interferon alfa-2b and ribavirin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Interferon alfa-2b and ribavirin is in the FDA pregnancy category X. This means that it is known to cause birth defects in an unborn baby. Interferon alfa-2b and ribavirin should not be used by women who are pregnant or by male partners of pregnant women. Extreme care must be taken to avoid pregnancy during treatment with interferon alfa-2b and ribavirin and for 6 months following the completion of treatment in women taking this medication and women partners of men being treated with this medication. Women who could become pregnant during treatment and men must use two reliable forms of birth control during treatment and during the 6-month period following treatment. Notify your doctor immediately if pregnancy occurs. It is not known whether interferon alfa-2b and ribavirin passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take interferon alfa-2b and ribavirin?

Take interferon alfa-2b and ribavirin exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

The ribavirin (Rebetol) capsules are taken by mouth. Take each dose with a full glass of water. The capsules can be taken with or without food, but each dose should be taken in the same manner (e.g., with food or without food) every day. Maintain adequate fluid intake to prevent dehydration during treatment with interferon alfa-2b and ribavirin. Extra fluids may be necessary during hot weather, vigorous exercise, and illness. Discuss with your doctor the amount of fluid that should be consumed daily.

The interferon alfa-2b (Intron A) injection is administered subcutaneously. Your doctor or nurse will give you detailed instructions on how and where to inject this medication. Do not inject this medication if you are unsure how.

Only use the Intron A multidose pen with the Novofine needles provided. Using other needles with the pen may result in the pen not working properly and/or the wrong dose of medication being delivered.

Do not inject interferon alfa-2b if it is discolored or has particles in it.

Never reuse a needle or syringe. Dispose of all needles and syringes in an appropriate, puncture-resistant disposal container. Always cap the needle and remove it from the pen before discarding.

Your doctor may want you to have blood tests or other medical evaluations before and during treatment with interferon alfa-2b and ribavirin to monitor progress and side effects.

It is not known whether treatment with interferon alfa-2b and ribavirin will prevent the transmission of hepatitis to others. It is also not known whether interferon alfa-2b and ribavirin will cure hepatitis or prevent cirrhosis, liver failure, or liver cancer that may be the result of infection with a hepatitis virus.

Do not stop taking this medication without first talking to your doctor. Store the Rebetron combination package in the refrigerator between 36 and 46 degrees Fahrenheit (2 and 8 degrees Celsius). When separated, store the individual carton of Rebetol capsules in the refrigerator or at room temperature (77 degrees Fahrenheit, 25 degrees Celsius) and store the Intron A injection in the refrigerator.

What happens if I miss a dose?

If you miss a dose of the Rebetol capsules, take the missed dose as soon as possible during the same day. If an entire day has gone by, check with your doctor about what to do. Do not double the next dose. If you miss a dose of the Intron A injection, use the missed dose as soon as possible during the same day or on the next day, and continue the dosing schedule provided to you by your doctor. If several days go by, check with your doctor about what to do. Do not double the next dose.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of an interferon alfa-2b and ribavirin overdose are not known.

What should I avoid while using interferon alfa-2b and ribavirin?

Do not drink alcohol during treatment with interferon alfa-2b and ribavirin unless otherwise directed by your doctor. Drinking alcohol may be harmful to the liver and may increase drowsiness or dizziness caused by the medication. Use caution when driving, operating machinery, or performing other hazardous activities. Interferon alfa-2b and ribavirin may cause drowsiness, dizziness, or impaired alertness. If you experience drowsiness, dizziness, or impaired alertness, avoid these activities. Maintain adequate fluid intake to prevent dehydration during treatment with interferon alfa-2b and ribavirin. Extra fluids may be necessary during hot weather, vigorous exercise, and illness. Discuss with your doctor the amount of fluid that should be consumed daily.

Interferon alfa-2b and ribavirin side effects

If you experience any of the following serious side effects, stop using interferon alfa-2b and ribavirin and seek emergency medical attention or notify your doctor immediately:

  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); or

  • chest pain or shortness of breath.

Interferon alfa-2b and ribavirin may cause anemia, which is a decrease in the number of red blood cells in the body. This can be dangerous, especially for patients who already have heart or circulatory problems. Your doctor will want to check your red blood cell count before starting and periodically during treatment. Talk to your doctor before taking this medication if you have or have ever had any heart or circulatory problems.

Call your doctor or seek emergency medical attention if you develop symptoms of depression or are contemplating suicide; become unusually irritable, anxious (nervous), or aggressive; or experience other mood or behavior changes. In some cases, interferon alfa-2b and ribavirin has caused serious mood or behavioral problems.

Flulike symptoms are likely to occur. These symptoms include fever or chills, headache, muscle aches, and fever. They are most common at the start of therapy and may decrease with continued use. Injecting the interferon alfa-2b (Intron A) at bedtime may minimize some of these side effects. Over-the-counter fever and pain reducers, such as acetaminophen (Tylenol, others) and ibuprofen (Motrin, Advil, others) may relieve some of these symptoms.

Other side effects may also occur. Talk to your doctor if you experience any of the following:

  • loss or thinning of the hair;

  • a rash or itching;

  • nausea, vomiting, or decreased appetite;

  • dizziness or drowsiness;

  • nervousness;

  • irritability;

  • insomnia; or

  • pain, redness, or bruising at the injection site.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect interferon alfa-2b and ribavirin?

Before taking interferon alfa-2b and ribavirin, tell your doctor if you are taking any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, and do not start taking any other medicines during treatment without first talking to your doctor. You may require a dosage adjustment or special monitoring during treatment.

Where can I get more information?

  • Your pharmacist has additional information about interferon alfa-2b and ribavirin written for health professionals that you may read.

What does my medication look like?

Interferon alfa-2b and ribavirin is available with a prescription under the brand name Rebetron. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Rebetron combination package contains both Rebetol 200 mg white, opaques capsules and Intron A vials or multidose pens of clear, colorless solution.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with other, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 3.03. Revision Date: 8/23/04 3:39:04 PM.



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