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Avonex®
This section does not contain all the available information regarding drug therapy. It does not take the place of talking to your neurologist, general practitioner or pharmacist. Further information is also available from the MS Society in your state and from the pharmaceutical companies.
What is avonex®?
Avonex®, the active ingredient of which is interferon beta-1a. The interferons are a family of proteins that occur naturally in the body and are involved in the activities of the body's immune system. This is a very complex system involving many specialised cells and proteins, which defend the body against infections and disease.
What does avonex® do?
Clinical trials found that avonex® (interferon beta -1a) has a significant beneficial effect in people with relapsing-remitting multiple sclerosis by reducing the accumulation of permanent physical disability, exacerbation frequency and disease activity measured by gadolinium-enhanced lesions on brain magnetic resonance images (MRI).
Who can get a script for avonex®?
An authority script for 1 month's supply of avonex® with 5 repeats may be available to people with multiple sclerosis following consultation with a neurologist or GP if they fulfill the following criteria:
- Have relapsing/remitting MS.
- Able to walk without assistance or support.
- MS diagnosis confirmed by MRI.
- Have had 2 exacerbations (attacks) in the last 2 years.
Before you have an avonex® injection, you should tell your doctor if you:
- are depressed or have contemplated suicide.
- are pregnant or planning to become pregnant.
- are breastfeeding.
- have had any fits or seizures.
- have had any liver or kidney problems.
- have any heart disease.
- have any blood disorder.
General information
Avonex® is not stored at the chemist. It will take 2-3 working days for the chemist to receive it from the pharmaceutical company distributing the medication. It is dispatched in a small foam esky with 1 cooling brick. On arrival at home the avonex® is to be stored below 25°C and the cooling brick placed in the freezer. If traveling in summer, repack the medication in the foam esky with the cooling brick.
Patient co-payments
The co-payment is the amount you pay towards the cost of your PBS medicine. Many PBS medicines cost a lot more than you actually pay as a co-payment.
From 1 January 2008, you pay up to $31.30 for most PBS medicines or $5.00 if you have a concession card. The Australian Government pays the remaining cost.
The amount of co-payment is adjusted on 1 January each year in line with the Consumer Price Index (CPI).
Can avonex® be taken while pregnant?
Discuss with your doctor.
There are no adequate studies on the effect of this medication in pregnant woman. It is important for a woman to inform her doctor if she becomes pregnant or plans to become pregnant while on avonex®. It is not known if avonex® is excreted in breast milk.
It is generally recommended that:
- Males - If concerned discuss with your doctor who may wish to contact Biogen Australia Pty. Ltd. medical staff regarding individual cases.
- Females - stop avonex® 1 month before trying to conceive and during pregnancy and breastfeeding.
Side effects
- The written material accompanying avonex® details the side effects.
- Symptoms reported more frequently were flu like symptoms, muscle aches, weakness, chills and fever. These side effects usually occur 3-6 hours after the injection is given and may last for 24-36 hours.
- The side effects are common in the early stages of treatment but decrease dramatically over the first 3 months but may last up to 6 months in some cases.
- Most of the side effects may be controlled with: Paracetamol (Panadol®).
- Best for fever/temperature. 4 hours prior to the injection and then every four hours over the next 24-36 hours (8 tablets in 24 hours may be taken).
Ibuprofen (Nurofen®) - Best for flu-like symptoms and headaches and should be taken after food.
Having the injection in the evening may allow you to sleep through the flu-like symptoms should they occur.
Frequently Asked Questions Concerning Avonex®
How is avonex® taken?
Avonex® is a weekly intramuscular injection (into the muscle), which you or a chosen person is taught to give. MS Society staff are available to educate you and/or the chosen person in giving the injections.
Avonex® cannot be taken by mouth, as it is a protein and therefore digested (broken down) by gastric juices in the stomach.
Where on my body do I have the avonex® injection?
For self-injection the only possible site is the thigh muscle. Instructions are as follows:
You need to sit on the edge of the seat with your legs at right angles. This allows the soft tissue to drop and bring the muscle closer to the skin surface. Place one hand on top of the thigh at the groin and the other hand on the thigh fingers touching the knee. The area between the hands on top of the thigh is the injection site.
Other areas can be used if someone else is injecting the medication.
Will I get marks on my skin from the injection?
It depends on the individual.
Are there any contradictions with other medications?
No significant interactions with any treatments commonly used in MS were noted in the clinical trials. People with hypersensitivity to natural or recombinant interferon beta, albumin, or any other formulation should not take these agents.
Caution should also be exercised in people with severe anaphylactic reactions and asthma, as the treatments have not been studied in these people.
Can I continue having a yearly flu vaccination while on this medication?
Yes. It is suggested you take paracetamol before the flu vaccine then every 4 hours as needed.
Can alcohol be consumed while on this medication?
