Interferon, the name of western medicine, is a classglycoproteinIt has a high species specificity, so the animal interferon has no effect on human. Interferon has antiviral, inhibiting cell proliferation, regulating immunity and anti-tumor effects.[1]
Common dosage forms include injection (powder), etc.For malignant tumors: including hairy cell leukemia, chronic leukemia, non Hodgkin's lymphoma, myeloma, bladder cancer, advanced metastatic renal cancer of ovarian cancer, malignant endocrine tumor of pancreas, melanoma, Kaposi sarcoma, etc.For viral skin diseases: such as condyloma acuminatum, herpes simplex, genital herpes and herpes zoster.It is used for some inflammatory skin diseases, such as Behcet's disease, hereditary allergic dermatitis, keloids, scleroderma, annular granuloma, etc.[4]
Drug name
interferon
Foreign name
Interferon，IFN[2]
alias
IFN
Prescription or not
yes
Mainly applicable
Malignant tumor, used together with other anti-tumor drugs, as an auxiliary therapeutic agent for radiotherapy, chemotherapy and surgery, viral skin diseases, skin tumors, some inflammatory skin diseases, eye tumors[4]
Main drugs
Allergic person;Severe heart, liver or kidney dysfunction;Prohibited for myelosuppressor[4]
Dosage form
injection[3]
Whether included
yes
Science popularization in China
Committed to authoritative science communication
The certification expert of this term is
Zhang Zheng|Pharmacist in charge
Pharmacy Department of Beijing Chaoyang Hospitalto examine
Qiu Kui|Pharmacist in charge
Pharmacy Department of Beijing Chaoyang Hospitalto examine
Malignant tumor, used together with other anti-tumor drugs, as auxiliary therapeutic agent for radiotherapy, chemotherapy and surgery, viral dermatosis, skin tumor, some inflammatory dermatosis, eye tumor[4]
Main drug contraindications
Allergic person;Severe heart, liver or kidney dysfunction;Prohibited for myelosuppressor[4]
Dosage form
injection[3]
Whether included in medical insurance
yes
Drug type
Immune stimulants[3]
component
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The main component of this product is interferon.
character
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The general character of this product is injection (powder).
indication
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1. Malignant tumors: including hairy cell leukemia, chronic leukemia, non Hodgkin's lymphoma, myeloma, bladder cancer, advanced metastatic renal cancer of ovarian cancer, malignant endocrine tumor of pancreas, melanoma, Kaposi sarcoma, etc.
2. Used together with other anti-tumor drugs.
3. As an adjuvant for radiotherapy, chemotherapy and surgery.
4. Viral diseases.
5. Viral skin diseases: such as condyloma acuminatum, herpes simplex, genital herpes and herpes zoster.
6. Skin tumors: such as skin T-cell lymphoma (CTCL), malignant melanoma, Kaposi sarcoma, solar dermatitis, basal cell carcinoma, squamous cell carcinoma, etc.
7. Some inflammatory skin diseases: such as Behcet's disease, hereditary allergic dermatitis, keloids, scleroderma, annular granuloma, etc.
8. Eye tumor.
Specifications
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Injection (lyophilized powder): 1 million U;3 million U;5 million U;10 million U;30 million U.
Usage and dosage
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1. Subcutaneous injection:
(1) For multiple myeloma, the initial dose is 2 million U/mtwo, 3 times a week (or once every other day) can gradually increase to the maximum tolerance of 5 million to 10 million U/m according to the tolerancetwo, 3 times a week.
(2) For hair cell leukemia, the initial dose is 2 million U/mtwo, 3 times a week (or once every other day). The dose can be adjusted according to tolerance;Within one month of treatment, one or several hematological indicators can be normalized. The improvement of granulocyte, platelet count and hemoglobin may take more than 6 months, which is equally effective for patients with unresectable spleen as for patients with resected spleen.
(3) For chronic myeloid leukemia, 4 million to 5 million U/m per daytwoAfter the condition is controlled, it can be changed once every other day.
