Rebif

Generic Name: interferon beta-1a (in ter FEAR on BAY tah 1a)
Brand Names: Avonex, Avonex Prefilled Syringe, Rebif

What is Rebif?

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Rebif (interferon beta-1a) is a protein identical to one found in the body. Interferon beta-1a is made from human proteins. Interferons help the body fight viral infections.

Rebif is used to treat relapsing multiple sclerosis (MS). This medication will not cure MS, it will only decrease the frequency of relapse symptoms.

Rebif may also be used for other purposes not listed in this medication guide.

Important information about Rebif

This medication may be harmful to an unborn baby, or may cause a miscarriage. Do not use Rebif if you are pregnant. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Before using Rebif, tell your doctor if you are allergic to any drugs, or if you have liver disease, a thyroid disorder, epilepsy or other seizure disorder, heart disease, chest pain (angina), congestive heart failure, a heart rhythm disorder, or a history of depression or suicidal behavior.

Some patients using interferon medications have become very depressed or had thoughts of suicide. Stop using Rebif if you have symptoms of depression (sadness, crying, loss of interest in things you once liked) or if you have any thoughts of hurting yourself. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

To be sure this medication is not causing harmful effects, your blood and liver function will need to be tested on a regular basis. Your thyroid function may also need to be tested. Do not miss any scheduled appointments.

Before using Rebif

Do not use this medication if you are allergic to interferons or human albumin. Some patients using interferon medications have become very depressed or had thoughts of suicide. Stop using Rebif if you have symptoms of depression (sadness, crying, loss of interest in things you once liked) or if you have any thoughts of hurting yourself.

Before using Rebif, tell your doctor if you are allergic to any drugs, or if you have:

• liver disease;

• epilepsy or other seizure disorder;

• heart disease, chest pain (angina), congestive heart failure, or a heart rhythm disorder;

• a thyroid disorder; or

• a history of depression or suicidal behavior.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use Rebif.

FDA pregnancy category C. This medication may be harmful to an unborn baby, or may cause a miscarriage. Do not use Rebif if you are pregnant. Tell your doctor if you become pregnant during treatment. It is not known whether Rebif passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Rebif is made from human plasma (part of the blood) and may contain viruses and other infectious agents that can cause disease. Although donated human plasma is screened, tested, and treated to reduce the risk of it containing anything that could cause disease, there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of using this medication.

How should I use Rebif?

Rebif is available in ready-to-use, pre-measured, pre-filled syringes and requires no needle assembly. Rebif is given as an injection under the skin or into a muscle. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home.

Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Rebif is injected into a muscle of the thigh, the outer surface of your upper arm, your stomach or buttocks. Do not use the area near your navel or waistline. Use a different site each time you inject (thigh, hip, stomach or upper arm). Do not inject Rebif into an area of your body where the skin is irritated, reddened, bruised, infected or abnormal in any way. This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Use each syringe only one time. Throw away used syringes in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

To be sure Rebif is not causing harmful effects, your blood and liver function will need to be tested on a regular basis. Your thyroid function may also need to be tested. Do not miss any scheduled visits to your doctor.

Rebif should be stored refrigerated between 2-8°C (36-46°F). DO NOT FREEZE. If a refrigerator is not available, Rebif may be stored at or below 25°C/77°F for up to 30 days and away from heat and light. You may take the prefilled syringe out of the refrigerator and allow it to reach room temperature before giving the injection. Do not heat the medicine before using.

Throw away any Rebif that has become frozen or has been exposed to light or high heat.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of this medication.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of an Rebif overdose are not known.

What should I avoid while using Rebif?

Avoid drinking alcohol while using Rebif. Alcohol may increase your risk of liver damage.

Interferons can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Rebif side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

• depressed mood, anxiety, trouble sleeping, restlessness, or thoughts of suicide or hurting yourself;

• easy bruising or bleeding, weakness;

• seizure (convulsions);

• numbness or tingling in your hands or feet;

• pain or burning when you urinate;

• pain, swelling, or skin changes where the injection was given;

• fever, chills, body aches, flu symptoms; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• headache, dizziness;

• stomach pain; or

• runny or stuffy nose.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Rebif?

Rebif can be harmful to your liver, and these effects are increased when Rebif is used together with other medicines that can harm the liver. Before using this medication, tell your doctor if you are also using:

• acetaminophen (Tylenol);

• cancer medications;

• tuberculosis medications;

• birth control pills or hormone replacement therapy;

• methotrexate (Rheumatrex, Trexall);

• arthritis medications such as auranofin (Ridaura) or aurothioglucose (Solganol);

• an antibiotic;

• HIV/AIDS medications;

• cholesterol medications such atorvastatin (Lipitor), simvastatin (Zocor), and others;

• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), lisinopril (Prinivil, Zestril), and others;

• an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), indomethacin (Indocin), and others; or

• seizure medications such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), or valproic acid (Depakene).

This list is not complete and there may be other drugs that can interact with Rebif. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your doctor or pharmacist can provide more information about Rebif.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with other, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2008 Cerner Multum, Inc. Version: 3.01. Revision Date: 03/05/2008 4:47:37 PM.

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