Natural interferons produced by human leukocytes, recombinant interferons produced in bacteria, and recombinant interferons conjugated to monomethoxy polyethylene glycol (PEG; pegylated interferons) are available in the United States. The various preparations may be administered subcutaneously, intramuscularly, intravenously, or intralesionally (e.g., into genital warts). Natural or recombinant interferons typically achieve peak plasma levels within 4 to 8 hours of subcutaneous or intramuscular injection and are undetectable in the bloodstream within 16 to 36 hours. Maximal plasma concentrations of pegylated interferons are reached 15 to 44 hours after subcutaneous or intramuscular injection and are sustained for much longer than nonpegylated preparations (48 to 72 hours). Intralesional injection of interferons results in negligible systemic absorption. Interferons are eliminated from the bloodstream by a combination of cellular uptake and catabolism in the kidney and liver. Minimal amounts of intact protein are excreted in the urine or feces.
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