Interferon Beta-1b Injection (patient information)

# About your treatment
Your doctor has ordered interferon beta-1b, a biologic response modifier. This medication is used to treat patients with multiple sclerosis (MS), a disease in which the nerves do not function properly and patients may experience weakness; numbness; loss of muscle coordination; and problems with vision, speech, and bladder control. This medication will be injected subcutaneously (under the skin) every other day. Your health care provider will show you how to prepare and give the injection.
Interferon beta-1b is a man-made version of a naturally occuring protein. It is used to treat patients with relapsing forms of MS (course of disease where symptoms flare up for a short time, then go away). Interferon beta-1b does not cure MS but may reduce the number of disease flare-ups.Interferon beta-1b may be prescribed for other uses; ask your doctor or pharmacist for more information.
Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how you respond to the medication.

# Precautions
Before using interferon beta-1b:
- tell your doctor and pharmacist if you are allergic to interferon beta-1b, or any other medications, or human albumin.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you drink or have ever drunk large amounts of alcohol, if you have or have ever had anemia (low red blood cells) or low white blood cells, blood problems such as bruising easily or bleeding, diabetes, anxiety, depression,mental illness, thoughts of hurting yourself, seizures, trouble falling asleep or staying asleep, or prostate, skin, thyroid, blood, heart, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking interferon beta-1b, stop using interferon beta-1b immediately and call your doctor.

# Administering your medication
Before you administer interferon beta-1b, look at the solution closely. It should be clear and free of floating material. Observe the solution container to make sure there are no leaks and check the expiration date. Do not use the solution if it is discolored, if it contains particles, or if the container leaks or it is expired. Use a new solution, but show the damaged or expired one to your health care provider.
It is important that you use your medication exactly as directed. Your health care provider may start you on a low dose of interferon beta-1b and gradually increase your dose. Do not change your dosing schedule without talking to your health care provider. Your injections should be approximately 48 hours (2 days) apart, so it is best to give them at the same time, preferably in the evening just before bedtime.
Do not inject interferon beta-1b into an area of skin that is irritated, sore, red, bruised, infected, damaged, or abnormal in any way. It is important that you change your injection area each time interferon beta-1b is injected; keeping a record will help you to remember to rotate injection sites. Do not use the same injection area two times in a row. Do not inject interferon beta-1b near the navel (bellybutton) or waistline.
If you miss a dose of interferon beta-1b, inject your next dose as soon as you remember or are able to give it. Your next injection should then be given 48 hours (2 days) after that dose. Do not use interferon beta-1b on 2 days in a row. If you accidentally take more than your prescribed dose, or give it on 2 days in a row, call your health care provider right away.

# Side effects

## Minor side effects
Side effects from interferon beta-1b can occur. Interferon beta-1b sometimes causes a flu-like illness with headache, fever, chills, sweating, muscle aches, tiredness, and general discomfort. Tell your health care provider if any of these problems continue or worsen. You should talk with your health care provider about whether to take an over the counter medication for pain or fever before or after taking your dose of interferon beta-1b.
Tell your health care provider if any of these symptoms are severe or do not go away:
- upset stomach
- indigestion
- diarrhea
- constipation
- weight gain or weight loss
- feeling cold or hot much of the time
- dizziness
- increased urinary frequency
- incontinence
- flushing
- hair loss
- joint or muscle weakness or pain
- leg cramps
- difficulty falling asleep or staying asleep
- changes in sex drive or ability (in men)
- increased menstrual pain

## Severe side effects
If you experience any of the following symptoms, call your health care provider immediately:
- extreme tiredness
- lack of energy
- unusual bruising or bleeding
- loss of appetite
- pain in the upper right part of the stomach
- yellowing of the skin or eyes
- hives
- rash
- itching
- difficulty breathing or swallowing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, abdomen (stomach), or *lower legs
- hoarseness
- vaginal bleeding or spotting between menstrual periods
- change in coordination
- heart palpitations or rapid heart rate
- chest pain
- nervousness
- depression
- anxiety
- thoughts of hurting yourself
- swollen lymph nodes
Interferon beta-1b affects your immune system so it may increase your risk of developing a serious infection. Talk to your health care provider about the risks of using this medication.
Interferon beta-1b may cause other side effects. Call your health care provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storing your medication
Your health care provider probably will give you a several-day supply of interferon beta-1b at a time and provide you with directions on how to prepare each dose. Store the vials at room temperature. 
You should use a prepared dose immediately after mixing and allowing any foam in the solution to settle. If you must wait to give the injection, you may refrigerate the prepared dose and use it within 3 hours after bringing it to room temperature before injecting. Avoid shaking the vial. Use a vial and syringe only once, and do not reenter a needle into the vial. Throw away any unused portion of medication. 
Do not allow interferon beta-1b to freeze.
Store your medication only as directed. Make sure you understand what you need to store your medication properly.
Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Do not throw needles or syringes in the household trash or recycle. Your health care provider will tell you how to throw away used needles and syringes in a puncture-proof container to avoid accidental injury.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Signs of infection
If you are receiving interferon beta-1b under your skin, you need to know the signs of an injection area infection (an infection at the area where you have given your medication subcutaneously). If you experience any of these signs near an injection area, call your health care provider as soon as possible:
- swelling
- lump
- pain
- irritation
- redness
- bruising
- drainage
- dark discoloration
- other skin problems

# Brand names
- Betaseron