Other Cardiotoxic Drugs
Moderate
Textbook
Increased cardiotoxic effects.
Monitor for cardiac effects.
Source: G&G 14e · p1231
Drug reference
pegylated interferon alfa
Drug monograph
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
—
none in our sources
PREGNANCY
—
not curated
Mechanism
Not yet extracted
Indications
viral hepatitisChronic Hepatitis B virus (HBV) infection (preferred agent)Chronic Hepatitis C virus (HCV) infection (pegIFN-α2a, for children 5 years or older, previously used for adults but replaced by DAAs)Hepatitis D virus (limited success)
Dosing
- Adult
- 180 μg subcutaneously once weekly for 48–52 weeks (pegIFN-α2a)
- Pediatric
- 6 million IU/m2 thrice weekly (interferon-α2b) for children 1 year or older; 180 μg/1.73 m2 × body surface area once weekly (pegIFN-α2a) for children 5 years or older with HCV
- Renal adjustment
- Reduced for ClCr less than 30 mL/min; dose reductions required for end-stage renal disease (ESRD) for both pegIFN products
Pharmacokinetics
Onset
Antiviral state in peripheral blood mononuclear cells peaks at 24 h and decreases slowly to baseline by 6 days after injection.
Half-life
30–54 h (pegIFN-α2b); 80–90 h (pegIFN-α2a)
Excretion
About 30% of pegIFN-α2b is cleared by the kidneys; the remainder by liver and cellular degradation of IFN-receptor complexes. PegIFN-α2a is cleared by the liver and kidney.
Contraindications
- Advanced liver disease
- Decompensated cirrhosis
- Pregnancy
Side effects
Common
FeverChillsHeadacheMyalgiaArthralgiaNauseaVomitingDiarrheaFatigue/astheniaPyrexiaInjection site inflammationNeutropenia
Serious
- Depression
- Myelosuppression (granulocytopenia, thrombocytopenia)
- Neurotoxicity (somnolence, confusion, behavioral disturbance, seizures)
- Debilitating neurasthenia
- Autoimmune disorders (thyroiditis, hypothyroidism)
- Cardiovascular effects (hypotension, tachycardia)
- Elevations in hepatic enzymes
- Elevations in triglycerides
- Alopecia
- Proteinuria
- Azotemia
- Interstitial nephritis
- Autoantibody formation
- Pneumonia
- Hepatotoxicity
- Fatal neuropsychiatric disorders
- Fatal autoimmune disorders
- Fatal ischemic disorders
- Fatal infectious disorders
Drug interactions
Other Neurotoxic Drugs
Moderate
Textbook
Increased neurotoxicity.
Monitor for signs of neurotoxicity.
Source: G&G 14e · p1231
Ribavirin
Moderate
Textbook
Increased hematological toxicity.
Monitor hematological parameters.
Source: G&G 14e · p1231
Zidovudine
Moderate
Textbook
Increased hematological toxicity.
Monitor hematological parameters.
Source: G&G 14e · p1231
Related guidelines
Hepatitis B — chronic infection
EASL · Gastroenterology · 2025
Hepatitis B — chronic infection
INASL · Gastroenterology · 2023
Hepatitis B — chronic infection
WHO · Hepatology · 2025
Antiretroviral therapy for HIV
NACO · Infectious Diseases · 2018
Hepatitis C — chronic infection
EASL · Gastroenterology · 2020
Other Unclassified drugs
Ask House about pegylated interferon alfa
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Textbook-sourced·Sources: Goodman & Gilman 14e·Updated: 2026-05-10