Peginterferon Alfa 2A
Indication :
- Chronic Hepatitis B infection
- Hepatitis C infection
Dosing :
Hepatitis C infection:
>5 years:
180 mcg/1.73 m² x BSA SC once weekly (Max: 180 mcg/week) plus
ribavirin. Duration of treatment is 24 weeks for genotype 2 and 3 and 48 weeks for all other genotypes.
Chronic Hepatitis B infection:
180 mcg/1.73 m² x BSA SC once weekly (Max: 180 mcg/week) for 48 weeks.
Adverse Effect :
Infection, headache, fatigue, nausea, vomiting, fever, myalgia, anxiety, asthenia, neutropenia, rigors, injection site reactions.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function. |
| 10-20 | 135 mcg (Pegasys) once weekly. |
| <10 | 135 mcg (Pegasys) once weekly. |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
| HD | Dialysed. Dose as in GFR<10 mL/ min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
Hepatic impairment prior to initiation: Contraindicated in autoimmune hepatitis, hepatic decompensation (Child-Pugh >6 [class B and C]) in cirrhotic patients before treatment, and hepatic decompensation with Child-Pugh =6 in cirrhotic HCV patients coinfected with HIV before treatment.
Hepatic impairment during therapy:
Persistent or increasing ALT elevations =5 times ULN but <10 times ULN:
Chronic hepatitis B: Children =3 years and Adolescents: Decrease dose to 78 mcg/sqm once weekly; monitor ALT weekly to ensure stable or decreasing concentrations.
Chronic hepatitis C: Children =5 years and Adolescents: Decrease dose to 78 mcg/sqm once weekly; monitor ALT weekly; further reduce dose if necessary until stable or ALT decreases.
Persistent ALT values =10 times ULN: Discontinue treatment.