Peginterferon Alfa-2b (Sylatron™)
Last Modified: January 11, 2016
Pronounced: peg-IN-ter-FEER-on AL-fa
Classification: Biologic Response Modifier
About Peginterferon Alfa-2b
Interferon-alpha is a type of medication called a biologic response modifier. It is a type of protein called a cytokine that works to increase the function of various components of the body's immune system. This protein is normally produced in the body, but in small amounts. By increasing the levels of interferon, the immune system gets a kick-start, mounting an attack against the cancer cells, which are seen as foreign invaders. In addition, interferon-alpha is able to interfere with the cancer cell's ability to divide.
Peginterferon alfa-2b starts with the medication interferon alfa-2b and covers it with a protective coating, which allows it to avoid destruction by the body's immune system and remain in the body for a longer amount of time. As a result, peginterferon alfa-2b is given weekly as opposed to interferon alfa-2b, which is given 3 times a week.
How to Take Peginterferon Alfa-2b
Peginterferon Alfa-2b is given as an injection under the skin (subcutaneous injection), once a week. The actual dose is based on your body size.
Storage and Handling
Peginterferon alfa-2a should be stored at room temperature. Do not refrigerate or freeze the medication. Do not throw the vials, syringes, or needles in the household trash. Dispose of all used needles and syringes in a puncture-proof disposable container with a lid. The FDA provides further information about the disposal of vials, syringes and needles. Keep the vials out of the reach of children.
Where do I get this medication?
Depending on your insurance coverage, you may receive this medication at your doctor’s office or at home. You or a caregiver will be taught how to give injections if you are receiving this medication at home. If you receive this medication at home it will be supplied by a home infusion company or through a specialty pharmacy. Your oncology team will work with your prescription drug plan to identify an in-network specialty pharmacy for distribution of this medication and shipment directly to your home.
This medication may be covered under your major medical or your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources, if they are available.
Possible Side Effects of Peginterferon Alfa-2b
There are a number of things you can do to manage the side effects of peginterferon alfa-2b. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Flu-like syndrome occurs in a majority of patients because of the "revving-up" of the immune system. It generally occurs within hours of the injection and includes fever, chills, headache, muscle and joint aches, and poor appetite. Medications, such as acetaminophen, can be used to manage these symptoms. Try to keep warm with blankets and warm clothes, and drink plenty of non-alcoholic fluids. Some patients find that taking the dose before bedtime allows them to sleep through the flu-like symptoms. These symptoms do decrease, for some patients, over time on the therapy.
Peginterferon alfa has been reported to cause mood disturbances, depression, anxiety, aggressive behavior, suicidal thoughts, and even suicide. You (or your caregiver) should contact your healthcare provider immediately if you have signs of depression, including extreme sadness, crying, changes in mood, loss of interest in activities, or thoughts of hurting yourself.
Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.
Decrease in Appetite
Nutrition is an important part of your care. Cancer treatment can affect your appetite and, in some cases, the side effects of treatment can make eating difficult. Ask your nurse about nutritional counseling services at your treatment center to help with food choices.
- Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals.
- If you are not eating enough, nutritional supplements may help.
- You may experience a metallic taste or find that food has no taste at all. You may dislike foods or beverages that you liked before receiving cancer treatment. These symptoms can last for several months or longer after treatment ends.
- Avoid any food that you think smells or tastes bad. If red meat is a problem, eat chicken, turkey, eggs, dairy products and fish without a strong smell. Sometimes cold food has less of an odor.
- Add extra flavor to meat or fish by marinating it in sweet juices, sweet and sour sauce or dressings. Use seasonings like basil, oregano or rosemary to add flavor. Bacon, ham and onion can add flavor to vegetables.
This medication can cause hypothyroidism (under active thyroid) and hyperthyroidism (over active thyroid). Your doctor will perform blood tests to check the function of your thyroid and treat this side effect if it develops. Symptoms of thyroid problems include: tiredness, feeling hot or cold, change in your voice, weight gain or loss, hair loss and muscle cramps.
High Blood Sugar
This medication can cause elevated blood sugar levels in patients with and without diabetes. Your healthcare team will monitor your blood sugar. If you develop increased thirst, urination or hunger, blurry vision, headaches or your breath smells like fruit, notify your healthcare team. Diabetics should monitor their blood sugar closely and report elevations to the healthcare team.
This medication can cause liver toxicity, which your doctor may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown or pain in your abdomen, as these can be signs of liver toxicity.
While receiving peginterferon alfa-2b, some patients may develop a decrease or loss of vision, retinopathy, retinal hemorrhages and other rare eye problems. You should have a baseline eye exam before starting this medication. Notify your healthcare team if you develop any eye pain, swelling, redness or any vision changes, including blurriness and sensitivity to light.
Peginterferon alfa-2b can cause or worsen pre-existing heart problems including low blood pressure, arrhythmia, cardiomyopathy, and heart attack. Notify your healthcare provider if you have sudden weight gain or swelling in the ankles or legs. If you develop chest pain or pressure, pain in the left arm, back, or jaw, sweating, shortness of breath, clammy skin, nausea, dizziness or lightheadedness, call 911 or go to the nearest emergency room.
Injection Related Reactions
In some cases, patients can have an allergic reaction to this medication. Signs of a reaction can include: shortness of breath or difficulty breathing, rash, itching, swelling in the face, lips or throat. Let your care team know immediately if you develop any signs of a reaction.
You may experience redness or swelling at the injection site. Rotate injection sites. Notify your care provider if the injection site is painful or warm, as these can be signs of infection.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.