Key takeaways
- Rebif is self-injected three times per week to treat certain forms of multiple sclerosis (MS) and clinically isolated syndrome (CIS).
- Rebif comes in prefilled syringes and an autoinjector called Rebif Rebidose. Each form is single-dose, meaning each time you give an injection you’ll use a new syringe or autoinjector.
- You’ll start with a low dose and your doctor will typically have you increase your dose every two weeks. They might prescribe a target dosage of either 22 micrograms (mcg) or 44 mcg per week.
Rebif (interferon beta-1a) is approved by the Food and Drug Administration (FDA) to treat:
Rebif is a biologic and belongs to a drug class called interferons. It’s not available in a biosimilar version.
Keep reading for specific information about the dosage of Rebif, including its strengths and how to use the medication.
This section describes recommended dosages of Rebif and other details about the drug.
Rebif forms
Rebif is a liquid solution that’s given as a subcutaneous injection. It comes in:
- single-dose prefilled autoinjectors (Rebif Rebidose)
- single-dose prefilled syringes
Your doctor will show you how to self-inject Rebif.
Rebif strengths
The Rebif prefilled syringe and Rebidose autoinjector both come in three strengths:
- 8.8 mcg per 0.2 milliliters (mL)
- 22 mcg per 0.5 mL
- 44 mcg per 0.5 mL
A Rebif Titration Pack is also available. It contains the doses you need during the titration period when you start taking Rebif. (Titration refers to starting with a low dose and gradually increasing it.)
The Rebif Titration Pack contains six doses of 8.8 mcg and six doses of 22 mcg. It’s available for the syringes and the Rebidose autoinjectors.
Typical dosage for MS and CIS
The recommended Rebif dosage for MS and CIS is either 22 mcg or 44 mcg. Which dose your doctor prescribes may depend on how severe your symptoms are. (See “Factors that can affect your dosage” for details.)
If your target dose is 22 mcg
Your starting dose will likely be 4.4 mcg. Typically, you’ll administer this three times per week on Monday, Wednesday, and Friday. This allows at least 48 hours between each dose. It’s best to inject Rebif in the late afternoon or early evening.
After 2 weeks, your doctor may recommend increasing your dose to 11 mcg. Then, in another 2 weeks, they will likely increase it to a maintenance (ongoing) dosage of 22 mcg.
If this dose isn’t working for you, your doctor may recommend another dose increase, up to 44 mcg. This is the maximum recommended dose of Rebif.
Rebif dose increases for a 22-mcg target dose are shown in the following table. Note: You’ll use a syringe for your starting doses, and you should dispose of the syringe after each injection, even when you only use half of it.
| Week of treatment | Dosage | Amount of syringe/autoinjector to use |
|---|---|---|
| Week 1 | 4.4 mcg | Use one half of an 8.8 mcg syringe. |
| Week 2 | 4.4 mcg | Use one half of an 8.8 mcg syringe. |
| Week 3 | 11 mcg | Use one half of a 22 mcg syringe. |
| Week 4 | 11 mcg | Use one half of a 22 mcg syringe. |
| Week 5 and after (maintenance dosage) | 22 mcg | Use one full 22 mcg syringe or autoinjector. |
If your target dose is 44 mcg
Your starting dose will likely be 8.8 mcg. Typically, you’ll administer this three times per week on Monday, Wednesday, and Friday. This allows at least 48 hours between each dosage. It’s best to inject Rebif in the late afternoon or early evening.
After 2 weeks, your doctor may recommend increasing your dosage to 22 mcg. Then, in another 2 weeks, they will likely increase it to a maintenance (ongoing) dose of 44 mcg. This is the maximum dose of Rebif that’s recommended.
Rebif dose increases for a 44-mcg target dose are shown in the following table.
| Week of treatment | Dosage | Amount of syringe/autoinjector to use |
|---|---|---|
| Week 1 | 8.8 mcg | Use one full 8.8 mcg syringe or autoinjector. |
| Week 2 | 8.8 mcg | Use one full 8.8 mcg syringe or autoinjector. |
| Week 3 | 22 mcg | Use one full 22 mcg syringe or autoinjector. |
| Week 4 | 22 mcg | Use one full 22 mcg syringe or autoinjector. |
| Week 5 and after (maintenance dosage) | 44 mcg | Use one full 44 mcg syringe or autoinjector. |
Long-term treatment
Rebif is meant to be used as a long-term treatment. If you and your doctor determine that Rebif is safe and effective for you, you’ll likely use it long term.
The Rebif dosage your doctor prescribes will depend on several factors. These include:
- your age
- how your body responds to Rebif
- the type and severity of your MS
- any Rebif side effects you experience
- your liver and kidney function
Other medical conditions you have can also affect your Rebif dosage.
Dosage adjustments
Your doctor may need to adjust your dosage if you have liver damage or kidney disease, or if you’re age 65 years or older.
Be sure to tell your doctor about all medications you take and any health conditions you may have.
Rebif comes as a liquid solution in single-dose prefilled syringes and Rebidose autoinjectors. It’s given as a subcutaneous injection, which is an injection under your skin.
Your doctor will administer your first dose. Then, they’ll show you (or a caregiver) how to do it. Make sure to inject Rebif according to your doctor or healthcare professional’s instructions.
