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Pegylated interferon is a new and improved modified interferon. It is produced by attaching a substance known as polyethylene glycol (PEG) to the interferon molecule ­ "pegylation". PEG is a large substance that causes the interferon to stay in the body longer than just plain interferon alone. This prolonged time in the body is important for two reasons. First, it reduces the frequency of administration of the medication to once weekly, instead of 3 times a week, as with standard interferons. This is certainly much more acceptable to patients who must inject themselves. Second, it allows for more consistent and prolonged blood levels of the medication in the body. This means that the pegylated interferon stays in the body longer and is able to fight off the HCV virus more effectively. This allows less chance for treatment failure and liver damage.

There are currently two pegylated interferon preparations available on the market: Peginterferon alfa-2b (PEG-Intron®) and Peginterferon alfa-2a (Pegasys®). Overall, clinical studies have found that pegylated interferon used in combination with ribavirin (Rebetol®, Copegus®) is more effective than standard interferon in combination with ribavirin or pegylated interferon used alone. HCV disease characteristics, i.e. genotype, help to guide treatment decisions.

In clinical studies, patients with genotypes 2 or 3 had comparable sustained viral response (SVR)* rates with standard interferon plus ribavirin as with pegylated interferon plus ribavirin. Therefore, standard interferon plus ribavirin may be an effective therapeutic option for individuals with genotypes 2 or 3. HCV genotype can also help to determine the duration of treatment. Studies have shown that individuals with genotype 1 achieve SVRs of 42-46 % when treated with pegylated interferon plus ribavirin for 48 weeks, whereas individuals with genotypes 2 or 3 achieve SVRs of 76-82 % after 24 weeks of treatment. This suggests that it may be sufficient to treat individuals with genotype 2 or 3 for 24 weeks while individuals with genotype 1 may require 48 weeks of treatment.

In clinical studies, approximately 10-14% or patients treated with pegylated interferon plus ribavirin discontinued therapy due to side effects. It is always important to alert your physician if you experience any potential side effects. Flu-like symptoms are commonly reported with combination therapy. This can be minimized by pretreatment with acetaminophen or ibuprofen or taking the interferon at night to limit symptoms during awake hours. Anemia (a decrease in red blood cells) is another side effect that can occur with combination therapy. Potential symptoms associated with anemia include severe fatigue, shortness of breath, heart palpitations, and headache. Finally, pegylated interferons, like standard interferons, may cause or worsen psychiatric problems (depression, irritability, mood changes and anxiety). It is important to alert your physician if you have a history of depression or if you experience any of these symptoms.

*SVR is defined as undetectable HCV in the blood at 24 weeks after the end of therapy.

Reference

NIH Consensus Development Conference Statement. Management of Hepatitis C: 2002.

This information is provided for educational purposes only. It is not intended to be a substitute for medical advice or treatment from a health care provider or to cover all possible uses, actions, precautions, side effects or interactions. Like any printed material, it may become out-of-date over time. If you have other questions, you should discuss them with your physician or PharmaCare Pharmacist.

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