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Rebetron Combination Therapy

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Generic Name: Interferon alfa-2b, Ribavirin
Product Name: Rebetron Combination Therapy

Indication

Rebetron Combination Therapy is used for the treatment of chronic hepatitis C in patients who have not before been treated with alfa interferon therapy, or who have relapsed following alfa interferon monotherapy. Patients must be over the age of 18 with compensated liver disease.

Action

Rebetron Combination Therapy is made up of therapy with Interferon alfa-2b and Ribavirin.
Interferon alfa-2b
Intron A Redipen contains Interferon alfa-2b, a member of the family of interferons, substances that are naturally found in the body. Interferons are involved in the immune response to viral infections and other biological mediators. They are involved in preventing spread of viruses through the body, stopping cells multiplying (eg: tumour cells) and enhancing the effects of other immune cells.
Ribavirin
Ribavirin is an antiviral agent that has been shown to have activity against a number of different viruses. On its own, it has negligible activity against the hepatitis C virus, but when used in combination with Interferon alfa-2b, its effects have been found to increase tenfold. Therefore, in combination therapy, Ribavirin is useful in the removal of hepatitis C DNA and improvement in liver condition and function.

Dose advice

Rebetol capsules are given at a dose of 1000-1200mg daily in divided doses. 3 x 106 IU Intron A should be administered by injection every other day.
Rebetol capsules can be administered without regard to food, but should be given in a consistent manner.
Dose of Rebetol depends on body weight:
– ¡Ã?75kg: 2 x 200mg capsules am, 3 x 200mg capsules pm
– >75kg: 3 x 200mg capsules am, 3 x 200mg capsules pm
The dose of Intron A remains the same for all patients.
Duration of treatment
– patients previously untreated with interferon therapy should be treated for 24-48 weeks
– duration should be individualised depending on clinical response, baseline genotype of hepatitis C virus and viral load
– virological response should be assessed after 24 weeks
– in patients who have relapsed following interferon therapy, the duration of treatment is 24 weeks
Dosage adjustments
– if adverse effects occur, dosage can be reduced
– if intolerance persists after dosage reduction, therapy should be discontinued
Patients with cardiovascular disease
– these patients require different dosage adjustments because they are more sensitive to the haemolysis that may occur
– a permanent dose reduction is required if haemoglobin decreases by 20g/L or more
– a haemoglobin of less than 120g/L for longer than four weeks following dose reduction requires treatment to be discontinued
Treatment of side effects
– paracetamol (500mg-1g) can be administered 30 minutes before administration of Intron A to treat fever
– maximum paracetamol dose is 1g 4 times daily

Schedule

S4

Common side effects

Side effects are more common in people who have never been treated with interferon therapy before. The most common side effects are:
– fever
– rigors
– fatigue
– headache
– muscle aches
– joint aches
– nausea
– diarrhoea
– loss of appetite
– insomnia
– flu-like symptoms
– hair loss
– dizziness
– abdominal pain
– depression
– irritability
– itching skin
– rash

Uncommon side effects

Effects that occur less commonly (ie: <10% of patients) include:
– injection site reaction
– shortness of breath
– dry skin
– dry mouth
– increased sweating
– malaise
– stomach upset
– vomiting
– anxiety
– impaired concentration
– emotional lability
– coughing
– altered sensation of taste
– upper respiratory tract infection
– agitation
– chest pain
– altered sensation/partial loss of sensation
– decrease in weight
– nervousness
– oversleeping
– viral infection
– blurred vision
There are many other rare side effects. Report any new or unusual symptoms to your doctor.


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For further information talk to your doctor.


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Dates

Posted On: 22 July, 2003
Modified On: 1 January, 1970


Created by: myVMC