(4) For chronic hepatitis B, the initial dose is 35 million U per week, 5 million U per day or 10 million U every other day;You can also take prednisone 60mg once a day for two consecutive weeks, then 40mg once a day for two consecutive weeks, and then 20mg once a day for two consecutive weeks. After stopping the drug for two more weeks, you can start the treatment with this drug and inject 5 million U subcutaneously every day;The above schemes shall be administered for 4 months;For chronic non-A, non-B hepatitis, the initial dose is 1 million to 5 million U per day for at least 4 months.
(5) For chronic hepatitis D, the initial dose is 5 million U/mtwo3 times a week for at least 3-4 months.
(6) 10 million U/m for malignant melanomatwo, 3 times a week (or once every other day), and the median time of significant effect is about 2 months.
2. Intravenous infusion: for kaposi sarcoma, 50 million U/m per daytwo, intravenous drip for 30 minutes, continuous for 5 days, and start the next 5-day course at least every 9 days.
3. Local injection: for condyloma acuminatum, first use ethanol pad to clean the focus, then use No. 30 fine needle to inject at the bottom of the focus, once every other day, 0.1-0.5ml of sterile isotonic injection containing 1 million U of the drug is injected each time, for three consecutive weeks, and five lesions can be treated at a time.The maximum weekly dose should not exceed 15 million U.
Adverse reactions
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1. Systemic reaction: mainly manifested as influenza like symptoms, namely, chills, fever and discomfort.Dose exceeds 44 × 10fourU/mtwoFever can occur 2-6 hours after injection.With the prolongation of the course of treatment, the fever can be gradually reduced, and generally it can stop after 7 days.To avoid fever, acetaminophen can be used prophylactically.If still hot, contact IFNαIt is related to impurities and should not be reused.
2. Myelosuppression: leukopenia, thrombocytopenia and reticulocytosis may occur in the course of medication.Reduce the dosage by 8.5 × 10fourU/mtwoThe following can reduce the occurrence of myelosuppression.
3. Local reaction: some patients may have erythema and tenderness at the injection site, which will subside after 24 hours.
4. Others: alopecia, rash, ESR acceleration, lethargy, transient liver injury.Allergic shock is occasionally seen, and allergy test should be conducted before use.
5. Dyspnea, decreased liver function, allergic reaction, elevated serum creatinine, general fatigue, alopecia, nasal congestion, epistaxis, epithelial atrophy, somnolence and even seizures.
6. It is rare to have depression, consciousness disorder, weight loss, rash, alopecia, local reaction after administration, abnormal sensation, dyspnea, herpes simplex, eye pain, tachycardia, anxiety, pruritus, cough, hypertension, hypoesthesia, abdominal pain, pharyngitis, etc.
7. The adverse reaction of cardiovascular system, especially arrhythmia, seems to be related to the original cardiovascular disease and the treatment of previous cardiac toxicity.When the dose is more than 10 million U per day, transaminase increases, granulocyte and platelet counts decrease, and it can recover quickly when the drug is stopped or reduced.In other cases, leukopenia and serum creatinine, LDH and alkaline phosphatase increased.
taboo
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Allergic person;Severe heart, liver or kidney dysfunction;Bone marrow suppressor.
matters needing attention
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1. Pregnant women, lactating women and patients under 18 years of age should be cautious.
2. Patients with a history of heart disease, myocardial infarction or arrhythmia should be cautious.ECG should be checked before or during medication.
3. Patients with advanced compensatory cirrhosis, esophageal varices bleeding, ascites, decreased platelet count, increased total bilirubin level, prolonged prothrombin time, or decreased plasma albumin level should not take prednisone orally before using this drug, but should use this drug with caution and be closely monitored.
4. Allergy test shall be conducted before use to prevent allergic reaction.In case of allergic reaction, the drug should be stopped immediately.
5. Moderate to severe adverse reactions may require changes in the dosage scheme, and in some cases, the drug should be stopped.
6. Hypotension in some patients may be related to fluid loss.
7. The central nervous system response is usually reversible, but it may take 3 weeks for some patients to completely disappear.
8. In case of central nervous system reaction, the drug may need to be stopped, and large doses of this drug occasionally lead to seizures in Tibet.
