The Navigation Model of Therapy: Why Awareness Changes Everything
November 16, 2025
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Brand Name :
SYlatron, PEG Intron, PegIntron Redipen
Synonyms :
peginterferon alfa-2b
Class :
Antiviral/Antineoplastic interferons, Hepatitis B/C agents
Brand Name :
SYlatron, PEG Intron, PegIntron Redipen
Synonyms :
peginterferon alfa-2b
Class :
Antiviral/Antineoplastic interferons, Hepatitis B/C agents
Dosage Forms & StrengthsÂ
Prefilled vial/Pen Â
50mcgÂ
80mcgÂ
120mcgÂ
150mcgÂ
Injectable powder, along with diluentÂ
296mcg/vialÂ
444mcg/vialÂ
888mcg/vialÂ
6mcg/kg subcutaneous weekly once for eight weeks, followed by 3mcg/kg subcutaneous weekly once for up to 5 years
Indication: indicated for the adjuvant management of melanoma following definitive surgical resection, including total lymphadenectomy, within 84 days of microscopic or gross nodal involvement
Alternative treatment regimens:
Genotype 1
Simeprevir- 150mg per day for 12 weeks, along with a combination of peginterferon alfa-2b and ribavirin for 24 weeks
Genotype 3
Sofosbuvir, along with a combination of peginterferon alfa-2b and ribavirin for 12 weeks
Genotype 4
150mg per day for 12 weeks, along with a combination of peginterferon alfa-2b and ribav:
Combination therapy:
Genotypes 1, 4, 5, or 6
Optimal regimen: Peginterferon alfa 2b+ ribavarin+ sofosbuvir
1.5mcg/kg subcutaneous weekly once along with ribavirin 1000-1200mg orally per day and sofosbuvir 400mg orally once daily
Note: do not exceed the dose of peginterferon alfa 2b to 150mcg per week
Treatment-naive patients: treated for 12 weeks
Treatment with peginterferon alfa- 2b and ribavirin may be extended to 24 weeks for those who don't respond
If the CrCl is ≤ 50 mL per minute, the dose of ribavirin should be reduced
Dose Adjustments
Renal dose adjustments
Patients receiving alpha interferons for chronic hepatitis C are advised to reduce their dosage by 25% and 50%, respectively, if they have moderate or severe renal dysfunction.
If CrCl is 30-50ml/min, reduce the dose to 25%
If CrCl is 10-29ml/min, reduce the dose to 50%
It has not been investigated how different levels of renal impairment affect peginterferon alfa-2b pharmacokinetics at the suggested doses of 3 mcg/kg or six mcg/kg for melanoma patients.
Hepatic dose adjustments:
Patients with known melanoma and hepatic impairment who are receiving treatment for viral hepatitis should not receive peginterferon alfa-2b because it has not been studied in this population; patients with moderate to severe hepatic impairment (Child-Pugh scores >6) should not receive peginterferon alfa-2b
If hepatic decompensation (Child-Pugh scores >6) develops while on Sylatron, stop the medication.
Dosage Forms & StrengthsÂ
Prefilled vial/Pen Â
50mcgÂ
80mcgÂ
120mcgÂ
150mcgÂ
For children under three years:
Safety study not established
For children of 3- 17 years of age:
60mcg/m2 , subcutaneous every week in combination with ribavirin (15 mg/kg) orally once a day divided into two doses
Note: administer ribavirin on the same day of giving Peginterferon alfa-2b
Refer to adult dosingÂ
may increase the serum concentration of each other when combined
may decrease the diagnostic effect of Immunosuppressants
may decrease the diagnostic effect of Immunosuppressants
may decrease the diagnostic effect of Immunosuppressants
may decrease the diagnostic effect of Immunosuppressants
may decrease the diagnostic effect of Immunosuppressants
may diminish the serum concentration of each other when combined
may diminish the serum concentration of each other when combined
may diminish the serum concentration of each other when combined
may diminish the serum concentration of each other when combined
may diminish the serum concentration of each other when combined
may enhance the serum concentration of CYP3A4 inhibitors
may enhance the serum concentration of CYP3A4 inhibitors
may enhance the serum concentration of CYP3A4 inhibitors
may enhance the serum concentration of CYP3A4 inhibitors
may enhance the serum concentration of CYP3A4 inhibitors
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
acetaminophen and phenyltoloxamine
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
may enhace the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
the effects of fezolinetant may be increased by altering CPY1A2 metabolism
may decrease the therapeutic effects of antiherpetic antivirals
may decrease the therapeutic effects of antiherpetic antivirals
may enhance the severity of adverse effects when combined
may enhance the severity of adverse effects when combined
may enhance the severity of adverse effects when combined
may enhance the severity of adverse effects when combined
may enhance the severity of adverse effects when combined
may decrease the therapeutic effect of each other when combined
may decrease the therapeutic effect when combined with lenograstim
may diminish the therapeutic effect when combined with lipegfilgrastim
may increase the adverse effect when combined with antineoplastic agents
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may increase the serum concentration of each other when combined
may increase the serum concentration of each other when combined
may increase the serum concentration of each other when combined
may increase the serum concentration of each other when combined
may increase the serum concentration of each other when combined
