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Interferon alfa-2b Side Effects

Medically reviewed by Last updated on Oct 13, 2022.


Commonly reported side effects of interferon alfa-2b include: hemolytic anemia, abdominal pain, cough, depression, dyspnea, fever, flu-like symptoms, nausea, thrombocytopenia, and vomiting. Continue reading for a comprehensive list of adverse effects.

Applies to interferon alfa-2b: injection powder for solution.


Injection route (Solution; Powder for Solution)

Alpha interferons, including interferon alfa-2b, cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Patients should be monitored closely with periodic clinical and laboratory evaluations. Patients with persistently severe or worsening signs or symptoms of these conditions should be withdrawn from therapy. In many but not all cases these disorders resolve after stopping interferon alfa-2b therapy.

Serious side effects of Interferon alfa-2b

Along with its needed effects, interferon alfa-2b may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking interferon alfa-2b:

More common

  • Depression
  • difficult or labored breathing
  • swelling or puffiness of the face
  • tightness in the chest
  • weight loss

Less common

  • Back, leg, or stomach pains
  • bleeding, tender, or enlarged gums
  • bloody, black, or tarry stools
  • bloody nose
  • bloody or cloudy urine
  • blurred vision
  • change in personality
  • changes in behavior
  • chest pain, discomfort, or heaviness
  • chills
  • clay-colored stools
  • confusion as to time, place, or person
  • constipation
  • cough producing mucus
  • coughing or spitting up blood
  • dark urine
  • decreased urination
  • diarrhea
  • difficult or painful urination
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • fainting
  • fast, slow, pounding, irregular, or racing heartbeat or pulse
  • feeling, seeing, or hearing things that are not there
  • feeling that others are watching you or controlling your behavior
  • feeling that others can hear your thoughts
  • fever
  • hallucinations
  • headache
  • hearing loss
  • heavier menstrual periods
  • hives or rash
  • hoarseness or husky voice
  • inability to speak
  • increased thirst
  • increased urination
  • indigestion
  • irritability
  • itching, pain, redness, or swelling of the skin
  • light-colored stools
  • lightheadedness
  • loss of appetite
  • loss of consciousness
  • loss of hearing
  • lower back or side pain
  • metallic taste
  • muscle aches or cramps
  • nausea or vomiting
  • pale skin
  • passing of gas
  • pinpoint red spots on the skin
  • seizures
  • severe mood or mental changes
  • severe stomach pain with nausea and vomiting
  • slow speech
  • sneezing
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • stiffness of the limbs
  • stomach cramps, tenderness, or discomfort
  • stomach pain, continuing
  • stomach upset
  • sweating
  • swelling around the eyes
  • swelling of the face, fingers, hands, ankles, feet, or lower legs
  • swollen, painful, or tender lymph glands in the neck, armpit, or groin
  • thoughts of hurting or killing oneself
  • trouble sleeping
  • unusual behavior
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weight gain
  • yellowing of the eyes or skin

Other side effects of Interferon alfa-2b

Some side effects of interferon alfa-2b may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Acid or sour stomach
  • bleeding gums
  • blistering, crusting, irritation, itching, or reddening of the skin
  • body aches or pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in taste, or bad, unusual, or unpleasant (after) taste
  • cracked, dry, or scaly skin
  • hair loss or thinning of the hair
  • irritation in the mouth
  • joint pain
  • lack or loss of strength
  • loss of memory
  • muscle or bone pain
  • pain or tenderness around the eyes and cheekbones
  • poor concentration
  • problems with memory
  • redness and swelling of the gums
  • stuffy or runny nose
  • swollen joints

