Example orders for adjuvant Interferon alfa-2b (Intron-A) in melanoma

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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

Interferon alfa-2b (Intron-A)

Published regimens and references can be found on the melanoma page.

Example order set #1 (5 days per week)

Induction phase

• Interferon alfa-2b (Intron-A) 20,000,000 units/m² IV once per day on days 1, 2, 3, 6, 7

7-day cycles x 4 cycles, then proceed to maintenance phase

Supportive medications

• Acetaminophen (Tylenol) 1000 mg PO once 30 minutes prior to interferon
• Naproxen (Naprosyn) 375 mg PO Q12H prn fevers, chills, myalgias, headache if acetaminophen not effective
• Lorazepam (Ativan) 0.5 to 1 mg PO once prn nausea/anxiety 30 minutes prior to chemotherapy

Hydration:

• Normal saline 500 mL IV bolus over 20 minutes prior to interferon
• Normal saline IV continuous infusion at 5 mL/H during administration of interferon
• Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.

Maintenance phase

Frequency and dose may need to be adjusted based on patient's tolerance of induction phase.

• Interferon alfa-2b (Intron-A) 10,000,000 units/m² SC three times per week

48-week course

Example order set #2 (3 days per week)

Induction phase

• Interferon alfa-2b (Intron-A) 20,000,000 units/m² IV once per day on days 3, 6, 7

7-day cycles x 4 cycles, then proceed to maintenance phase

Supportive medications

• Acetaminophen (Tylenol) 1000 mg PO once 30 minutes prior to interferon
• Naproxen (Naprosyn) 375 mg PO Q12H prn fevers, chills, myalgias, headache if acetaminophen not effective
• Lorazepam (Ativan) 0.5 to 1 mg PO once prn nausea/anxiety 30 minutes prior to chemotherapy

Hydration:

• Normal saline 500 mL IV bolus over 20 minutes prior to interferon
• Normal saline IV continuous infusion at 5 mL/H during administration of interferon
• Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.

Maintenance phase

Frequency and dose may need to be adjusted based on patient's tolerance of induction phase.

• Interferon alfa-2b (Intron-A) 10,000,000 units/m² SC three times per week

48-week course

Example order set #3 (2 days per week)

Induction phase

• Interferon alfa-2b (Intron-A) 20,000,000 units/m² IV once per day on days 6 & 7

7-day cycles x 4 cycles, then proceed to maintenance phase

Supportive medications

• Acetaminophen (Tylenol) 1000 mg PO once 30 minutes prior to interferon
• Naproxen (Naprosyn) 375 mg PO Q12H prn fevers, chills, myalgias, headache if acetaminophen not effective
• Lorazepam (Ativan) 0.5 to 1 mg PO once prn nausea/anxiety 30 minutes prior to chemotherapy

Hydration:

• Normal saline 500 mL IV bolus over 20 minutes prior to interferon
• Normal saline IV continuous infusion at 5 mL/H during administration of interferon
• Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.

Maintenance phase

Frequency and dose may need to be adjusted based on patient's tolerance of induction phase.

• Interferon alfa-2b (Intron-A) 10,000,000 units/m² SC three times per week

48-week course