<p><strong>Hepatic Impairment:</strong><br />
<br />
<strong>Chronic hepatitis C:</strong>&nbsp;Alanine transaminase (ALT) progressively rising above baseline: Decrease dose to 135 mcg/wk. If ALT continues to rise or is accompanied by increased bilirubin or hepatic decompensation, discontinue immediately.<br />
<strong>Chronic hepatitis B:</strong>&nbsp;Alanine transaminase (ALT) &gt;5 times the upper limits of normal: Monitor LFTs more frequently; consider 135 mcg/wk or temporarily discontinuing (may resume after ALT flare subsides). ALT &gt;10 times the upper limits of normal: Consider discontinuing.<br />
<br />
<strong>Dose modifications:</strong><br />
<br />
For moderate-to-severe adverse reactions: Initially, 135 mcg/wk or in some cases, 90 mcg/wk. Haematologic parameters: ANC &lt;750/mm3: 135 mcg/wk; ANC &lt;500/mm3: Discontinue therapy until &gt;1000/mm3, then restart at 90 mcg/wk; monitor ANC. Platelet count: &lt;50,000/mm3: 90 mcg/wk; &lt;25,000/mm3: Discontinue therapy. Depression: Moderate: Decrease to 90-135 mcg once/wk; evaluate once wkly, if symptoms improve and remain stable for 4 wk, continue reduced dosing or return to normal dose; Severe: Discontinue treatment permanently. Administer in the abdomen or thigh.<br />
<br />
<strong>Renal Impairment:</strong><br />
CrCl &lt;50:&nbsp;Use caution; monitor for toxicity .</p>