doctor: Interferon

Description overdue on 11/11/2014

Latin name: Interferon
ATC code: L03AB
Active substance: The interferon preparations can be used as the active ingredient: the human α, β or γ interferon (IFN)
Manufacturer: Hoffmann-La Roche, Switzerland; Schering-Plough, USA; InterMune, USA and others.

Photos of the drug

Composition
Product form
Pharmacological action
Pharmacodynamics and pharmacokinetics
Indications
Contraindications
Side effects
Interferon, instructions for use
Overdose
Cooperation
Terms of sale
Storage conditions
Shelf life
Cautions
Analogs
Interferon for children
During pregnancy (and lactation)
Reviews
Price, where to buy

Interferon

Composition

The composition of the drugs interferon depends on the release form.

Product form

Interferon preparations have the following forms of production:

Lyophilized powder for ocular and nasal drops, injectable solution;
injectable solution;
eye drops;
eye film;
nasal drops and sprays;
ointment;
dermatological gel;
liposomes;
spray;
oral solution;
rectal suppositories;
vaginal suppositories;
implants;
microclysters;
pills (tablets interferon is produced under the brand name Entalferon).

Pharmacological action

IFN preparations belong to the group of medicines antiviral and immunomodulatory effects .

All IFN have antiviral and antitumoral effect . Equally important is considered to be their property and to stimulate to action Macrophages - Cells that play an important role in the initiation cellular immunity .

IFN contribute to the body's resistance to penetration Virus And reproduction block Virus when they enter the cage. The latter is due to the ability to inhibit IFN translation matrix (information) RNA virus .

This IFN antiviral activity is not directed against certain Virus That is not characterized by IFN virusospetsifichnostyu. This explains their versatility and wide range of antiviral activity.

Pharmacodynamics and pharmacokinetics

The main biological effect of α-IFN is inhibition of the synthesis of viral proteins . Antiviral state cells evolves within a few hours after the drug or induce production of IFN in the body.

Thus IFN no effect on the early stages of replicative cycle, i.e. the adsorption step, penetration Virus the cell (penetration) and release inner component Virus during its "stripping."

Antiviral activity α-IFN is evident even in the case of infection of cells infectious RNA . IFN does not penetrate into the cell, but only interacts with specific receptors on cell membranes ( ganglioside or similar to these structures, which contain oligosaccharides ).

The mechanism of activity of IFN alpha resembles the action of the individual glycopeptide hormone . It stimulates the activity gene , Some of which are involved in encoding the formation of products Direct antiviral .

β interferons also possess antiviral Which is associated with several mechanisms of action. Beta interferon activates N0-synthetase, which in turn contributes to the concentration of nitric oxide within the cell. Last plays a key role in the suppression of reproduction Virus .

β-IFN to activate secondary effector functions aturalnyh killers at . B-lymphocytes of type . blood monocytes . tissue macrophages (mononuclear phagocytes) and neutrophils Which are characterized by antibody and antitelonezavisimoy cytotoxicity.

Besides β-IFN blocking the release of internal components Virus and interferes with the methylation RNA .

IFN-γ is involved in the regulation of immune responses and regulates the intensity inflammatory reactions. Despite the fact that it has a self- antivirus and antitumor effect . gamma interferon very weak. He greatly enhances the activity of α- and β-IFN.

After parenteral administration, the maximum concentration of IFN in plasma observed after 3-12 hours. The bioavailability index - 100% (both after administration under the skin, and after administration into the muscle).

T? Long half-life is about 2 to 7 hours. Trace concentrations of IFN in the plasma can not be detected after 16-24 hours.

Indications

IFN for treatment viral diseases Affecting respiratory tract .

In addition, the drugs interferon administered to patients with chronic Hepatitis B, C and Delta .

For treatment viral diseases and, in particular, Hepatitis C Used mainly IFN-α (both of its shape - IFN-alfa-2b and IFN-alfa-2a). The "gold standard" treatment Hepatitis C It is considered to be pegylated interferon alfa-2b and alpha-2a. In comparison with conventional interferons them less effective.

Hepatitis C genotype 1 is recommended to be treated by applying pegylated IFN alpha-2a or pegylated IFN alpha-2b (available under the trade names Pegasys or PegIntron ) In combination with Ribavirin .

Genetic polymorphism, according to the gene IL28B, which is responsible for encoding IFN lambda 3, causes significant differences in the effect of treatment.

Patients with genotype 1 Hepatitis C with normal alleles of the gene are more likely to achieve a more prolonged and more severe treatment results in comparison with other patients.

IFN is also often prescribed to patients with oncological diseases : malignant melanoma . pancreatic endocrine tumors . non-Hodgkin lymphoma . carcinoid tumors ; Kaposi's sarcoma Due AIDS ; hairy cell leukemia . multiple myeloma . kidney cancer etc..

It considered appropriate to its use in the thrombocythemia . eye disease Provoked herpes infection and adenoviruses . shingles (IFN-γ), multiple sclerosis (IFN β-1a), as well as for prevention Flu and SARS .