You can self-inject Rebif into your abdomen, the top of your thigh, your outer buttocks, or the back of your upper arm. If you inject into your abdomen, do not inject it within 2 inches of your belly button.
Be sure to choose a different injection site each time you inject Rebif. And avoid areas where your skin is tender, hard, or irritated. This will reduce your risk of injection-related side effects, such as bleeding or pain at the injection site.
You’ll store Rebif syringes or autoinjectors in the refrigerator. Rebif can be stored at room temperature (out of heat and light) for up to 30 days, but if you store it at room temperature, you’ll need to throw any remaining Rebif away after 30 days.
Rebif syringes and autoinjectors are single-dose, meaning you should safely dispose of them after one injection.
For detailed instructions on how to use each form of Rebif, refer to the step-by-step instructions and videos on the manufacturer site.
You can use Rebif prefilled syringes either alone or with devices called Rebiject II autoinjectors.
Using Rebif single-dose, prefilled syringes alone
When using Rebif syringes alone, administer the drug by following these steps:
- Wash your hands thoroughly, and clean the injection site with alcohol.
- Pinch the skin around the injection site to lift it up a bit.
- Hold the syringe at a 90-degree angle from your skin. Use a quick, firm motion to insert the needle straight into your skin.
- Once the needle is inserted, release the pinched skin and gently depress the syringe plunger all the way down.
- You can then remove the needle from your skin and gently apply pressure to the injection site with a clean cotton ball or gauze pad.
- Dispose of the used syringe in a sharps container. Here are some tips for safely disposing of the syringe. Your doctor can also give you instructions on how to do this.
- Monitor your injection site for any discoloration or swelling.
For more detailed instructions, see the manufacturer’s website.
Using Rebif single-dose, prefilled syringes with a Rebiject II autoinjector
To use a Rebiject II autoinjector with a prefilled syringe, place the syringe into the autoinjector device. You can use the Rebiject II autoinjector for multiple doses of Rebif.
Unlike the prefilled Rebidose autoinjector (discussed next), you don’t need to throw away the Rebiject II autoinjector after each use.
Using the autoinjector device with Rebif syringes can help make administering the drug a bit easier. This is because the autoinjector allows you to adjust the needle depth in your skin.
With the device, you’ll have a nonslip grip on the Rebif syringe. In addition, the autoinjector device has a signal that lets you know when your dose has been fully injected.
You can find detailed instructions on how to use the Rebiject II autoinjector device on the manufacturer’s website.
How to inject Rebif using single-dose, prefilled Rebidose autoinjectors
Rebif comes in single-dose, prefilled syringes and in single-dose, prefilled Rebidose autoinjectors. Here, we describe how to use the single-dose, prefilled Rebidose autoinjectors.
Rebif single-dose, prefilled Rebidose autoinjectors are fully assembled and ready to use. When using Rebidose autoinjectors, you can administer Rebif by following these steps:
- Wash your hands thoroughly, and clean the injection site with alcohol.
- Pull the needle cap off the autoinjector and throw it away.
- Hold the Rebidose autoinjector in your palm, with your thumb hovering above the injector button.
- Place the autoinjector at a 90-degree angle against your skin and press it until you feel some resistance.
- Use your thumb to push the injector button. You’ll hear a click, which indicates that the device has started injecting your dose of Rebif.
- Keep the Rebidose autoinjector pressed against your skin for 10 seconds while the medication is being injected. Before removing the device from your skin, make sure the device’s syringe plunger has moved all the way to the bottom. This means that your entire dose has been injected.
- Lift the Rebidose autoinjector from your skin and dispose of it in a sharps container.
For more detailed instructions on how to use the Rebidose autoinjector, visit the manufacturer’s website.
If you miss a dose of Rebif, inject it as soon as you remember. Then, take your next Rebif dose at least 48 hours later. Do not inject Rebif 2 days in a row. If you’re not sure whether you should inject a missed dose or skip it, talk with your doctor or pharmacist.
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How long a medication remains good can depend on many factors, including how and where you store the medication.
Both Rebif syringes and autoinjectors should be stored in the refrigerator. They should be kept at a temperature between 36°F and 46°F (2°C and 8°C). Rebif can be stored at this temperature until its expiration date. Do not freeze Rebif.
It’s also possible to store Rebif at a warmer temperature, up to 77°F (25°C). However, if Rebif is stored at room temperature, it’s only good for 30 days. This is because the drug doesn’t contain any preservatives.
In either case, store the drug away from heat and light.
It’s important that you do not use more Rebif than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.
If you take more than the recommended amount of Rebif
Call your doctor right away if you believe you’ve taken too much Rebif. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
Here are some frequently asked questions about Rebif.
How long does it take for Rebif to start working?
Rebif starts to work after your first dose. Because of how the drug works, you likely won’t feel the drug working in your body. But your doctor will monitor you during treatment to check whether the drug is working to treat your condition.
Over time, you may also notice fewer symptoms and flare-ups from your condition due to your Rebif treatment.
Talk with your doctor if you have questions about what to expect with Rebif treatment.
Is there a typical dosage range for Rebif?
Yes, the typical recommended dosage range for Rebif in the titration phase ranges from 4.4 to 22.0 mcg three times per week until you reach a target maintenance dosage of either 22 mcg or 44 mcg three times per week.
For more information about Rebif dosages, see the “Rebif dosage” section. You can also talk with your doctor or pharmacist.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.