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What should I discuss with my healthcare provider before using interferon alfa-2b and ribavirin (Rebetron)?

You should not use this medication if you are allergic to interferon alfa-2b (Intron A) or ribavirin (Copegus, Rebetol), or if you have:

• autoimmune hepatitis;
• liver failure;
• severe kidney disease;
• a hemoglobin blood cell disorder such as sickle-cell anemia or thalassemia;
• if you are pregnant or breast-feeding; or
• if you are a man and your female sexual partner is pregnant.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use interferon alfa-2b and ribavirin:

• lung disease;
• kidney disease (or if you are on dialysis);
• hepatitis B, or liver problems other than hepatitis;
• a thyroid disorder;
• uncontrolled diabetes;
• new or worsening problems with your eyes;
• cancer;
• HIV or AIDS;
• high cholesterol or triglycerides;
• heart disease or high blood pressure, history of heart attack, or stroke;
• history of organ transplant;
• any blood cell disorder causing bleeding episodes, infections, or fever-related illness;
• an autoimmune disorder such as rheumatoid arthritis, systemic lupus erythematosus (SLE), or psoriasis;
• a history of drug or alcohol addiction, depression, anxiety, or suicidal thoughts or behaviors; or
• if you have ever used an interferon to treat hepatitis in the past and it did not work.

FDA pregnancy category X. Ribavirin is known to cause birth defects or death in an unborn baby. Do not use interferon alfa-2b and ribavirin if you are pregnant. You may need to have a negative pregnancy test before using this medication and every month during your treatment.

• If you are a woman, do not use interferon alfa-2b and ribavirin if you are pregnant.
• If you are a man, do not use interferon alfa-2b and ribavirin if your female sexual partner is pregnant. An unborn baby could also be harmed if a man fathers the child while he is taking ribavirin.
• Use at least 2 effective forms of birth control while either sexual partner is using interferon alfa-2b and ribavirin. Keep using 2 forms of birth control for at least 6 months after treatment ends.
• Tell your doctor right away if a pregnancy occurs while either the mother or the father is using interferon alfa-2b and ribavirin.

Interferon alfa-2b and ribavirin may pass into breast milk and could harm a nursing baby. Do not use this medication if you are breast-feeding a baby.

Interferon alfa-2b and ribavirin can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

The powder form of interferon alfa-2b contains albumin, but the solution (liquid) form does not. Albumin comes 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 interferon alfa-2b and ribavirin (Rebetron)?

Interferon alfa-2b is given as an injection under the skin. 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.

Do not use the medication if it has changed colors or has any particles in it. Call your doctor for a new prescription.

Use a different place on your arm, stomach, or thigh each time you give yourself an injection. Your care provider will show you the places on your body where you can safely inject the medication. Do not inject into the same place two times in a row.

Use each disposable needle only one time. Throw away used needles 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.

The interferon alfa-2b injection is usually given 3 times per week. The ribavirin capsule is usually taken twice daily. You may take the capsules with or without food but take them the same way each time. Follow your doctor's instructions. Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Your ribavirin dose needs may change if you gain weight. Tell your doctor if your weight increases to 165 pounds or above.

To be sure this medication is helping your condition and not causing harmful effects, your blood may need to be tested on a regular basis. You may also need regular eye exams. Do not miss any scheduled appointments.

Store both the ribavirin capsules and the interferon alfa-2b vials (bottles) or injection pens in the refrigerator. Do not allow the medicine to freeze.

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