Interferon gamma-1b
Interferon gamma-1b (Actimmune)
Interferon gamma-1b
(in-ter- FEER-on GAM-uh)
Pregnancy Category: C Actimmune (Rx)

Classification: Interferon

Action/Kinetics: Consists of a single-chain polypeptide of 140 amino acids. Produced by fermentation of a genetically engineered Escherichia coli bacterium containing the DNA that encodes for the human protein. Manifests potent phagocyte-activating effects including generation of toxic oxygen metabolites within phagocytes. Such metabolites result in the death of microorganisms such as Staphylococcus aureus, Toxoplasma gondii, Leishmania donovani, Listeria monocytogenes and Mycobacterium avium intracellulare. Since interferon gamma regulates activity of immune cells, it is characterized as a lymphokine of the interleukin type. Interferon gamma interacts functionally with other interleukin molecules (e.g., interleukin-2) and all interleukins form part of a complex, lymphokine regulatory network. As an example, interferon gamma and interleukin-4 may interact reciprocally to regulate murine IgE levels; interferon gamma can suppress IgE levels and inhibit the production of collagen at the transcription level in humans. Slowly absorbed after SC injection. t 1/2, elimination: SC, 5.9 hr. Peak plasma levels: 7 hr after SC.

Uses: Decrease the frequency and severity of serious infections associated with chronic granulomatous disease.

Contraindications: Hypersensitivity to interferon gamma or E. coli-derived products. Lactation.

Special Concerns: Safety and effectiveness have not been determined in children less than 1 year of age. Use with caution in clients with preexisting cardiac disease, including symptoms of ischemia, arrhythmia, or CHF, and in clients with myelosuppression, seizure disorders, or compromised CNS function.

Side Effects: The following side effects were noted in clients with chronic granulomatous disease receiving the drug SC. GI: Diarrhea, vomiting, nausea, abdominal pain, anorexia. CNS: Fever (over 50%), headache, fatigue, depression. Miscellaneous: Rash, chills, erythema or tenderness at injection site, pain at injection site, weight loss, myalgia, arthralgia, back pain.
When used in clients other than those with chronic granulomatous disease, in addition to the preceding, the following side effects were reported. GI: GI bleeding pancreatitis, hepatic insufficiency. CV: Hypotension, heart block, heart failure syncope, tachyarrhythmia, MI. CNS: Confusion, disorientation, symptoms of parkinsonism, gait disturbance, seizures hallucinations, transient ischemic attacks. Hematologic: Deep venous thrombosis, pulmonary embolism. Respiratory: Bronchospasm tachypnea, interstitial pneumonitis. Metabolic: Hyperglycemia, hyponatremia. Miscellaneous: Reversible renal insufficiency, worsening of dermatomyositis.

How Supplied: Injection: 3 million U/0.5 mL

Dosage
?SC Chronic granulomatous disease.
50 mcg/m ² (1.5 million units/m ²) for clients whose body surface is greater than 0.5 m ². If the body surface is less than 0.5 m ², the dose of interferon gamma should be 1.5 mcg/kg/dose. The drug is given 3 times/week (e.g., Monday, Wednesday, Friday).