Interferon toxicity

Like most drugs, administration of interferons can elicit a number of unwanted side effects. Unfortunately, in some instances the severity of such effects can limit the maximum recommended therapeutic

Table 8.11 Side-effects sometimes associated with therapeutic administration of IFN-as. In most cases, only minor side effects are noted. However, more serious effects, necessitating cessation of treatment, may occur in up to 17 per cent of patients

Minor side effects

Range of flu-like symptoms, e.g. fever headache chills

Serious potential side effects

Anorexia Strong fatigue Insomnia

Cardiovascular complications Autoimmune reactions Hepatic decompression dose to a level below that which might have maximum therapeutic effect. Administration of interferons (in addition to many other cytokines) characteristically induces flu-like symptoms in many recipients. Such symptoms are experienced by most patients within 8 h of IFN-a administration. However, they are usually mild and are alleviated by concurrent administration of paracetamol. Tolerance of such effects also normally develops within the first few weeks of commencing treatment.

In some instances more severe side effects are noted (Table 8.11), whereas in a few cases very serious side effects, such as induction of autoimmune reactions and central nervous system or cardiovascular disturbances, render necessary immediate withdrawal of treatment.

Administration of IFN-P also characteristically causes flu-like symptoms. More serious side effects, however, are sometimes noted, including:

• hypersensitivity reactions;

• menstrual disorders;

anxiety and emotional liability;

• depression, which in rare instances may prompt suicidal thoughts.

The only common side effect associated with IFN-y is the characteristic flu-like symptoms. However, in rare instances and at high doses, adverse clinical reactions have been noted. These have included heart failure, central nervous system complications (confusion disorientation, Par-kinsonian-like symptoms), metabolic complications (e.g. hyperglycaemia), and various other symptoms.

Prediction of the range or severity of side effects noted after administration of any interferon preparation is impossible. Careful monitoring of the patients, particularly in the earliest stages of treatment, soon reveals the onset of any side effects that might warrant suspension of treatment.

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