abiraterone acetate and niraparibÂ
may decrease the therapeutic effect of Immunosuppressants
may diminish the effect of each other when combined
may diminish the effect of each other when combined
may diminish the effect of each other when combined
may diminish the effect of each other when combined
sodium picosulfate, citric acid, and magnesium oxide
may diminish the effect of each other when combined
may enhance the serum concentration of P-glycoprotein/ABCB 1 inhibitors
may diminish the metabolism of each other when combined
may diminish the metabolism of each other when combined
may diminish the metabolism of each other when combined
may diminish the metabolism of each other when combined
may diminish the metabolism of each other when combined
may diminish the metabolism of each other when combined
may diminish the metabolism of each other when combined
may diminish the metabolism of each other when combined
the toxicity of either of the drugs is increased due to pharmacodynamic synergism
combination may lead to hepatotoxicity
the toxicity of either of the drugs may be increased
may enhance the severity of adverse effects when combined
may enhance the severity of adverse effects when combined
may decrease the therapeutic effect when combined
may diminish the anti-neoplastic activity of corticosteroids
may diminish the anti-neoplastic activity of corticosteroids
may diminish the anti-neoplastic activity of corticosteroids
may diminish the anti-neoplastic activity of corticosteroids
may diminish the anti-neoplastic activity of corticosteroids
may diminish the anti-neoplastic activity of corticosteroids
may diminish the anti-neoplastic activity of corticosteroids
may diminish the anti-neoplastic activity of corticosteroids
may enhance the hypoglycemic effect of antidiabetic agents
may enhance the hypoglycemic effect of antidiabetic agents
may enhance the hypoglycemic effect of antidiabetic agents
may enhance the hypoglycemic effect of antidiabetic agents
may enhance the hypoglycemic effect of antidiabetic agents
may enhance the hypoglycemic effect
may enhance the hypoglycemic effect
may enhance the hypoglycemic effect
may enhance the hypoglycemic effect
may enhance the hypoglycemic effect
It may diminish the therapeutic efficacy when combined with pegloticase
it may increase the levels of serum concentration
it may increase the levels of serum concentration
it may increase the levels of serum concentration
it may increase the levels of serum concentration
it may increase the levels of serum concentration
antiviral agents (HCV): they may increase the hypoglycemic effect of antidiabetic drugs
may decrease the therapeutic effect of immunosuppressive Agents
measles, mumps, rubella, and varicella vaccine, live 
may decrease the therapeutic effect of immunosuppressive Agents
measles mumps and rubella vaccine, live
may decrease the therapeutic effect of immunosuppressive Agents
may decrease the therapeutic effect of immunosuppressive Agents
smallpox (vaccinia) vaccine, live
may decrease the therapeutic effect of immunosuppressive Agents
the toxicity of either of the drugs is increased due to pharmacodynamic synergism
an alteration in the therapeutic activity of either of the drugs may be seen
an alteration in the therapeutic activity of either of the drugs may be seen
an alteration in the therapeutic activity of either of the drugs may be seen
an alteration in the therapeutic activity of either of the drugs may be seen
an alteration in the therapeutic activity of either of the drugs may be seen
by altering metabolism, the levels of dapsone may be reduced
an alteration in the therapeutic activity of either of the drugs may be seen
an alteration in the therapeutic activity of either of the drugs may be seen
by altering metabolism, the levels of fluvastatin may be reduced
by altering metabolism, the levels of glipizide may be reduced
by altering metabolism, the levels of ibuprofen may be reduced
an alteration in the therapeutic activity of either of the drugs may be seen
an alteration in the therapeutic activity of either of the drugs may be seen
may enhance the severity of gastrointestinal bleeding when combined
may enhance the severity of gastrointestinal bleeding when combined
may enhance the severity of gastrointestinal bleeding when combined
may enhance the severity of gastrointestinal bleeding when combined
may increase the hypoglycemic effect of Antidiabetic Agents
it enhance the risk of pulmonary toxicity
it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates
it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates
it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates
it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates
it may increase the levels of serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates
may increase the hypoglycemic effect of Antidiabetic Agents
may increase the Glucose-lowering effect of Antidiabetic Agents
Actions and spectrum:Â
The recombinant human interferon alfa-2b moiety is the source of peginterferon alfa-2b. Human type 1 interferon receptors dimerize when they attach to and activate them. This triggers the JAK/STAT pathway. Numerous genes involved in the innate antiviral response are expressed more frequently in multiple tissues when the JAK/STAT pathway is activated. The nuclear factor ÎşB pathway may also be activated by peginterferon alfa-2b.
