27 Rebif FAQs

Rebif overview

Side effects with Rebif

How to take Rebif

Living with Rebif

Choosing a relapsing MS therapy

Rebif overview

Q. What is Rebif?

A. Rebif is a brand name for a product called interferon beta-1a. Interferons belong to a family of proteins that occur naturally in the body.

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Q. Is Rebif proven effective?

A. Rebif was studied in a large placebo-controlled 2-year clinical evaluation of interferon beta-1a in relapsing MS. Called the PRISMS* study, it included 560 people and measured how they responded to either dose of Rebif, Rebif 22 mcg or Rebif 44 mcg, versus placebo. Rebif is the only self-injected relapsing MS therapy proven to achieve 3 key treatment goals in relapsing MS:

  • Slows disability progression.
  • Reduces relapse rate.
  • Reduces active brain lesions on the studied MRI measures.†‡

The exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.

*Prevention of Relapses and Disability by interferon B-1a Subcutaneously in Multiple Sclerosis.

†Refers to new lesions and total lesion burden or area as defined in the AAN and MS Council guidelines.

‡New or enlarging lesions detected with PD/T2-weighted MRI.

What is the most important information I should know about Rebif?

Rebif will not cure multiple sclerosis (MS) but it has been shown to decrease the number of flare-ups and slow the occurrence of some of the physical disability that is common in people with MS. Rebif can cause serious side effects, so before you start taking Rebif, you should talk with your health care provider about the possible benefits of Rebif and its possible side effects to decide if Rebif is right for you.

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Q. How is Rebif different?

A. Rebif is the only self-injected relapsing MS therapy proven to achieve 3 key treatment goals in relapsing MS:

  • Slows disability progression.
  • Reduces relapse rate.
  • Reduces active brain lesions on the studied MRI measures.*

The exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.

*Refers to new lesions and total lesion burden or area as defined in the AAN and MS Council guidelines.

†New or enlarging lesions detected with PD/T2-weighted MRI.

Important safety information

Potential serious side effects include:

  • Depression. Some patients treated with interferons, including Rebif, have become seriously depressed (feeling sad). Some patients have thought about killing themselves and a few have committed suicide. Depression (a sinking of spirits or sadness) is not uncommon in people with multiple sclerosis. However, if you are feeling noticeably sadder or helpless, or feel like hurting yourself or others you should tell a family member or friend right away and call your doctor as soon as possible. Your doctor may ask that you stop using Rebif. You should also tell your doctor if you have ever had any mental illness, including depression, and if you take any medications for depression.

Rebif also differs in how it is prepared and taken—offering product features designed for your flexibility.

Considering Avonex® (interferon beta-1a)?

The EVIDENCE* study was a head-to-head trial that compared Rebif® (interferon beta-1a) with Avonex® (interferon beta-1a) over an average of 64 weeks. Rebif 44 mcg was given to 339 people 3 times a week just under the skin. Avonex 30 mcg was given to 338 people once a week into the muscle.

  • Over 64 weeks, significantly more people taking Rebif 44 mcg versus Avonex 30 mcg were relapse-free (percentage of people remaining relapse-free—Rebif: 56%; Avonex: 48%).

605 people remained at the end of the head-to-head phase of the EVIDENCE study. A total of 495 people participated in the extension phase of the EVIDENCE study, which lasted an average of 8 months. In the extension phase, all patients were offered the option of either taking Rebif 44 mcg three times a week or leaving the study. 73% of people taking Avonex 30 mcg chose to take Rebif 44 mcg, while 91% of people taking Rebif 44 mcg 3 times a week chose to stay on Rebif 44 mcg.

  • People who chose to stay in the extension phase of the study and changed from Avonex to Rebif had fewer relapses and brain lesions after just 8 months of Rebif treatment, compared with their last 6 months on Avonex.
  • People taking Rebif 44 mcg through the extended phase continued to experience significant reductions in relapses over an average of 8 months.

Important safety information

Compared with Avonex, side effects were generally similar despite the higher, more frequent dosing of Rebif. Differences included people taking Avonex had more flu-like symptoms than those taking Rebif. People taking Rebif had a greater number of injection-site reactions, elevated liver enzymes and decreased white blood cell counts; these events also occurred more frequently with Rebif posttransition versus prior use of Avonex.

  • Avonex also offers an autoinjector, called the Avonex Pen®.

  • Rebif also offers an autoinjector, called the Rebiject II®.

