1/2 shot?

A board to discuss the Multiple Sclerosis modifying drug Avonex

1/2 shot?

Postby Tiramisu » Sun Jun 11, 2006 7:20 am

My doctor asked me to use 1/2 the dose of Avonex because I called him and let him know that I had experienced ALL the side effects ever imagined and Im a diabtic T1 as well. My blood sugar did rise a lil bit, but that was the least of it. My side effects worried me more.

Has anyone ever tried this 1/2 shot?
Mars
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Postby sh8un » Sun Jun 11, 2006 12:17 pm

Hey girl
I started on half a dose as well. For two weeks, and then moved to full. Are you a small person? That could be one reason. My Dr. thought that the side effects would be two hard on me to start full dose right away.

It's just your body responding to a foreign protein. It can be pretty scary at first though. You have to find out if your fever responds better to Tylenol or Ibuprofen. Hopefull you are not allergic to either.Mine works better with Ibuprofen but that upsets my stomach. I guess I can't win them all. Anyway, I take the pill 200mg right when I get my shot and the every two hours. I usually now only take 3-4 in all. I like to do it early in the day so that I won't have to deal with the chills at night. some people like to do it at night so that they sleep though the side effects. I like to take the least amount of medication and that is why I only take 200mg of Ibuprofen but you could take 400mg every four hours up to a max of 6/day as specified on the pckg. I still take 2 in four hours but I just spread them to 1 every 2 hours because I find it works better because there is a constant supply of it in my blood. At the end I need less of the drug.Ibuprofen is also a muscle relaxent and may help with the muscle aches as well. Those are the only side effects that I have.
Hope this helps
NN
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Re: 1/2 shot?

Postby NHE » Mon Jun 12, 2006 3:57 am

sh8un wrote:It's just your body responding to a foreign protein.

Interferon Beta-1A is not a foreign protein. It is molecularly identical to the interferon beta that's naturally produced in the body. You can access the Drs. Prescribing Information from here which states...
AVONEX ® (Interferon beta-1a) is a 166 amino acid glycoprotein with a predicted molecular weight of approximately 22,500 daltons. It is produced by recombinant DNA technology using genetically engineered Chinese Hamster Ovary cells into which the human interferon beta gene has been introduced. The amino acid sequence of AVONEX ® is identical to that of natural human interferon beta.

and...
Natural interferon beta and Interferon beta-1a are glycosylated, with each containing a single N-linked complex carbohydrate moiety.

Both of these characteristics make it different from Betaseron, interferon beta-1b, which is not identical sequence wise and is also not glycosylated since it's produced in bacteria. This lack of glycosylation in Betaseron may likely be the characteristic which is responsible for the higher probability of forming neutralizing antibodies against Betaseron as opposed to a lower incidence with Avonex.

In summary, Avonex is identical to natural interferon beta and is not a foreign protein.

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Postby Tiramisu » Mon Jun 12, 2006 6:08 am

I just spoke to someone from Avonex and they stated I must throw out the other half. Wow.. this is way expensive to do that. I asked about the needles and they told me, no, this must be done this way and my doctor a should have explained it to me. What does everyone think of this?
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Postby sh8un » Mon Jun 12, 2006 7:34 am

Hi NHE
What I meant was that it is protien that is introduced to the body. It is not our own body's. It is still a foriegn protien because it comes from the outside of the body. You are right in that it is a naturally occurring protien in the body. The fact that you can still develop antibodies to it (lower risk with this drug) also tells me that it is not exactly the same as the one some people's body makes????
Thanx for allowing me to clear that up,
NN
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Re: 1/2 shot

Postby NHE » Mon Jun 12, 2006 7:09 pm

Tiramisu wrote:I just spoke to someone from Avonex and they stated I must throw out the other half. Wow.. this is way expensive to do that. I asked about the needles and they told me, no, this must be done this way and my doctor a should have explained it to me. What does everyone think of this?

That depends on if you're using the prefilled syringes or the dried form of Avonex. If you're using the dried form, then yes, it does seem reasonable since the included literature states that it expires within 6 hours of mixing. However, if you're using the prefilled syringes, then there might be a gray area. The medication remaining in the syringe should be OK but it's possible that it's no longer sterile and needles should not be reused. I agree with you though. It is an expensive waste and it's unfortunate that Biogen does not market lower dose vials for people in your situation. Hopefully, you will only need the 1/2 shot for the first couple of times so it shouldn't be too bad.

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Postby Tiramisu » Wed Jun 14, 2006 7:29 pm

Id like to say that Last night i did my 1/2 shot and absolutely NO side effects. I woke up a few times and I couldnt believe it.
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Postby Tiramisu » Tue Jul 11, 2006 8:24 pm

I saw my Neuro yesterday and he tells me to go for the full shot whenever I felt comfortsble. I was thinking that it would be easier for me to gradually keep adding till I get to the full shot, what does everyone think?
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play it safe?

Postby jimmylegs » Tue Jul 11, 2006 8:31 pm

hi when they were prepping me for rebif it was supposed to ramp up to full dose in five 20% increments.

tira, yea i think playing it safe by ramping it up in stages might be easier but i usually get side effects from things. how long do you do partial doses for when starting avonex? if it's a short time, i don't think missing a day or two of full dose would be a problem in the long term. just my thoughts.
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Postby sh8un » Tue Jul 11, 2006 8:39 pm

Hi again
I was only on the 1/2 shots for two weeks. Then I went full. It was hard and I ached and had pretty bad fevers. I wanted to get to the full dose right away because I have heard that even at full dose it takes up to about 2 months for the drug to take full effect. To be honest I was not given the choice to gradually increase. I would not have gone that route anyway. The side effects might be a little easier on you if you gradually increase. To me it's nothing a little pain killer won't help.I think you had said that you did not experience too many side effect if I rememeber correctly. So, if I were you I would go full dose and get that drug in your system since you are paying for it anyway.
NN
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Postby Tiramisu » Tue Jul 11, 2006 9:02 pm

Thanks evryone...
I upped up a bit and plan to continue till I get to the full. It wont be too long. I just worry to much of experiencing a low blood sugar and these side effects, at the smae time. I will tell u how it goes. :?
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Postby jimmylegs » Thu Oct 02, 2008 2:25 pm

i was just at the walk-in clinic for a non-ms related visit and was waiting forever in the examining room so i picked up the 08 compendium of pharms and specialties and flipped to rebif, only because that's what i was originally supposed to go for. somehow i think i missed the chinese hamster ovary origins back at first reading in '06 lol!

here's a link to the compendium's rebif description, which appears to be the same as NHE's posted reference to avonex literature.

http://www.rxlist.com/cgi/generic/rebif.htm
Rebif® (interferon beta-1a) is a purified 166 amino acid glycoprotein with a molecular weight of approximately 22,500 daltons. It is produced by recombinant DNA technology using genetically engineered Chinese Hamster Ovary cells into which the human interferon beta gene has been introduced. The amino acid sequence of Rebif® is identical to that of natural fibroblast derived human interferon beta. Natural interferon beta and interferon beta-1a (Rebif®) are glycosylated with each containing a single N-linked complex carbohydrate moiety.
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