Contraindications

Interferon is not indicated in patients with hypersensitivity to it, as well as children and adolescents suffering from severe mental disorders and disorders of the nervous system Which are accompanied by thoughts of suicide and suicide attempts, severe and protracted depression .

In combination with antiviral drug ribavirin IFN is contraindicated in patients who are diagnosed with serious violations in the work kidney (conditions in which CC than 50 ml / min).

Interferon drugs are contraindicated in epilepsy (in those cases where appropriate therapy does not give the expected clinical effect).

Side effects

Interferon belongs to the category of drugs that can cause a large number of adverse reactions from the various systems and organs. In most cases they are the consequence of the introduction of interferon in / n / or / m, but may provoke them and other pharmaceutical forms of the drug.

The most common adverse reactions to receiving IFN are:

anorexia;
nausea;
chills;
tremors.

Less frequently observed vomiting, drowsiness, dry mouth, hair loss ( alopecia ) asthenia ; nonspecific symptoms resembling flu-like symptoms ; back pain, depression . musculoskeletal pain , Suicidal thoughts and suicide attempt, malaise, taste disturbance and concentration, irritability, sleep disorders (often insomnia ) hypotension , Confusion.

Rare side effects include: pain in the right upper abdomen, rash on the body (erythematous maculopapular and), increased anxiety, pain and inflammation at the site marked the introduction of the drug in injectable form, secondary viral infection (including infection herpes simplex virus ), Increased dryness of the skin, itch . pain in the eyes . conjunctivitis , Blurred vision, impaired function lacrimal glands , Anxiety, mood lability; psychotic disorders Including hallucinations , Increased aggression, etc .; hyperthermia . dyspeptic symptoms , Respiratory disorders, weight loss, tachycardia , Loose stools, myositis . hyper- or hypothyroidism , Hearing impairment (up to complete its loss), the formation of pulmonary infiltrates, increased appetite, bleeding gums, convulsions in the extremities, dyspnea , Renal failure, and the development of renal failure . peripheral ischemia . hyperuricemia . neuropathy etc..

Treatment with drugs can provoke IFN reproductive disorders . Primate studies showed that interferon violates the menstrual cycle in women . In addition, women undergoing a course of treatment with IFN-α, decreased level Estrogen and progesterone at serum .

For this reason, in the case of interferon-purpose women of childbearing age must use barrier contraception . The men of reproductive age are also encouraged to inform about potential side effects.

In rare cases, treatment with interferon may be associated ophthalmologic disorders, which are expressed in the form retinal hemorrhage . retinopathy (including but not limited macular edema ), Focal changes of the retina, visual acuity reduction and / or limitation of the visual field, papilledema . neuritis of the eye (the second cranial) nerve . obstruction of arteries or retinal vein .

Sometimes, in patients receiving interferon can develop hyperglycemia . symptoms of nephrotic syndrome . diabetes . renal failure . Patients with diabetes can worsen the clinical picture of the disease.

It is not excluded likelihood colitis . pancreatitis . cerebrovascular hemorrhage . myocardial infarction . erythema multiforme . tissue necrosis at the injection site, cardiac and cerebrovascular ischemia . gipertriglitseridermii . sarcoidosis (or worsening its course) Lyell's syndrome and Stevens-Johnson .

The use of interferon as monotherapy or in combination with Ribavirin in rare cases can cause aplastic anemia (AA) or PAKKM ( full aplasia of bone marrow ).

Also registered cases when on the background of treatment with interferon in patients develop different Autoimmune and immune-mediated disorders (including idiopathic thrombocytopenic purpura and disease Moshkovitsa ).

Interferon, instructions for use

Instructions for use of interferon alpha, beta and gamma states that before a patient receives medication, it is recommended to determine how sensitive to it microorganisms , Which became the cause of the disease.

The method of administration of human leukocyte interferon is determined depending on a patient diagnosis. In most cases, it is administered by subcutaneous injection, but in some cases, the drug may be administered in a muscle or a vein.

The dose for the treatment, maintenance dose and duration of treatment is determined depending on the clinical situation and the response of the patient to his assigned therapy.

"Children" interferon - a candle, drops and ointment.

Instructions for use of interferon for Children recommends the use of this drug as a treatment and as a preventive tool. The dose for infants and older children picks physician.

In prophylactic INF applied as a solution, which is used for the preparation of distilled or boiled water at room temperature. The final solution is red and opalescent. Keep it should be in the cold no more than 24-48 hours. The drug is instilled into the nose of children and adults.

At ophthalmic viral diseases the drug is prescribed in the form of eye drops.

The recommended dose for instillation conjunctival cavity the affected eye infection - 2 drops (dropped them every two hours). The multiplicity instillation - not less than 6 per day.

Once symptoms of the disease is reduced, the volume of instillation should be reduced to a single drop. The course of treatment - from 7 to 10 days.

For the treatment of lesions caused by herpesviruses , A thin layer of the ointment applied to the affected areas of skin and mucous membranes twice a day, surviving 12 tichasovye intervals. The course of treatment - from 3 to 5 days (until fully restore the integrity of the impaired skin and mucous membranes).