Rebif may cause redness, pain, or swelling at the place where an injection was given. Some patients have developed skin infections or areas of severe skin damage (necrosis) requiring treatment by a health care provider. If one of your injection sites becomes swollen and painful or the area looks infected and it doesn’t heal within a few days, you should call your health care provider. For more information, please see medication guide.

Considering Betaseron® (interferon beta-1b)?
  • With Rebif® (interferon beta-1a), each injection requires 13 fewer steps than with Betaseron.*

*No conclusions regarding comparative safety or effectiveness of these products can be drawn from these data.

Considering Extavia® (interferon beta-1b)?
  • Extavia is another branded version of interferon beta-1b with the same dosing and administration as Betaseron® (interferon beta-1b).
Considering Copaxone® (glatiramer acetate injection)?
  • Rebif® (interferon beta-1a) has 209 fewer injections per year than Copaxone.*
  • The 3-times-weekly dosing schedule of Rebif allows for injection-free weekends. Rebif injections should be at least 48 hours apart.

Rebif may cause redness, pain or swelling at the place where an injection was given.

*No conclusions regarding comparative safety or effectiveness of these products can be drawn from these data.

Considering Tysabri® (natalizumab)?
  • Tysabri must be administered by a health care provider once every 4 weeks through an intravenous infusion.

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Q. Has Rebif been studied against any other relapsing MS drug?

A. Rebif is the only self-injected relapsing MS treatment proven to work better than another in a class I clinical trial.*

The EVIDENCE study was a head-to-head trial that compared Rebif with Avonex over an average of 64 weeks. Rebif 44 mcg was given to 339 people 3 times a week just under the skin. Avonex 30 mcg was given to 338 people once a week into the muscle.

Over 64 weeks, significantly more people taking Rebif 44 mcg versus Avonex 30 mcg:

  • Were relapse-free (percentage of people remaining relapse free—Rebif: 56%; Avonex: 48%).
  • Had no new or enlarging lesions detected on MRI (percentage of people with no new or enlarging lesions—Rebif: 58%; Avonex: 38%).

605 people remained at the end of the head-to-head phase of the EVIDENCE study. A total of 495 people participated in the extension phase of the EVIDENCE study, which lasted an average of 8 months. In the extension phase, all patients were offered the option of either taking Rebif 44 mcg or leaving the study. 73% of those taking Avonex 30 mcg chose to take Rebif 44 mcg, while 91% of those taking Rebif 44 mcg 3 times a week chose to stay on Rebif 44 mcg.

People who chose to stay in the extension phase of the study and changed from Avonex to Rebif had fewer relapses and brain lesions after an average of 8 months of Rebif treatment, compared with their last 6 months on Avonex.

Significant reductions were seen across 2 key treatment goals:

  • 22% reduction in active T2 brain lesions.§
  • 50% reduction in relapses.**

The exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.

Important safety information

Compared with Avonex, side effects were generally similar despite the higher, more frequent dosing of Rebif. Differences included people taking Avonex had more flu-like symptoms than those taking Rebif. People taking Rebif had a greater number of injection-site reactions, elevated liver enzymes, and decreased white blood cell counts; these events also occurred more frequently with Rebif posttransition versus prior use of Avonex.

*According to the American Academy of Neurology, data from class I studies are collected under the highest scientific standards and are thought to be the most valid.

†EVIDENCE study—EVidence for Interferon Dose-response: European North American Comparative Efficacy study.

‡New or enlarging lesions detected with PD/T2-weighted MRI.

§New or enlarging lesions detected with PD/T2-weighted MRI: 0.9 for patients during their last 6 months on Avonex versus 0.7 after transitioning from Avonex to Rebif.

** Annualized relapse rate—Rebif: 0.32; Avonex: 0.64.

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Side effects with Rebif

Please refer to the Medication Guide (PDF).

