When initiating, to allow tachyphylaxis & reduce adverse effects: 8.8 mcg (0.1 mL of 44 mcg or 0.2 mL of 22 mcg) 3 times wkly during 1st 2 wk, 22 mcg (0.25 mL of 44 mcg or 0.1 mL of 22 mcg) 3 times wkly in wk 3 & 4 then 44 mcg 3 times wkly from 5th wk onwards. 1st demyelinating event & relapsing multiple sclerosis 44 mcg SC 3 times wkly. Patient who cannot tolerate higher dose 22 mcg SC 3 times wkly.
Not to be used in primary progressive multiple sclerosis. TTP or haemolytic uraemic syndrome; suicidal ideation, depression; history of seizures; angina, CHF or arrhythmia; inj site necrosis; nephrotic syndrome; severe myelosuppression; neutralising Ab. Regularly monitor liver enzyme, complete & differential blood cell & platelet counts. Perform thyroid function testing at baseline & every 6-12 mth after initiation. Severe renal & hepatic failure. May affect ability to drive & use machines. Pregnancy. Not to be used in childn <12 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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