Less common

  • Abnormal ejaculation
  • absent, missed, or irregular menstrual periods
  • bleeding, burning, inflammation, itching, or pain at the injection site
  • bone deformity
  • burning, itching, and pain in the hairy areas, pus at the root of the hair
  • burning, numbness, pain, or tingling in all fingers except smallest finger
  • cold and clammy skin
  • decrease in height
  • decreased interest in sexual intercourse
  • degenerative disease of the joint
  • difficulty with moving or walking
  • discoloration of the skin
  • inability to have or keep an erection
  • increased clear or white vaginal discharge
  • increased sensitivity of the skin to sunlight
  • itching or pain of the genital area
  • leg cramps
  • longer menstrual periods
  • loss in sexual ability, desire, drive, or performance
  • multiple swollen and inflamed skin lesions
  • pain in the ankles or knees
  • pain in the ribs
  • pain, inflammation, or swelling in the calves, shoulders, or hands
  • painful, red lumps under the skin, mostly on the legs
  • pelvic pain
  • rash with flat lesions or small raised lesions on the skin
  • red or irritated eyes
  • redness or swelling in the arms or legs
  • redness, tenderness, itching, burning, or peeling of the skin
  • severe sunburn
  • shivering
  • skin rash, encrusted, scaly, and oozing small lumps under the skin
  • small lumps under the skin
  • soreness of the muscles
  • stopping of menstrual bleeding
  • swelling or redness in the joints
  • tanning or blue-gray discoloration of the skin
  • tearing of the eyes
  • underactive reflexes
  • unexpected menstrual bleeding

For Healthcare Professionals

Applies to interferon alfa-2b: injectable kit, injectable powder for injection, injectable solution.


Clinical trials were conducted for various indications using a wide range of doses (from 6 million international units/m2/week in hairy cell leukemia up to 100 million international units/m2/week in melanoma). Most side effects reported during clinical trials were mild to moderate in severity and manageable. Some side effects were transient and most diminished with continued therapy. Influenza-like symptoms (mainly fever, headache, rigors/chills, myalgia, malaise, and fatigue) were reported most often; these side effects were reversible within 72 hours after interrupting or stopping therapy. Side effects were dose-related. In general, more severe toxicities were observed at higher doses; hematologic, hepatic, cardiovascular, and neurologic toxicities were more common with higher doses.

The manufacturer product information for ribavirin should be consulted, if applicable.[Ref]


Very common (10% or more): Fatigue (up to 96%), pyrexia (up to 94%), influenza-like symptoms (up to 79%), asthenia (up to 63%), chills (up to 54%), rigors (up to 42%), chest pain (up to 28%), irritability (up to 22%), unspecified pain (up to 18%), moniliasis (up to 17%), malaise (up to 14%), decreased weight (up to 13%), viral infection

Common (1% to 10%): Facial edema, nonspecific infection, peripheral edema, herpes simplex resistance, thirst, flushing, breast pain

Uncommon (0.1% to 1%): Bacterial infection

Rare (0.01% to 0.1%): Sepsis, resistance mechanism disorders (e.g., altered resistance to infection [rarely life-threatening or fatal]), weakness

Very rare (less than 0.01%): Cachexia, earache, hot flashes/flushes, fungal infection, malignant hyperpyrexia

Frequency not reported: Hernia, edema, hypothermia, nonspecific inflammation, mastitis, increased weight, substernal chest pain, hyperthermia, abscess, Haemophilus, infection, parasitic infection, otitis media, Trichomonas

Postmarketing reports: Asthenic conditions (including asthenia, malaise, fatigue)[Ref]


Very common (10% or more): Decreased granulocyte count (up to 92%), neutropenia (up to 92%), decreased WBC count (up to 68%), decreased hemoglobin (up to 32%), anemia (up to 27%), decreased platelet count (up to 15%), leukopenia

Common (1% to 10%): Thrombocytopenia, bleeding, lymphadenopathy, lymphopenia

Very rare (less than 0.01%): Aplastic anemia, pure red cell aplasia, hemolytic anemia, coagulation disorder, splenomegaly

Frequency not reported: Hypochromic anemia, granulocytopenia, lymphadenitis, lymphocytosis, thrombocytopenia purpura

Postmarketing reports: Pancytopenia (concurrent anemia, leukopenia, thrombocytopenia), idiopathic thrombocytopenia purpura, thrombotic thrombocytopenic purpura[Ref]

Aplastic anemia and pure red cell aplasia have also been reported during postmarketing experience.[Ref]


Very common (10% or more): Myalgia (up to 75%), musculoskeletal pain (up to 21%), arthralgia (up to 19%), back pain (up to 19%)