Yes. There have been no problems reported.
Does avonex® cause drowsiness?
No significant drowsiness has been reported. However, the effect of the disease or initial side effects may influence your ability to drive and operate heavy machinery. If you are concerned you should discuss this with your doctor.
What does the medication not do?
Avonex® does not reverse MS. It will not make you physically any better than you are now.
My neurologist told me to contact the MS Society to get information on treatments for MS, what medication do you recommend?
This is a clinical question and treatment choice is made by the doctor in conjunction with the patient. We can offer information on ALL treatments. When you have read all the information you should contact your neurologist to discuss the treatment choice.
My neurologist has ordered avonex® for me but I will not be able to inject as I am sight impaired/have poor hand control. What do I do?
The NSW MS Society will either teach a family member to inject avonex® or refer you to the community nurses who will visit each week.
Why do I need a blood test and how often are they recommended?
Tests are done to determine base levels of liver function test (LFT), white cell count (WCC), platelet count and haemoglobin (Hb) before commencing therapy then 6 monthly after starting therapy.
What time should I inject if I work evening or night shift?
The time of injection depends on the time any side effects occur after the injection. Have the injection so there is time to recover from possible side effects. We suggest you have the injection at the same time each week so you develop a routine and will be less likely to forget a dose. E.g. 4 hours before you go to bed.
My avonex® mixture is bubbly. What should I do?
DO NOT DISCARD.
Place vial in fridge until bubbles settle (1-2 hours).
Before use, warm up the vial in your hands.
Why did the bubbles occur?
Pushing the sterile water into the avonex® vial too quickly or shaking the vial can cause bubbling.
Travel, Transport and Storage of Avonex®. It is recommended that avonex® be stored below 25°C but not frozen at any time. This means that it can generally be stored at room temperature. However, if you are visiting somewhere with a hot climate with little or no cooling in the room, than it is advisable to store avonex® in the fridge.
I am going overseas for 6 months. Is it possible to have all the scripts for avonex® made up at once?
Yes. However, notify your pharmacy a few working days in advance.
I am travelling overseas. What can I do to ensure I have no problems with customs?
Carry with you a letter from your prescribing doctor explaining why you need the treatment.
Photocopies of the letter and the avonex® prescription for the customs authorities for departure and entry to every country you visit.If flying through a country that has strong anti-drug laws and regulations, contact the embassy of the country concerned and discuss the situation. Some require papers to be completed before leaving Australia.
It may be worthwhile obtaining a contact name and phone number of a representative from the Australian embassy in the country concerned.
Are there any special precautions when travelling by air?
Ensure that the avonex® pack is kept below 25°C but not frozen. This can be achieved by carrying your medication onto the plane with you so remember to notify the Special Handling Department of the airline.
I am going camping for 3 days. How do I store the medication?
Store in an esky or pack that is kept below 25°C but not frozen.
I am going overseas for 1 month how do I handle the medication once I arrive?
If room temperature is below 25°C there is no special handling required.
However if travelling to a hot climate the following may be helpful:
When booking accommodation check if there is a fridge in the room, always check the fridge is switched on and its temperature. Inspect the water jug for signs of freezing.
If no fridge is available, have the hotel staff refreeze the ice bricks, keep the medication in your room and keep replacing the ice bricks as required.
It is a good idea to check and see where your bricks are stored. There are two reasons for this. Often they are put in the fridge not the freezer and secondly when you go to collect them other staff may have difficulty locating them.
The medication was delivered frozen from my chemist. Do I have to throw it out?
Yes. The manufacturer does not recommend the use of avonex® if it has been frozen at any time.
How should avonex® be transported?
Avonex® needs to be transported below 25°C. Medication should NOT be left in the boot or glove box of the car, or left for 30 minutes in a parked car.
The medication was left out on my kitchen bench overnight. Must it be discarded?
Not if the temperature was less than 25°C.
Yes if the temperature was over 25°C.
Where do I dispose of the sharps container when full? Can it be placed in my garbage bin?
No. If you ring your local council, they will provide you with a list of chemists who will take the filled containers.
Where can I get more information?
You can get information from your neurologist, GP or the MS Society.
Avonex® is manufactured by:
Biogen Idec Australia Pty Ltd.
Suite 2, Level 4,
123 Epping Road,
North Ryde
NSW - 2113
Toll Free Phone 1800 286 639 (Pharmaceutical Information Service)
Packed and distributed in Australia by:
CSL Limited A.C.N. 051 588 348
45 Poplar Road
Parkville
Victoria 3052
Source - The questions and answers included on the sheets are authentic and questions asked by people with MS in NSW, who are on treatment or are considering starting immunotherapy treatment. The questions were compiled through the NSW MS Society Information Service and Immunotherapy Support Program.
Immunotherapy Program Coordinator
MS Society of NSW 2001