Discontinue use if thrombotic microangiopathy is diagnosed; has multiple lesions; icterus or other clinical symptoms of liver dysfunction occur; nephrotic syndrome. Further testing of blood platelet level, serum, LDH, blood films & renal function is recommended if clinical features of TMA is observed. Monitor serum ALT prior to, at mth 1, 3 & 6 & periodically after treatment; early signs or symptoms eg, oedema, proteinuria & impaired renal function; liver enzyme & complete & differential blood cell counts & platelet counts at regular intervals (1, 3 & 6 mth) following initiation of therapy & periodically thereafter in the absence of clinical symptoms; thyroid function at baseline & if abnormal, every 6-12 mth following initiation of therapy. Evaluate patients at least every 2nd yr in the 4-yr period after initiation of treatment. Flu-like syndrome, previous or current depressive disorders, suicidal ideation. History of seizures, to those receiving treatment w/ anti-epileptics. Closely monitor patients w/ cardiac disease eg, angina, CHF or arrhythmia. Rotate inj site w/ each dose & use aseptic inj technique to minimize inj site necrosis (ISN). Patients w/ myelosuppression. Serum neutralising Abs against interferon β-1a may develop. Not to be used in patients w/ primary progressive multiple sclerosis. Might influence the patient’s ability to drive or use machines. Severe renal & hepatic failure. History of significant liver disease, clinical evidence of active liver disease, alcohol abuse or increased serum ALT (>2.5 x ULN). Pregnancy. Not to be used in childn <2 yr. Not to be given in premature babies or neonates. May cause toxic & anaphylactoid reactions in infants & childn up to 3 yr due to benzyl alcohol.
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