Pegylated interferon is a medication used to treat hepatitis C. It is often combined with the medication ribavirin. Pegylated interferon stimulates the immune system while ribavirin dramatically slows viral replication. Pegylated interferon was first approved by the Food and Drug Administration in 2001. There are two variations of the drug, alfa-2a and alfa-2b, with similar success rates and treatment regimens. Pegylated interferon has been studied extensively in clinical trial and post-marketing adverse events. Pegylated interferon can cause several side effects, ranging from mild to life threatening. Hepatitis C is a potentially fatal disease and patients should weigh the costs and benefits of treatment side effects with potentially restoring liver health.
Flu-like Symtoms
Pegylated interferon can cause several flu-like symptoms. According to Drugs.com, the most common symptom is fatigue, occurring around 56 percent of the time. Thirty-seven percent of patients experience fever and 35 percent experience shaking and chills that accompany the fever. Eleven percent of patients experience pain. These symptoms usually occur at the initial injection site and last for three or four days. Patients often get injections before the weekend so they can return to work by Monday with symptoms in remission.
Neurological Effects
Pegylated interferon can also cause several neurological and psychiatric symptoms. The symptoms and incidence are similar for the alfa-2a and alfa-2b medications, Pegasys and PEG-Intron, respectively. The most common neurological symptom is headache, occurring in around 55 percent of patients for both medications. Other neurological symptoms include memory impairment and dizziness. Psychiatric symptoms were slightly higher with alfa-2b. The PEG-Intron prescribing insert states that anxiety, depression, insomnia and emotional lability all occurred in around 25 percent of patients. These same symptoms ranged from 3 percent to 19 percent with Pegasys, the alfa-2a brand. According to the prescribing labels for both alfa-2a and alfa-2b medications, patients may also be at a higher risk for suicide, suicidal thinking, homicidal thinking, relapse of drug addiction and drug overdose.
Serious Effects
Although most of the side effects for pegylated interferon are mild in nature, some of the side effects on the body systems can be serious and life threatening. The Pegasys insert states that patients may develop bone marrow toxicity due to suppressed bone marrow function. This occurrence is higher when the medication is taken in combination with ribavirin. It is also more likely when patients are co-infected with HIV. Other serious side effects of Pegasys include heart damage, stroke, liver failure, diabetes, pneumonia, inflammation of the pancreas, vision damage and birth defects. Serious side effects are similar for PEG-Intron and also include stunted growth in pediatric patients, tooth and gum disease, and kidney damage.
Management
The side effects of pegylated interferon can be alleviated with proper management. According to the Pegintron website, there are several tips that can help with the symptoms. The site suggests administering injections at bedtime in order to possibly sleep through most of the flu-like symptoms. The guide also states that patients should eat regularly in order to stay strong as a way to combat the fatigue and weakness brought on by the medication. Over-the-counter pain relievers can help with the flu-like symptoms, but certain drugs like acetaminophen may be toxic to the already compromised liver. Patients should also drink plenty of water and juice, and try to avoid caffeine. The Veterans Affairs Department also provides an extensive list of suggestions for managing pegylated interferon side effects. Their guide book suggests that patients should join a local support group of patients going through the same treatment. Patients can share tips on managing depression, diet, exercise and fatigue.
Combination Therapy
Some side effects can also vary significantly depending on whether patients are taking pegylated interferon alone or in combination with ribavirin. Some side effects become worse in combination therapy while others are lessened. Fatigue, lymphatic disorders, weight loss, anxiety, insomnia and shortness of breath are all made significantly worse in combination therapy. Treatment outcomes are often more successful in combination therapy, but patients should consider the risk of a higher incidence of side effects.
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