Common (1% to 10%): Arthritis

Rare (0.01% to 0.1%): Rhabdomyolysis (sometimes serious), myositis, leg cramps

Very rare (less than 0.01%): Arthrosis, bone pain, muscle weakness, myopathy

Frequency not reported: Arthritis aggravated, bone disorder, carpal tunnel syndrome, muscle atrophy, tendinitis, rheumatoid arthritis (new or aggravated), spondylitis, twitching[Ref]

Myositis has also been reported during postmarketing experience.[Ref]


Very common (10% or more): Anorexia (up to 69%), increased alkaline phosphatase (up to 13%)

Common (1% to 10%): Hypocalcemia, dehydration, hyperuricemia

Uncommon (0.1% to 1%): Increased LDH

Rare (0.01% to 0.1%): Diabetes mellitus, hyperglycemia, increased appetite

Very rare (less than 0.01%): Acidosis, aggravation of diabetes mellitus, hypercalcemia, hypertriglyceridemia

Frequency not reported: Alcohol intolerance[Ref]


Pancreatitis has also been reported during postmarketing experience.[Ref]

Very common (10% or more): Nausea (up to 66%), diarrhea (up to 45%), vomiting (up to 32%), dry mouth (up to 28%), abdominal pain (up to 23%), right upper quadrant pain (up to 15%), constipation (up to 14%), gingivitis (up to 14%), stomatitis, dyspepsia

Common (1% to 10%): Loose stools, gastrointestinal (GI) disorder, ulcerative stomatitis, glossitis

Rare (0.01% to 0.1%): Gingival bleeding

Very rare (less than 0.01%): Abdominal distension, colitis, dysphagia, eructation, esophagitis, flatulence, gastric ulcer, GI hemorrhage, GI mucosal discoloration, gum hyperplasia, ileus, increased saliva, ischemic colitis, melena, oral leukoplakia, pancreatitis, rectal bleeding after stool, rectal hemorrhage, tenesmus, tongue disorder, ulcerative colitis

Frequency not reported: Abdominal ascites, gallstones, gastritis, gastroenteritis, halitosis, hemorrhoids, intestinal disorder, mouth ulceration, mucositis, oral hemorrhage, tooth disorder, periodontal disorder (not otherwise specified), dental disorder (not otherwise specified)[Ref]


Very common (10% or more): Elevated AST (up to 63%), elevated ALT (up to 15%)

Common (1% to 10%): Hepatomegaly

Rare (0.01% to 0.1%): Hepatotoxicity (including fatality)

Very rare (less than 0.01%): Abnormal hepatic function tests, bilirubinemia, hepatic encephalopathy, hepatic failure, hepatosplenomegaly, jaundice

Frequency not reported: Biliary pain, hepatitis, increased transaminases (AST/ALT), worsening liver disease[Ref]

Worsening liver disease, including jaundice, hepatic encephalopathy, hepatic failure, and death have been reported after use of this drug in patients with decompensated liver disease, autoimmune hepatitis, or history of autoimmune disease, and in immunosuppressed transplant recipients.[Ref]

Nervous system

Very common (10% or more): Headache (up to 62%), somnolence (up to 33%), dizziness (up to 24%), altered taste/taste perversion (up to 24%), paresthesia (up to 21%), impaired concentration (up to 14%), amnesia (up to 14%)

Common (1% to 10%): Hypoesthesia, vertigo, tremor, migraine, tinnitus

Uncommon (0.1% to 1%): Peripheral neuropathy

Rare (0.01% to 0.1%): Impaired consciousness, neuropathy, polyneuropathy, seizure

Very rare (less than 0.01%): Abnormal coordination, abnormal gait, aphasia, ataxia, central nervous system dysfunction, cerebrovascular hemorrhage, cerebrovascular ischemia, coma, convulsions, deafness, dementia, dystonia, encephalopathy, extrapyramidal disorder, hearing disorder, hearing loss, hyperacusis, hyperesthesia, hyperkinesia, hypertonia, oculomotor nerve paralysis, paralysis, paresis, speech disorder, stupor, syncope, taste loss

Frequency not reported: Bell's palsy, hearing impairment, hypokinesia, hyporeflexia, labyrinthine disorder, loss of consciousness, mononeuropathies, neuralgia, neuritis, parosmia, stroke, frontal subcortical dementia, choreic movements mimicking Huntington's disease[Ref]

Impaired consciousness included cases of encephalopathy.

