Avonex Special Precautions

Talk to the doctor before using Avonex if the patient has or had in the past: Depression or problems affecting the moods.
Thoughts about committing suicide.
Changes to the mood, thoughts about suicide, feeling unusually sad, anxious or worthless, should be reported to the doctor immediately.
Epilepsy or other seizure disorders not controlled by medication.
Serious kidney or liver problems.
A low number of white blood cells or platelets, which can cause an increased risk of infection, bleeding or anaemia.
Heart problems, which can cause symptoms such as chest pain (angina), particularly after any activity; swollen ankles, shortness of breath (congestive heart failure); or an irregular heartbeat (arrhythmias).
Talk to the doctor in the event of any of these conditions, or if they worsen whilst taking Avonex.
Blood clots in the small blood vessels may occur during treatment. These blood clots could affect the kidneys. This might happen several weeks to several years after starting Avonex.
The doctor may want to check the blood pressure, blood (platelet count) and function of the kidneys.
Thrombotic microangiopathy (TMA): Cases of thrombotic microangiopathy, manifested as thrombotic thrombocytopenic purpura (TTP) or haemolytic uraemic syndrome (HUS), including fatal cases, have been reported with interferon beta products. Events were reported at various time points during treatment and may occur several weeks to several years after starting treatment with interferon beta. Early clinical features include thrombocytopenia, new onset hypertension, fever, central nervous system symptoms (e.g. confusion, paresis) and impaired renal function. Laboratory findings suggestive of TMA include decreased platelet counts, increased serum lactate dehydrogenase (LDH) due to haemolysis and schistocytes (erythrocyte fragmentation) on a blood film. Therefore if clinical features of TMA are observed, further testing of blood platelet levels, serum LDH, blood films and renal function is recommended. If TMA is diagnosed, prompt treatment is required (considering plasma exchange) and immediate discontinuation of Avonex is recommended.
Nephrotic Syndrome: Cases of nephrotic syndrome with different underlying nephropathies including collapsing focal segmental glomerulosclerosis (FSGS), minimal change disease (MCD), membranoproliferative glomerulonephritis (MPGN) and membranous glomerulopathy (MGN) have been reported during treatment with interferon-beta products. Events were reported at various time points during treatment and may occur after several years of treatment with interferon-beta. Periodic monitoring of early signs or symptoms, e.g. oedema, proteinuria and impaired renal function is recommended, especially in patients at higher risk of renal disease. Prompt treatment of nephrotic syndrome is required and discontinuation of treatment with Avonex should be considered.
Tell the doctor that the patient is using Avonex: If he/she is having a blood test, Avonex may interfere with the results.
Important information about some of the ingredients of Avonex: This medicine is essentially 'sodium-free'. It contains less than 23 mg (1 mmol) sodium in each weekly dose.
Driving and using machines: If the patient feels dizzy, do not drive. Avonex makes some people feel dizzy. If this happens, or if the patient gets any other side effects that could affect the ability, do not drive or use machines.