Q. What are the potential serious side effects of Rebif?

A. Potential serious side effects include:

  • Depression. Some patients treated with interferons, including Rebif, have become seriously depressed (feeling sad). Some patients have thought about killing themselves and a few have committed suicide. Depression (a sinking of spirits or sadness) is not uncommon in people with multiple sclerosis. However, if you are feeling noticeably sadder or helpless, or feel like hurting yourself or others you should tell a family member or friend right away and call your doctor as soon as possible. Your doctor may ask that you stop using Rebif. You should also tell your doctor if you have ever had any mental illness, including depression, and if you take any medications for depression.
  • Liver problems. Your liver may be affected by taking Rebif and a few patients have developed severe liver injury. Your health care provider may ask you to have regular blood tests to make sure that your liver is working properly. If your skin or the whites of your eyes become yellow or if you are bruising easily you should call your doctor right away.
  • Risk to pregnancy. If you become pregnant while taking Rebif you should call your doctor right away. Rebif may cause you to lose your baby (miscarry) or may cause harm to your unborn child. You and your doctor will need to decide whether the potential benefit of taking Rebif is greater than the risks are to your unborn child
  • Allergic reactions. Some patients taking Rebif have had severe allergic reactions leading to difficulty breathing, and loss of consciousness. Allergic reactions can happen after your first dose or may not happen until after you have taken Rebif many times. Less severe allergic reactions such as itching, flushing or skin bumps can also happen at any time. If you think you are having an allergic reaction, stop using Rebif immediately and call your doctor.
  • Injection-site problems. Rebif may cause redness, pain or swelling at the place where an injection was given. Some patients have developed skin infections or areas of severe skin damage (necrosis) requiring treatment by a doctor. If one of your injection sites becomes swollen and painful or the area looks infected and it doesn't heal within a few days, you should call your doctor.

For more information, please see medication guide.

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Q. Who should not take Rebif?

A. Do not take Rebif if you:

  • Have had an allergic reaction such as difficulty breathing, flushing or hives to another interferon beta or to human albumin

If you have any of the following conditions or serious medical problems, you should tell your health care provider before taking Rebif:

  • Depression (a sinking feeling or sadness), anxiety (feeling uneasy or fearful for no reason), or trouble sleeping
  • Liver diseases
  • Problems with your thyroid gland
  • Blood problems such as bleeding or bruising easily and anemia (low red blood cells) or low white blood cells
  • Epilepsy
  • Are planning to become pregnant

Tell your health care provider about all medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Rebif and other medicines may affect each other causing serious side effects. Talk to your health care provider before you take any new medicines.

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Q. What are the possible side effects of Rebif?

A. Possible side effects of Rebif:

  • Flu-like symptoms (fever, chills, sweating, muscle aches and tiredness)
  • Skin reactions. Soreness, redness, pain, bruising or swelling may occur at the place of injection
  • Depression and anxiety. Some patients taking interferons have become very depressed and/or anxious
  • Liver problems
  • Abdominal pain
  • Blood problems. You may have a drop in the levels of infection-fighting blood cells, red blood cells or cells that help to form blood clots. If the drop in levels are severe, they can lessen your ability to fight infections, make you feel tired or sluggish or cause you to bruise or bleed easily
  • Thyroid problems. Your thyroid function may change. Symptoms of changes in the function of your thyroid include feeling cold or hot all the time, change in your weight (gain or loss) without a change in your diet or amount of exercise you are getting
  • Severe allergic reactions. Allergic reactions are rare and may be associated with difficulty in breathing and loss of consciousness, which require immediate medical attention

Let your doctor know if you have any of these symptoms or feel sad, tired, hot or cold, or experience hives, rashes, bruising, yellowing of the skin, or a change in body weight (gain or loss).

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Q. What can I do to help with flu-like symptoms?

A. Flu-like symptoms are one of the most common side effects of Rebif. Not everyone experiences them, but the symptoms can range from fever, chills and sweating to muscle aches and tiredness. For many people taking Rebif, flu-like symptoms tend to diminish over time.

With planning and guidance from your health care provider, you may be able to help manage flu-like symptoms.

There are steps you can take that may help you with flu-like symptoms:

  • Take an over-the-counter pain reliever/fever reducer as directed by your health care provider.
    • Taking them just before an injection may help to reduce flu-like symptoms.
    • Some medications are available without a prescription, but they can still have some side effects; read dosing instructions carefully.
  • Find a time of day that works for you.
    • Some people inject Rebif before bed so they can sleep through some of their flu-like symptoms.
    • Others find that injecting earlier in the day works best for them.
    • Be sure to keep up a consistent three-times-per-week injection schedule (at least 48 hours apart) as prescribed by your health care provider.

These tips have been recommended by some health care providers.

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Q. What can I do to help with injection-site reactions?

A. The term "injection-site reaction" refers to any redness, pain, irritation and swelling that may occur at the site of your injection. It's one of the most common side effects of Rebif.

With a few simple strategies, you may be able to help manage these reactions. Talk to your health care provider about how to help manage these reactions.