Frontal subcortical dysfunction and choreic movements of the limbs appeared in a 68-year-old woman almost 2 years after the start of interferon alfa-2b (3 x 10[6] units/day) for chronic myeloid leukemia. She had no history of psychiatric disorders and no hereditary neurodegenerative disease with long-term recombinant interferon therapy. Symptoms of personality changes, short memory loss, and choreic movements progressively worsened over a 4 month period until she became bedridden. One month after this drug was discontinued, patient's cognitive performance had improved and choreic movements had disappeared. Clinical examination of her cognitive performances at six and 12 months later were normal.

Peripheral neuropathy and hearing loss have also been reported during postmarketing experience.[Ref]


Very common (10% or more): Depression (up to 40%), confusion (up to 12%), insomnia (up to 12%), anxiety, emotional lability, nervousness, agitation

Common (1% to 10%): Decreased libido, sleep disorder

Uncommon (0.1% to 1%): Suicidal ideation, suicide attempt, suicide

Rare (0.01% to 0.1%): Aggressive behavior (sometimes directed against others), psychosis (including hallucinations)

Very rare (less than 0.01%): Abnormal thinking, apathy, depression aggravated, feeling of ebriety, neurosis, paroniria, personality disorder

Frequency not reported: Abnormal dreaming, delirium, manic depression, mania, psychosis, mental status change, bipolar disorders

Postmarketing reports: Homicidal ideation[Ref]

Psychosis (including hallucinations) has also been reported during postmarketing experience.[Ref]


Case reports of aseptic necrosis of the skin and ulceration have been described in patients with Kaposi's sarcoma associated with HIV infection treated with this drug.

Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and urticaria have also been reported during postmarketing experience.[Ref]

Very common (10% or more): Alopecia (up to 38%), rash (up to 25%), increased sweating (up to 21%), pruritus (up to 11%), dry skin

Common (1% to 10%): Dermatitis, purpura, herpes simplex, psoriasis (new or aggravated), maculopapular rash, erythematous rash, eczema, erythema, skin disorder

Very rare (less than 0.01%): Abnormal hair texture, acne, chloasma, dermatitis lichenoides, epidermal necrolysis, erythema multiforme, furunculosis, increased hair growth, melanosis, nail disorders, nonherpetic cold sores, photosensitivity, skin depigmentation, skin discoloration, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, vitiligo

Frequency not reported: Cellulitis, cold and clammy skin, erythema nodosum, folliculitis, herpes zoster, lipoma, pallor, sebaceous cyst, skin nodule, urticaria, hair discoloration, trichomegaly, radiation recall dermatitis (manifested as erythematous macular rash in region of irradiation), aseptic necrosis of the skin and ulceration, lipoatrophy, cutaneous vasculitides[Ref]


Very common (10% or more): Dyspnea (up to 34%), coughing (up to 31%), pharyngitis (up to 31%), sinusitis (up to 21%), nonproductive cough (up to 14%)

Common (1% to 10%): Nasal congestion, bronchitis, rhinitis, epistaxis, respiratory disorder, rhinorrhea

Rare (0.01% to 0.1%): Pneumonia, pulmonary infiltrates, pneumonitis

Very rare (less than 0.01%): Bronchospasm, hypoxia, laryngitis, pleural pain, pulmonary edema, pulmonary embolism, pulmonary fibrosis, sneezing, stridor, wheezing

Frequency not reported: Asthma, dysphonia, hemoptysis, hypoventilation, pleural effusion, orthopnea, pneumothorax, pulmonary arterial hypertension, rales, respiratory insufficiency, tonsillitis, tracheitis, upper respiratory tract infection, severe asthma

Postmarketing reports: Pulmonary hypertension[Ref]

Pulmonary arterial hypertension (PAH) has been reported with alpha interferons, particularly in patients with risk factors for PAH (e.g., portal hypertension, HIV infection, cirrhosis). Such events occurred at various time points normally several months after starting interferon alfa therapy.

Severe asthma developed in 2 patients as soon as 8 weeks after the start of this drug in patients diagnosed with chronic hepatitis C and mild asthma.

