AVONEX Expert Q&A
AVONEX Expert Q&A
The opinions of these experts do not necessarily reflect the opinions of Biogen Idec. Always discuss your healthcare-related questions with your healthcare provider. You should never disregard medical advice or delay in seeking it because of something you read here.
- Efficacy & Duration of Use
- Interactions & Possible Side Effects
- Injecting AVONEX
- Storing AVONEX Properly
- For Women Taking AVONEX
Efficacy & Duration of Use
Q: Can you tell me the differences in benefits of high-dose interferons (Betaseron® and Rebif®) and AVONEX?
A: Controversy exists among experts concerning whether or not there is any benefit to using a "higher dose of interferon" than the dose provided by AVONEX. Most available studies show little or no difference between the different interferon products based on the way we currently measure drug effectiveness. Until studies show a clear-cut difference in effectiveness between these products, which in my opinion seems to be unlikely to occur, the controversy of whether a higher dose of interferon is more effective will most likely continue. In fact, in a study conducted with AVONEX giving 30 mcg vs. 60 mcg doses, there was an increase in side effects with a higher dose. Effectiveness was similar between the regular dose of AVONEX and the higher dose of AVONEX.
Q: How long can you stay on AVONEX and how often should you have an MRI to check on your progression?
A: The safety and efficacy data for AVONEX does not currently extend past three years. However, I personally care for a patient who was involved in the early AVONEX trials and has been on AVONEX for 18 years without a problem. Certainly there are thousands of patients who have been on AVONEX for five to ten years or more. Because MS is a lifelong disease, we feel that most patients will need lifelong therapies. Most physicians now check MRI scans every year for the first three to five years of the illness, then may check MRI scans less often. Frequency of MRI scanning varies quite a bit among physicians and may depend, in some cases, on a patient's MS-related symptoms.
Q: I have been taking AVONEX for about five and a half years. By taking it that long will it become less effective like some drugs do after time?
A: Patients who take AVONEX respond differently. Some patients respond extremely well. For example, in my practice, I have a significant number of patients who have been taking AVONEX since 1996 and are doing extremely well. Accordingly, in patients who are doing well without significant number of exacerbations and without progression of physical disability, generally AVONEX does not become less effective over time.
Q: I have been on AVONEX for eight years with out any exacerbations. Can I stay on AVONEX for many more years?
A: Being on AVONEX for eight years and having no exacerbations is an excellent response. If you are responding well to AVONEX, you may very well continue to respond well to medication.
Interactions & Possible Side Effects
Q: I picked up my AVONEX (Interferon beta-1a) and the pharmacy printed a page about taking it, warnings, etc. One was to avoid over exposure to sun. Am I at risk for sunburn or is the warning about heat exposure?
A: Heat exposure results in worsening of MS symptoms for the period of raised temperature and shortly thereafter. The warning refers to raised temperature not sun exposure.
Q: I stopped my AVONEX. Will that hurt me?
A: AVONEX is prescribed to be taken as a weekly injection to slow the progression of physical disability in MS. The decision to stop therapy should be made by you and your physician together for sound reasons. By stopping your AVONEX, you are withdrawing this beneficial effect. Any decision to stop AVONEX is a potentially risky act.
Q: I will be attending my daughter's wedding. Is it ok to have a champagne toast or glass of wine during the night? How will this affect me while taking AVONEX?
A: Generally speaking, moderate alcohol use is not contraindicated in MS patients taking AVONEX. You should, however, check with your physician who knows your medical history, and any other medications you may be taking.
Injecting AVONEX
Q: I only take my shots in the leg. I alternate the leg each week and take the shot in the middle thigh. Can I damage the thigh and leg muscles?
A: Patients who give themselves injections of AVONEX typically alternate between the legs and most often give the injections in the mid-thigh region. Giving the injections in this way and alternating from one thigh to the other does not cause damage to the thigh or leg muscles. Again, this is typically how the injections are given, and patients give injections in this way over the course of many years.
Q: Why does the shot hurt sometimes but not always?
