Interferondosage

For intramuscular use only Recommended dose: 30 micrograms once a week AVONEX may be titrated, starting with 7.5 micrograms for first week, to reduce flu-like symptoms Increase dose by 7.5 micrograms each week for next 3 weeks until recommended dose of 30 micrograms See patient instructions for use for complete administration instructions Perform first injection under the supervision of an appropriately qualified health care professional Analgesics and/or antipyretics on treatment days may help ameliorate flu-like symptoms 2.1 Dosing Information AVONEX is administered intramuscularly. The recommended dose is 30 micrograms once a week. To reduce the incidence and severity of flu-like symptoms that may occur when initiating AVONEX therapy at a dose of 30 micrograms, AVONEX may be started at a dose of 7.5 micrograms and the dose may be increased by 7.5 micrograms each week for the next three weeks until the recommended dose of 30 micrograms is achieved (see Table 1 ). An AVOSTARTGRIP™ kit containing 3 titration devices can be used for titration and is to be used only with AVONEX Prefilled Syringes.

Table 1: Schedule for Dose Titration 1 Dosed once a week, intramuscularly AVONEX Dose 1 Recommended Dose Week 1 7.5 micrograms 1/4 dose Week 2 15 micrograms 1/2 dose Week 3 22.5 micrograms 3/4 dose Week 4+ 30 micrograms full dose

2.2 Important

Administration Instructions (All Dosage Forms) AVONEX dosage forms (prefilled syringe and prefilled autoinjector) are single-dose. See Patient's Instructions for Use for complete administration instructions. The first AVONEX injection should be performed under the supervision of an appropriately qualified healthcare professional. If patients or caregivers are to administer AVONEX, train them in the proper intramuscular injection technique and assess their ability to inject intramuscularly to ensure the proper administration of AVONEX. Advise patients and caregivers to: Rotate injection sites with each administration to minimize the likelihood of injection site reactions, including necrosis or localized infection NOT inject into an area of the body where the skin is irritated, reddened, bruised, infected or scarred in any way Check the injection site after 2 hours for redness, swelling, or tenderness Contact their healthcare provider if they have a skin reaction and it does not clear up in a few days Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. A 25 gauge, 1” needle for intramuscular injection with AVONEX prefilled syringe may be substituted for the 23 gauge, 1 ¼” needle by the healthcare provider, if deemed appropriate. A 25 gauge, 5/8” needle specific to the prefilled autoinjector is supplied with the AVONEX PEN ® Administration Dose Pack. DO NOT use any other needle with the autoinjector. Use safe disposal procedures for needles and syringes. DO NOT re-use needles, prefilled syringes, or autoinjectors. Following the administration of each titrated dose, discard any remaining product.

2.3 Premedication for

Flu-like Symptoms Concurrent use of analgesics and/or antipyretics on treatment days may help ameliorate flu-like symptoms associated with AVONEX use.