Drug Summary
Adverse Effects
Class and Mechanism
Indications
Dosing
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Leukopenia: The dose of peginterferon alfa-2a should be reduced to 135 mcg in patients who have an absolute neutrophil count (ANC) that declines to less than 750 cells/mm3; if the ANC declines to less than 500 cells/mm3, discontinue peginterferon alfa-2a until the ANC rises to greater than 1000 cells/mm3 and then restart at 90 mcg with close monitoring of the ANC.
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Thrombocytopenia: The dose of peginterferon alfa-2a should be reduced to 90 mcg in patients who have a decline in platelet count to a less than 50,000 cells/mm3; discontinue therapy if the platelet count declines to less than 25,000 cells/mm3.
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Renal Insufficiency: If the creatinine clearance is less than 30 mL/min or the patient is on hemodialysis, the dose of peginterferon alfa-2a should be reduced to 135 mcg and the patient should have close monitoring for any signs of medication toxicity. If toxicity (laboratory or clinical) develops, the dose of peginterferon alfa-2a can be reduced further to 90 mcg.
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Increased Alanine Transaminase (ALT): In patients who have persistent elevations in ALT levels above baseline, the recommendation is to have increased frequency of monitoring and reduce the dose of peginterferon alfa-2a to 135 mcg.
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Depression: the dose of peginterferon alfa-2a may need adjusting in patients who develop depression. In general, mild depression does not require a dose adjustment, but does warrant close monitoring. For moderate depression, the dose of peginterferon alfa-2a should be reduced to 135 mcg (or 90 mcg in some instances), with close follow-up and consideration for psychiatric consultation. With severe depression, therapy should be discontinued and the patient should immediate psychiatric consultation should be obtained.
Cost and Medication Access
Key Drug Interactions
Full Prescribing Information
Figures
![](http://cdn.hepatitisc.uw.edu/doc/190-1/thumb/packaging-peginterferon-alfa-2a-empegasysem.jpg)
![](http://cdn.hepatitisc.uw.edu/doc/191-1/thumb/single-use-syringe-peginterferon-alfa-2a-empegasysem.jpg)
![](http://cdn.hepatitisc.uw.edu/doc/196-1/thumb/180-mcg05-ml-autoinjector-peginterferon-alfa-2a-empegasysem.jpg)