A: In giving injections into the muscles, sometimes an injection will hurt more or less than at another time. Muscles are supplied by tiny nerves, and the nerves tend to cluster at certain points in the muscle. If one injects into an area where there happens to be a small cluster of nerves, this will hurt more than in another part of the muscle. Unfortunately, we cannot predict which specific places or parts of the muscle will tend to be more sensitive than others.
Q: Why after 11 months do I occasionally have a bad reaction to the injection?
A: We do not know why this occurs, but it is common that a person may have flu-like symptoms from the injection early on, have marked improvement in those flu-like symptoms over several months, and then occasionally have significant flu-like symptoms with an injection many months into the therapy. And the reason for these reactions occurring occasionally later in therapy is not known.
Q: I am currently taking my AVONEX shot on Tuesday nights. Is it okay to change the day I take my AVONEX? Do you have any recommendations on how to smoothly as possible change the day I take my AVONEX injection?
A: You should talk to your healthcare provider about changing your injection
schedule.
With regard to timing of the injection of AVONEX, don't take AVONEX on two
consecutive days. If you forget to take your AVONEX injection, take it as soon
as you remember.
Storing AVONEX Properly
Q: I travel frequently with my job. How should I pack my AVONEX to keep it at the correct temperature?
A: Guidelines and suggestions for handling AVONEX while traveling have been
created and are listed below. If you have additional questions, call the MS
Support Specialists at AVONEX Services at
1.800.456.2255.
- It is important to protect AVONEX from extreme hot and cold. Keep AVONEX away from sunlight also.
- Prefilled syringes of AVONEX must be refrigerated (36-46°F or 2-8°C) until you are ready to use them. Many hotels provide refrigerators in their rooms.
- You may consider packing your AVONEX in a small cooler or insulated bag to help protect it from extreme temperatures.
- If you pack your prefilled AVONEX in a cooler for transport, consider using a thermometer to make sure the medication is kept at 36-46°F or 2-8°C. Do not allow the prefilled syringes or vials to freeze.
- AVONEX in a prefilled syringe may be kept outside a refrigerator at room temperature (77°F or 25°C) for up to 7 days. The powdered form of AVONEX can be kept at room temperature (77°F or 25°C) for up to 30 days.
- If you are traveling for less then a week, take your shot before or after you leave for the trip.
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Thomas Scott, MD
Q: If I leave my AVONEX out for a few hours, will it compromise the efficacy of the drug or become otherwise unusable?
A: AVONEX prefilled syringes (PFS) will not lose efficacy or become unusable
if left at room temperature (77°F or 25°C) for up to 7 days. AVONEX in the
powdered form may be left at room temperature (77°F or 25°C) for up to 30
days.
For additional information, see the
AVONEX Patient Medication Guide.
For Women Taking AVONEX
Q: Does AVONEX have any effect on the effectiveness of birth control pills?
A: There is no known interaction between AVONEX and birth control pills.
Q: How soon after the delivery of my child should I restart my AVONEX therapy?
A: There is no definitive answer to that question. AVONEX should not be taken by women who choose to breast-feed. Some women choose to start AVONEX very soon after delivery and not breastfeed. Others choose to start AVONEX when they are finished nursing. There is some evidence that breast-feeding extends the protective effect seen in pregnancy, however. The choice is one that should be discussed with your neurologist.
Q: I am pre-menopausal. I take AVONEX® (Interferon beta-1a). Will there be any medication reaction when I add progesterone or estrogen?
A: No. There is no known interaction between AVONEX and estrogen or progesterone.
AVONEX has not been studied in pregnant women. If you become pregnant while taking AVONEX, you should stop taking AVONEX immediately and tell your healthcare provider. Biogen Idec, the makers of AVONEX, have established a voluntary study, called the AVONEX Pregnancy Registry, to monitor pregnancy outcomes of women who inadvertently took AVONEX during pregnancy. For more information on the registry and to find out how you can participate in this important study call 1-800-456-2255, M-F, 8:30am to 8:00pm ET.
Betaseron (Interferon beta-1b) is a registered trademark of Bayer Healthcare Pharmaceuticals.
Rebif (Interferon beta-1a) is a registered trademark of ARS Trading S.A.
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