Some suggestions include:

  • Bring the syringe to room temperature. Removing the syringe from your refrigerator 1–4 hours before injection may help to reduce irritation. Keep in mind that Rebif syringes should never be warmed in the microwave or placed in boiling water.
  • Clean your injection site beforehand with soap and water or alcohol swabs. If you use alcohol, allow the area to dry before injecting to reduce irritation.
  • Rotate your injection sites! Be sure to rotate your sites each time, and don't reuse the same injection spot for at least 7 days. Your MS LifeLines® treatment journal can help you to keep track of your injections.
  • Apply an ice pack to the site for no more than 2 minutes before and after injecting. This can help to minimize discomfort. If ice doesn't help, try a warm compress instead.*
  • Massage the area in a circular motion for at least 2 minutes after injection.*
  • Monitor your injection site over several days for redness, swelling or tenderness. If the site worsens over time, contact your health care provider.
  • See how it's done. You can refresh yourself on proper injection technique by watching our easy-to-follow training video.

*These tips have been recommended by some health care providers. Talk to your health care provider about what's best for you.

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How to take Rebif

Please refer to the Medication Guide (PDF).

Q. How will I receive my Rebif prescription?

A. The syringes are provided in convenient weekly or monthly supply packs. Your health care provider will explain what your starting dose should be and how to increase to recommended dose.

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Q. How is Rebif taken?

A. Rebif is injected just under the skin (subcutaneous injection). Rebif is available in ready-to-use prefilled syringes, so you don't have to worry about mixing any solutions before injection. No extra syringes, needles, needle assembly or other materials are needed. There is also an autoinjector available.

Rebif may cause redness, pain or swelling at the place where an injection was given. Some patients have developed skin infections or areas of severe skin damage (necrosis) requiring treatment by a health care provider. If one of your injection sites becomes swollen and painful or the area looks infected and it doesn't heal within a few days, you should call your health care provider.

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Q. Who can help me learn how to give myself injections?

A. Your health care provider may teach you and/or your care partner the proper way to inject Rebif. Your health care provider may also refer you to MS LifeLines, where you can arrange for a licensed and registered nurse to visit your home, at no charge, to provide injection training for Rebif. Do not give yourself an injection until you are comfortable with the dosing and injection process.

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Q. How often do I take Rebif?

A. Rebif injections should be taken three times a week. Injections should be at least 48 hours apart. Many people choose to take their injections on Monday, Wednesday and Friday so that they have injection-free weekends. After you decide which three days work best for you, stick with those to help make your injections part of your weekly routine.

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Q. What should I do if I forget to take an injection?

A. If it has been two days since your last injection, take your injection as soon as you remember it. Then skip a day and take the next one. If it has been more than three days, contact your health care provider.

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Q. What should I do if I take the wrong dose?

A. If you accidentally take the wrong dose, call your health care provider right away.

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Q. What is Rebiject II®?

A. Rebiject II is an autoinjector designed for use with Rebif.

With the Rebiject II, the needle remains hidden both before and after injecting.

Rebif may cause redness, pain, or swelling at the place where an injection was given. Some patients have developed skin infections or areas of severe skin damage (necrosis) requiring treatment by a health care provider. If one of your injection sites becomes swollen and painful or the area looks infected and it doesn’t heal within a few days, you should call your health care provider. For more information, please see medication guide.

Rebiject II is for use only with Rebif premeasured, prefilled glass syringes and is available exclusively for Rebif users. Rebiject II is available free of charge through MS LifeLines. Call 1-877-447-3243 Monday through Friday 8 AM to 10 PM ET and weekends from 9 AM to 5 PM ET.

You should use the Rebiject II autoinjector only after you have received proper training from a medical professional. The MS LifeLines® Nurse Network may be able to provide injection training to you in the comfort of your home. Call 1-877-447-3243 to learn more.

Learn more or watch an injection training video.

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Q. How should I store Rebif?

A. Store Rebif in the refrigerator between 36°F and 46°F (2°C to 8°C). Do not freeze. If a refrigerator is not available, it may be stored between 36°F and 77°F (2°C to 25°C) for up to 30 days away from heat and light.

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Q. Can I warm up Rebif before I take it?

A. You can allow your Rebif prefilled syringe to gradually reach room temperature before use (typically, 1 to 4 hours before the injection). Doing this may help minimize injection-site discomfort.

Remember to temporarily store your Rebif somewhere safe and out of the way like a kitchen cabinet so that exposure to light and heat is limited. Room temperature should be less than 77°F. Rebif syringes should never be warmed in the microwave or placed in boiling water.