Frequency definedÂ
>10%Â
Depression (16-29%)Â
Inflammation at the site of injection (47%)Â
Fatigue (52%)Â
Insomnia (23%)Â
Fever (22%)Â
Headache (56%)Â
Weight loss (11%)Â
Alopecia (34%)Â
Reactions at the site of injection (62%)Â
Hepatitis C trialsÂ
1-10%Â
Malaise (8%)Â
Pharyngitis (10%)Â
Dermatitis (7%)Â
Rashes (6%)Â
Hepatomegaly (6%)Â
Pain at the site of injection (2%)Â
Sinusitis (7%)Â
Flushing (6%)Â
Vomiting (7%)Â
Melanoma trialsÂ
1-10%Â
Proteinuria (7%)Â
Dyspnea (6%)Â
Cough (5%)Â
Anemia (6%)Â
Frequency not definedÂ
PancreatitisÂ
Aggressive behaviorÂ
DepressionÂ
Suicidal thoughtsÂ
blindnessÂ
Monitor patients closely, as the drug can cause suicidal tendencies.
Contraindication/Caution:Â
Contraindication:Â
HypersensitivityÂ
Decompensated hepatic impairmentÂ
Autoimmune hepatitisÂ
Caution:Â
PancreatitisÂ
IschemiaÂ
Dental disordersÂ
hypertriglyceridemia
Pregnancy consideration:Â Â
USFDA pregnancy category: C (monotherapy)Â
UFDA pregnancy category: X (combination therapy)Â
Lactation:Â Â
Data about the excretion of the drug into human milk is not known. The benefits of administering this drug to breastfeeding mothers should outweigh the risks to the infants.Â
Pregnancy category:Â Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
Category B: There was a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this categoryÂ
Pharmacology:Â
Peginterferon alfa-2b is a recombinant interferonÂ
Pharmacodynamics:Â
Peginterferon alfa-2b causes apoptosis, suppresses cell growth, prevents the replication of viruses in infected cells, and has anti-angiogenic properties. It has immunomodulatory effects that include boosting macrophage phagocytic activity, NK cell activation, cytotoxic T-lymphocyte stimulation, and Th1 T-helper cell subset upregulation.Â
Pharmacokinetics:Â
AbsorptionÂ
After being administered subcutaneously, peginterferon alfa-2b reaches its peak plasma concentration in 15–44 hours. The half-life of absorption is around 4.6 hours on average. Peginterferon alfa-2b’s bioavailability rises with repeated doses, reaching trough concentrations three times higher at week 48 than at week 4.Â
MetabolismÂ
The rate of metabolism may be reduced when in conjugation with PEG (polyethylene glycol)Â
Elimination and excretionÂ
30% of peginterferon alfa-2b is eliminated through urineÂ
Half-life:Â
40 hours
Administration:Â
Administer subcutaneously every week on the same day Â
Patient information leafletÂ
Generic Name: peginterferon alfa- 2bÂ
Why do we use peginterferon alfa- 2b?Â
A purified version of human interferon called peginterferon alfa-2b is used to treat genital warts, certain malignancies, and hepatitis B and C by boosting the innate immune system.
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