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Multiple Sclerosis - Medications
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glatiramer (Copaxone® )
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INDICATIONS: Treatment of relapsing-remitting type multiple sclerosis; studies indicate that it reduces the frequency of attacks and the severity of disability; appears to be most effective for patients with minimal disability Mechanism of Action Glatiramer is a mixture of random polymers of four amino acids; L-alanine, L-glutamic acid, L-lysine and L-tyrosine, the resulting mixture is antigenically similar to myelin basic protein, which is an important component of the myelin sheath of nerves; glatiramer is thought to suppress T-lymphocytes specific for a myelin antigen, it is also proposed that glatiramer interferes with the antigen-presenting function of certain immune cells opposing pathogenic T-cell function Dosing (Adults): (usual) SubQ: 20 mg daily Administration For SubQ administration in the arms, abdomen, hips or thighs. Bring to room temperature prior to use. SUPPLIED: Injection, solution [preservative free]: 20 mg/mL (1 mL) [prefilled syringe; contains mannitol; packaged with alcohol pads] |
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interferon beta-1A (Avonex ® , Rebif ® )
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INDICATIONS: Treatment of relapsing forms of multiple sclerosis (MS) Mechanism of Action Interferon beta differs from naturally occurring human protein by a single amino acid substitution and the lack of carbohydrate side chains; alters the expression and response to surface antigens and can enhance immune cell activities. Properties of interferon beta that modify biologic responses are mediated by cell surface receptor interactions; mechanism in the treatment of MS is unknown. DOSING (Adults): Note: Analgesics and/or antipyretics may help decrease flu-like symptoms on treatment days: I.M. (Avonex®): 30 mcg once weekly SubQ (Rebif®): Doses should be separated by at least 48 hours: Target dose 44 mcg 3 times/week: Initial: 8.8 mcg (20 % of final dose) 3 times/week for 8 weeks Titration: 22 mcg (50% of final dose) 3 times/week for 8 weeks Final dose: 44 mcg 3 times/week Target dose 22 mcg 3 times/week: Initial: 4.4 mcg (20 % of final dose) 3 times/week for 8 weeks Titration: 11 mcg (50% of final dose) 3 times/week for 8 weeks Final dose: 22 mcg 3 times/week Dosage adjustment in hepatic impairment: Rebif®: If liver function tests increase or in case of leukopenia: Decrease dose 20% to 50% until toxicity resolves Administration Avonex®: Must be administered by I.M. injection Rebif®: Administer SubQ at the same time of day on the same 3 days each week (ie, late afternoon/evening Mon, Wed, Fri); rotate injection site SUPPLIED: Combination package [preservative free] (Rebif® Titration Pack): Injection, solution: 8.8 mcg/0.2 mL (0.2 mL) [6 prefilled syringes; contains albumin] Injection, solution: 22 mcg/0.5 mL (0.5 mL) [6 prefilled syringes; contains albumin] Injection, powder for reconstitution (Avonex®): 33 mcg [6.6 million units; provides 30 mcg/mL following reconstitution] [contains albumin; packaged with SWFI, alcohol wipes, and access pin and needle] Injection, solution (Avonex®): 30 mcg/0.5 mL (0.5 mL) [albumin free; prefilled syringe; syringe cap contains latex; packaged with alcohol wipes, gauze pad, and adhesive bandages] Injection, solution [preservative free] (Rebif®): 22 mcg/0.5 mL (0.5 mL) [prefilled syringe; contains albumin]; 44 mcg/0.5 mL (0.5 mL) [prefilled syringe; contains albumin] |
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interferon beta-1B (Betaseron ®)
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INDICATIONS:
Betaseron is indicated for use in ambulatory patients with
relapsing-remitting multiple sclerosis to reduce the frequency of
clinical exacerbations. Relapsing-remitting MS is characterized by
recurrent attacks of neurologic dysfunction followed by complete or
incomplete recovery. The safety and efficacy of Betaseron in
chronic-progressive MS has not been evaluated. Mechanism of Action Interferon beta-1b differs from naturally occurring human protein by a single amino acid substitution and the lack of carbohydrate side chains; alters the expression and response to surface antigens and can enhance immune cell activities. Properties of interferon beta-1b that modify biologic responses are mediated by cell surface receptor interactions; mechanism in the treatment of MS is unknown. DOSING (Adults): SubQ: Children <18 years: Not recommended Adults: 0.25 mg (8 million units) every other day Administration Withdraw 1 mL of reconstituted solution from the vial into a sterile syringe fitted with a 27-gauge needle and inject the solution subcutaneously; sites for self-injection include arms, abdomen, hips, and thighs SUPPLIED: Injection, powder for reconstitution [preservative free]: 0.3 mg [9.6 million units] Recommended dose: 0.25 mg injected subcutaneously every other day. |
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Listed dosages are for - Adult patients ONLY. PLEASE READ THE
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any diagnosis or treatment made in reliance thereon. David F. McAuley, Pharm.D., R.Ph. GlobalRPh Inc. |
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