9. This medicine should be stored at 2-8 ℃.If it is found that the lyophilized preparation shrinks or discolors, the liquid preparation is turbid, has foreign matters or insoluble precipitation, etc., it should not be used.
Drug interaction
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1. In combination with arabinoside, it has synergistic antiviral effect.
2. Combined with acyclovir, ursodeoxycholic acid and bupleurum bupleurum, it is more effective than single use in the treatment of viral hepatitis or chronic hepatitis B.
3. Combined with nitrogen mustard phenylbutyrate, cyclophosphamide, vincristine, etc., it can improve the anti-tumor effect.
4. Combined with daunorubicin, it can enhance the anti leukemia effect.
5. Ginseng, Astragalus, Lentinus edodes, Panax notoginseng, Anemarrhena asphodeloides, Banlangen injection, Yinhuang injection, etc. all have the effect of inducing the body to produce interferon, which can increase the titer more than 4 times when used together.
6. When used together with astragalus membranaceus and 5-iododeoxyuracil, it can inhibit adenovirus additively.
7. It can inhibit the metabolism of liver microsomes to drugs and enhance the activity of dicoumarin. Coagulation status should be monitored when the two drugs are used together.
8. This drug can not detoxify acetaminophen metabolites, so combined use can aggravate liver damage.
9. Indomethacin can prevent shivering, fever and other side effects caused by interferon, and can increase the level of interferon.
10. Reduce the clearance of aminophylline in the body, and theophylline poisoning may occur when used together, namely nausea, vomiting, constipation, and seizures.
11. Glucocorticoids such as prednisone can reduce the biological activity of interferon, which should be paid attention to.
12. Combined with high dose of interleukin adi, it can increase the risk of hypersensitivity reaction, such as erythema, itching, hypotension, etc.
13. When used in combination with phenobarbital, this drug can inhibit the hepatic cytochrome P450 system, so it will increase the serum concentration of phenobarbital, resulting in poisoning of the latter.
14. Combined with zidovudine, it can increase blood toxicity such as anemia and neutropenia.
15. When used together with live vaccine, it will increase the chance of being infected by live vaccine.
16. Care should be taken when anesthetics, hypnotics and sedatives are used together with this drug.
17. Combined use with daunorubicin, vinblastine, alkylating agent, 5-Fu, PDD, etc. can improve the curative effect.
pharmacological action
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1. Interferon combines with special membrane receptors on the surface of virus cells to play an anti DNA and RNA role, including the induction of certain enzymes, preventing the replication of virus in virus infected cells, and inhibiting the proliferation of these cells.
2. This drug has an immunomodulatory effect, which can enhance the phagocytosis of macrophages and enhance the special cytotoxicity of lymphocytes to target cells.
3. Antiviral effect: its antiviral activity is not to kill but to inhibit the virus. It is generally a broad-spectrum virus inhibitor, which can inhibit both RNA and DNA viruses.The presence of interferon can be seen during the recovery period of viral infection, on the other hand, exogenous interferon can also alleviate infection.
4. It can directly inhibit the proliferation of tumor cells, or interfere with the growth of tumors through the host's immune defense.
5. It can regulate humoral immunity and cellular immunity, and also has a certain immune enhancement effect on macrophages and NK cells.
Pharmacokinetics
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1. Oral non absorption, intramuscular injection or subcutaneous injectionαInterferon absorption rate is above 80%, while IFNβ、IFNγThe absorption rate is low.Intravenous IFNαThe serum concentration reached its peak in 30 minutes, and could not be detected 4-8 hours later.
2. Interferon enters the blood slowly after intramuscular injection or subcutaneous injection, which takes a long time to detect in the blood.After intramuscular injectionmax5-8 hours.A single intramuscular injection of 106U resulted in a serum concentration of 100U/ml, which was higher than the amount of interferon naturally produced during virus infection.
3. Circulating interferon t1/22-4 hours.Only a small amount of interferon can enter the blood-brain barrier, and the concentration in cerebrospinal fluid is about 1/30 of that in blood.Only rabbits were used to study its excretion, and the excretion was only 0.2% - 20%.