For prevention ARI and Flu must be lubricated with ointment nasal passages . The multiplicity of procedures for the 1st and 3rd week of the course - 2 times a day. During the 2nd week it is recommended to make a break. In prophylactic interferon should be used during the entire period epidemics of respiratory disease .

Candles interferon is administered rectally. The recommended dose of instructions - 1 suppository 1 or 2 times per day. The course of treatment - from 5 to 10 days.

The duration of the course of the rehabilitation of children who often have recurrent viral and bacterial infections of the respiratory tract . Otolaryngology . recurrent infections Induced herpes simplex virus It shall be two months.

Tablets interferon is recommended to take a dose of 2050 IU per kilogram of body weight (not to exceed 1 million IU).

How to breed and how to use interferon in ampoules?

Instructions for use of interferon in ampoules indicates that the vial before use is necessary to open, pour it with water (distilled or boiled) at room temperature up to the mark on the vial, corresponding to the 2nd mL.

Content gently shaken until complete dissolution. The solution was introduced into each nasal passage twice daily for five drops, maintaining intervals between injections at least six hours.

For therapeutic purposes, IFN beginning to take at the first flu symptoms . The efficacy of the higher than before the patient starts taking it.

The most effective method is considered to be inhalation (through the nose or mouth). To take one inhalation recommended contents of three vials of drug dissolved in 10 ml of water.

The water is preheated to a temperature not exceeding +37 ° C. Procedures performed inhalations twice a day, keeping an interval therebetween of at least one-two hours.

When spraying or instillation of the contents of the ampoule were dissolved in two milliliters of water and administered at 0, 25 ml (or five drops) in each nostril three to six times per day. Duration of treatment - 2-3 days.

Nose drops for children as a preventive measure buried (5 drops), twice a day, in the early stages of the disease increases the frequency of instillation: the drug should be administered at least five or six times a day, every hour or two.

Many people wonder whether it is possible to drip into the eyes of interferon solution. The answer to this question is yes.

Overdose

Overdoses of interferon are not described.

Cooperation

β-IFN is compatible with corticosteroids and ACTH. Do not take it in the period of treatment myelosuppressive drugs , Including cytostatics (it can provoke additive effect ).

Precautions β-IFN administered with agents which clearance largely depends on the cytochrome P450 ( antiepileptic drugs Some antidepressants and etc.).

It should not be taken simultaneously and α-IFN Telbivudine . The simultaneous use of α-IFN provokes mutual reinforcement of action against HIV . In a joint application with Phosphazide It can mutually enhance myelotoxicity both drugs (it is recommended to carefully monitor the amount of change granulocytes and hemoglobin levels ).

Terms of sale

To release the drug requires a prescription.

Storage conditions

Interferon is stored in a cool, sheltered from sunlight at a temperature of +2 to + 8 ° C. List B.

Shelf life

24 months. Ready interferon solution at room temperature is stable for 3 days.

Cautions

Interferon - what is it?

Interferons - a class have similar properties glycoproteins That are produced by cells of vertebrates in response to various kinds of inducers both virus and viral nature.

According to Wikipedia, to the active substance was classified as interferon, it must have a protein nature, have expressed antiviral activity towards various viruses At least in homologous (similar) cells "mediated cellular metabolic processes involving synthesis of RNA and protein."

Classification of IFN, proposed by the WHO and interferonovym Committee, based on antigenic differences in their physical, chemical and biological properties. In addition, it takes into account their species and cellular origin.

Antigen (antigen specificity) IFN can be divided for acid and acid labile. By acid-related alpha and beta interferons (also referred to as IFN I type). It is acid-labile interferon-gamma (IFN-γ).

α-IFN produced peripheral blood leukocytes (leukocytes B- and T-type), so he had previously designated as leykotsitary interferon . There are currently at least 14 of its versions.

β-IFN produce fibroblasts So it is also called fibroblast .

Former designation of γ-IFN - immune interferon , As it stimulated produce T-lymphocytes of type . NK-cells (normal (natural) killers, from the English "natural killer"), and (presumably) Macrophages .

The basic properties and mechanism of action of IFN

Without exception, characterized polyfunctional IFN activity against target cells. The most common feature is their ability to induce in them antiviral state .

Interferon is used as a therapeutic and prophylactic agent for various viral infections . A feature of IFN preparations is that their effect is weakened by repeated injections.

The mechanism of action of IFN is linked to its ability to inhibit viral infections . As a result of treatment with interferon in a patient's body around source of infection It formed a barrier of resistance to Virus uninfected cells, which prevents the further spread of infection.

Interacting with the still intact (intact) cells, it prevents the implementation of the reproductive cycle Virus by activation of certain cellular enzymes ( protein kinases ).

The most important functions of interferons believe the ability to inhibit hematopoiesis ; modulate immune response and inflammation reaction; regulate the processes of proliferation and differentiation of cells; inhibit growth and prevent the breeding viral cells ; antigens ;