Pulmonary fibrosis has also been reported during postmarketing experience.[Ref]


Very common (10% or more): Injection site inflammation (up to 20%), injection site reaction

Common (1% to 10%): Injection site pain

Rare (0.01% to 0.1%): Injection site disorders

Very rare (less than 0.01%): Injection site necrosis

Frequency not reported: Burning, injection site bleeding, itching[Ref]

Injection site necrosis has also been reported during postmarketing experience.[Ref]


Nephrotic syndrome, renal failure, and renal insufficiency have also been reported during postmarketing experience.

Very common (10% or more): Increased serum urea nitrogen levels (up to 12%)

Common (1% to 10%): Increased serum creatinine

Rare (0.01% to 0.1%): Renal failure, renal insufficiency

Very rare (less than 0.01%): Nephrotic syndrome, nephrosis


Very common (10% or more): Amenorrhea (up to 12%)

Common (1% to 10%): Polyuria, urinary tract infection, micturition frequency, dysmenorrhea, menorrhagia, menstrual disorder, vaginal disorder

Very rare (less than 0.01%): Cystitis, hematuria, impotence, leukorrhea, micturition disorder, nocturia, oliguria, urinary incontinence, uterine bleeding, vaginal hemorrhage

Frequency not reported: Albumin/protein in urine, dysuria, genital pruritus, incontinence, menstrual irregularity, pelvic pain, penis disorder, scrotal/penile edema, sexual dysfunction, vaginal dryness[Ref]


Serous retinal detachment has also been reported during postmarketing experience.[Ref]

Very common (10% or more): Blurred vision

Common (1% to 10%): Conjunctivitis, abnormal vision, eye pain, lacrimal gland disorder

Rare (0.01% to 0.1%): Retinal hemorrhage, retinopathies (including macular edema), retinal artery or vein obstruction, optic neuritis, papilledema, loss of visual acuity or visual field, cotton wool spots

Very rare (less than 0.01%): Diplopia, dry eyes, night blindness, periorbital edema, photophobia, retinal disorder, serous retinal detachment, stye

Frequency not reported: Lacrimation, nystagmus

Postmarketing reports: Vogt-Koyanagi-Harada syndrome[Ref]


Common (1% to 10%): Hypertension, palpitations, tachycardia

Uncommon (0.1% to 1%): Hypotension

Rare (0.01% to 0.1%): Cardiomyopathy, peripheral ischemia

Very rare (less than 0.01%): Angina pectoris, arrhythmia, atrial fibrillation, bradycardia, cardiac failure, cardiac ischemia, cyanosis, extrasystoles, myocardial infarction, postural hypotension, thrombophlebitis

Frequency not reported: Arteritis, cardiomegaly, coronary artery disorder, cyanosis of the hand, heart valve disorder, hematoma, phlebitis, poor peripheral circulation, polyarteritis nodosa, Raynaud's disease, superficial phlebitis, thrombosis, varicose vein, vasculitis, congestive heart failure, pericardial effusion[Ref]

Cardiovascular side effects (especially arrhythmia) appeared to be associated with preexisting cardiovascular disease and prior use of cardiotoxic agents.[Ref]


Common (1% to 10%): Hypothyroidism, hyperthyroidism

Very rare (less than 0.01%): Gynecomastia, virilism

Frequency not reported: Goiter, increased thyroid-stimulating hormone levels

Postmarketing reports: Hypopituitarism[Ref]


A broad range of autoimmune and immune-mediated disorders have been reported with alpha interferons including thyroid disorders, systemic lupus erythematosus, rheumatoid arthritis (new or aggravated), idiopathic and thrombotic thrombocytopenic purpura, vasculitis, neuropathies (including mononeuropathies), and Vogt-Koyanagi-Harada syndrome.

Sarcoidosis and exacerbation of sarcoidosis have also been reported during postmarketing experience.[Ref]

Very rare (less than 0.01%): Sarcoidosis, exacerbation of sarcoidosis, increased gamma globulins, transplant rejection

Frequency not reported: Autoimmune disorders, immune-mediated disorders

Postmarketing reports: Systemic lupus erythematosus[Ref]


Frequency not reported: Allergic reaction

Postmarketing reports: Acute hypersensitivity reactions (including anaphylaxis, angioedema, urticaria, bronchoconstriction)


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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.