"Nov. 16, 2012 -- Air pollution may be bad for older brains, a new study shows.
Older adults who live in areas of high pollution did not do as well on tests of memory and other thinking skills, according to a new study.
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Rebif® (interferon beta-1a) is indicated for the treatment of patients with relapsing forms of multiple sclerosis to decrease the frequency of clinical exacerbations and delay the accumulation of physical disability. Efficacy of Rebif® in chronic progressive multiple sclerosis has not been established.
DOSAGE AND ADMINISTRATION
Dosages of Rebif® shown to be safe and effective are 22 mcg and 44 mcg injected subcutaneously three times per week. Rebif® should be administered, if possible, at the same time (preferably in the late afternoon or evening) on the same three days (e.g., Monday, Wednesday, and Friday) at least 48 hours apart each week (see Clinical Studies). Generally, patients should be started at 20% of the prescribed dose three times per week and increased over a 4-week period to the targeted dose, either 22 mcg three times per week (see Table 4) or 44 mcg three times per week (see Table 5). Patients prescribed a targeted dose of 22 mcg three times per week should use the pre-filled syringes for titration. Following the administration of each dose, any residual product remaining in the syringe should be discarded in a safe and proper manner.
A Titration Pack containing 6 doses of 8.8 mcg (0.2 mL) and 6 doses of 22 mcg (0.5 mL) is available for use during the titration period in both Rebif® pre-filled syringes and Rebif® Rebidose® autoinjectors.
Table 4: Titration Sc ledule for a 22 mcg Prescribed
|Week of Use||Dose||Syringe to Use||Amount of syringe|
|Week 1 Titration||4.4 mcg||8.8 mcg syringe||Use half of syringe|
|Week 2 Titration||4.4 mcg||8.8 mcg syringe||Use half of syringe|
|Week 3 Titration||11 mcg||22 mcg syringe||Use half of syringe|
|Week 4 Titration||11 mcg||22 mcg syringe||Use half of syringe|
|Week 5 and on||22 mcg||22 mcg syringe or autoinjector||Use full syringe or autoinjector|
|*Only pre-filled syringes can be used to titrate to 22 mcg Prescribed Dose|
Table 5: Titration Schedule for a 44 mcg Prescribed Dose**
|Week of Use||Dose||Syringe or Autoinjector to Use||Amount of syringe or autoinjector|
|Week 1 Titration||8.8 mcg||8.8 mcg syringe or autoinjector||Use full syringe or autoinjector|
|Week 2 Titration||8.8 mcg||8.8 mcg syringe or autoinjector||Use full syringe or autoinjector|
|Week 3 Titration||22 mcg||22 mcg syringe or autoinjector||Use full syringe or autoinjector|
|Week 4 Titration||22 mcg||22 mcg syringe or autoinjector||Use full syringe or autoinjector|
|Week 5 and on||44 mcg||44 mcg syringe or autoinjector||Use full syringe or autoinjector|
|**Pre-filled syringes or autoinjectors can be used to titrate to 44 mcg Prescribed Dose|
Leukopenia or elevated liver function tests may necessitate dose reduction or discontinuation of Rebif® administration until toxicity is resolved (see WARNINGS: Hepatic Injury, PRECAUTIONS: General and ADVERSE REACTIONS).
Rebif® is intended for use under the guidance and supervision of a physician. It is recommended that physicians or qualified medical personnel train patients in the proper technique for selfadministering subcutaneous (sc) injections using the pre-filled syringe or injection device approved for use with Rebif®. Injection depth of the Rebif® Rebidose® autoinjector is fixed at 8 mm; the health care provider should determine the injection technique. Patients should be advised to rotate sites for sc injections (see PATIENT INFORMATION). Concurrent use of analgesics and/or antipyretics may help ameliorate flu-like symptoms on treatment days. Rebif® should be inspected visually for particulate matter and discoloration prior to administration.
Stability and Storage
Rebif® should be stored refrigerated between 36°F to 46°F (2°C to 8°C ). DO NOT FREEZE. If a refrigerator is not available, Rebif® may be stored between 36°F to 77°F (2°C to 25°C) for up to 30 days and away from heat and light.
Do not use beyond the expiration date printed on packages. Rebif® contains no preservatives. Each pre-filled syringe and Rebif® Rebidose® autoinjector is intended for single use. Unused portions should be discarded.
Rebif® is supplied as a sterile, preservative-free solution packaged in two different delivery options:
- Pre-filled Syringes: graduated, ready to use in 0.2 mL or 0.5 mL with 29-gauge 0.5 inch needle for subcutaneous injections.
- Rebif® Rebidose® Autoinjectors: pre-assembled, ready to use in 0.2 mL or 0.5 mL with 29-gauge, 0.5 inch needle for subcutaneous injections.
The following package presentations are available:
Rebif® (interferon beta -1a) Titration Pack, NDC 44087-8822-1
- Six Rebif® 8.8 mcg pre-filled syringes and Six Rebif® 22 mcg pre-filled syringe
Rebif® (interferon beta -1a) 22 mcg Pre-filled syringe
- One Rebif® 22 mcg pre-filled syringe, NDC 44087-0022-1
- Twelve Rebif® 22 mcg pre-filled syringes, NDC 44087-0022-3
Rebif® (interferon beta -1a) 44 mcg Pre-filled syringe
- One Rebif® 44 mcg pre-filled syringe, NDC 44087-0044-1
- Twelve Rebif® 44 mcg pre-filled syringes, NDC 44087-0044-3
Rebif® Rebidose® Autoinjectors
Rebif® (interferon beta-1a) Titration Pack, NDC 44087-0188-1
- Six Rebif® 8.8 mcg autoinjectors with lime-green injector buttons and Six Rebif® 22 mcg with yellow injector buttons.
Rebif® (interferon beta-1a) 22 mcg Rebif® Rebidose® Autoinjector
- Twelve Rebif® 22 mcg autoinjectors with yellow injector buttons, NDC 44087-3322-1
Rebif® (interferon beta-1a) 44 mcg Rebif® Rebidose® Autoinjector
- Twelve Rebif® 44 mcg autoinjectors with teal-blue injector buttons, NDC 44087-3344-1
Manufactured by EMD Serono, Inc. Rockland, MA 02370 U.S. License # 1773. Marketed by: EMD Serono, Inc. Pfizer Inc., Rockland, MA 02370 New York, NY 10017. Revised: April 2013
Last reviewed on RxList: 5/3/2013
This monograph has been modified to include the generic and brand name in many instances.
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