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Living with Rebif

Q. Can I travel with Rebif?

A. If you will be spending time away from home, you can take your Rebif with you. First, pack the supplies you'll need for your trip. A handy travel kit that can carry all your injection supplies is available free through the MS LifeLines® support program. If a refrigerator is not available while you are traveling, Rebif may be stored at or below room temperature (25°C/77°F) for up to 30 days and away from heat and light. For this reason, the travel kit provides a reusable ice pack to help maintain Rebif syringes at the correct temperature while you travel.

Rebif should be stored in the refrigerator at 2°–8°C/36°–46°F. Do not freeze. You should check the temperature of the refrigerator you are using while traveling to avoid unintentionally freezing Rebif. For small hotel refrigerators, store Rebif away from the unit's cooling element and small freezer compartment.

If you are traveling by car, don't leave Rebif on the dash, in the glove box or in the trunk. This is important even if you have it in the insulated pack provided in the travel kit. Keep your syringes with you in the climate-controlled area of the car.

If you are flying, plan to carry your Rebif syringes with you onboard in your carry-on luggage. Be sure to check the latest FAA regulations regarding traveling with injectable medicines. These are subject to change and may require certain documentation.

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Q. What if I become pregnant while I am taking Rebif?

A. Be sure to tell your doctor if you are or plan to become pregnant. If you become pregnant while taking Rebif, you should stop using Rebif immediately and call your doctor. Rebif may cause you to lose your baby (miscarry) or may cause harm to your unborn child. You and your doctor will need to decide whether the potential benefit of taking Rebif is greater than the risks Rebif poses to your unborn child.

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Q. Is there a patient assistance program available for Rebif?

A. Yes. When it comes to helping you start and stay on Rebif therapy, MS LifeLines is committed to making sure cost is not a barrier to finding affordable access. There are a number of programs available. If you need assistance affording Rebif, call the MS LifeLines® Financial Support Team for information on financial support options toll-free at 1-877-447-3243 Monday through Friday 8 AM to 8 PM ET and Saturday from 9 AM to 5 PM ET.

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Choosing a relapsing MS therapy

Q. How can I tell if my current treatment is working?

A. Keep track of your symptoms and how you are feeling. This will help your health care provider follow your disease and determine how well your medicine is working. If you think you are having symptoms, write them down and include when they happened and for how long. You may have had a relapse. A periodic MRI scan may be another way to see whether your MS activity is getting better or worse. If the scan shows new lesions and you are having frequent relapses, you and your health care provider may want to consider another treatment. However, the exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.

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Q. What can I do to reduce relapses?

A. Choosing the right treatment and staying on therapy is key. Rebif is clinically proven to reduce MS relapses. Ask your health care provider if Rebif is right for you.

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Q. Where can I learn more about Rebif?

A. Talk to your health care provider to find out if Rebif may be right for you. You can also call MS LifeLines® toll-free at 1-877-447-3243 Monday through Friday 8 AM to 10 PM ET and weekends from 9 AM to 5 PM ET. MS LifeLines specialists and trained nurses are available to answer your questions about Rebif treatment, dealing with certain side effects and other MS-related questions.

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Q. What if I am having a hard time dealing with the side effects of treatment?

A. Talk to your health care provider. While many DMD treatments are given by injection and have side effects, people can respond differently to each treatment. There may be ways to help with certain side effects, and it is best to consult your health care provider to see what might work for you. Ask your health care provider if Rebif could be right for you.

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Q. What if my injection sites become red and irritated?

A. Talk to your health care provider. These reactions can occur at the injection site even when the injection has been given correctly. Your health care provider should examine any bruises or spots that remain longer than a few days. Local skin reactions are less likely to occur if you vary the injection site. If site reactions are lasting longer than a few days, you should discuss this with your health care provider. Never inject into a prior site that is still red, painful or swollen. Ask your health care provider if Rebif could be right for you.

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Q. How can I find someone to talk to about Rebif therapy?

A. Talk to your health care provider to find out if Rebif may be right for you. You can also call MS LifeLines® toll-free at 1-877-447-3243 Monday through Friday 8 AM to 10 PM ET and weekends from 9 AM to 5 PM ET. MS LifeLines specialists and trained nurses are available to answer questions about Rebif treatment, dealing with side effects and other MS-related questions.

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Ron B.
MS LifeLines Ambassador, living with relapsing MS

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