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What are the long term side effects of Rebif?

Medically reviewed by Kristianne Hannemann, PharmD. Last updated on March 31, 2025.

Official answer

by Drugs.com

Rebif (interferon beta-1a) is an effective medication for relapsing forms of multiple sclerosis (MS), but it has a few potential long-term side effects. Data from over two decades of clinical experience and studies have shown that most side effects of Rebif are temporary and reversible. More rare but long-term side effects may include liver damage, lung damage, and skin damage at the injection site.

Regular monitoring by a healthcare provider can help detect and manage these risks early. They might need to order blood tests to check the health of your organs and monitor your blood cell count.

1. Liver damage

Although rare, Rebif can cause liver damage. Your risk might be higher if you:

  • Drink excessive amounts of alcohol
  • Take other medications that can harm the liver
  • Have a history of liver problems

You might not notice any symptoms from liver damage, and most cases are mild. However, some patients have experienced liver failure and have required a liver transplant.

Symptoms of liver damage usually start after 1-6 months of starting treatment with Rebif. Signs of liver damage may include:

  • Yellowing of the skin or whites of the eyes
  • Nausea and/or vomiting
  • Stomach pain
  • Clay-colored stool

Contact your healthcare provider right away if you notice any of the symptoms listed above. They can check your liver health to make sure you do not have any liver problems. Your healthcare provider may need to temporarily lower your dose or stop your treatment with Rebif if necessary.

2. Lung damage

Some patients taking Rebif developed pulmonary arterial hypertension (PAH), a condition characterized by high blood pressure in the lungs. This has led to lung damage and even a lung transplant in one patient. PAH can occur anytime during treatment. Some patients have experienced PAH several years after starting Rebif.

Symptoms of PAH may include:

  • Shortness of breath
  • Feeling more tired than usual
  • Cough
  • Chest pain
  • Swelling in the feet or legs
  • Hoarse voice

Get medical attention if you have any of the symptoms listed above.

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3. Skin damage at the injection site

Rebif is administered via subcutaneous (under-the-skin) injection three times a week. While mild injection-site reactions such as redness, pain, and swelling are common, severe reactions like necrosis (skin tissue death) can occur in rare cases. Some patients have needed to get surgery to repair the skin damage.

Prevention Tips:

  • Rotate injection sites with each dose of Rebif
  • Monitor injection sites for severe reactions
  • Notify your healthcare provider if you experience significant pain, skin discoloration, or open sores

4. Damage to other organs in the body

Rebif has been linked to a rare condition called thrombotic microangiopathy, which can lead to blood clots that damage vital organs such as the kidneys. This can happen weeks to years after starting Rebif. Your healthcare provider may order blood tests to check for signs of organ damage and adjust your treatment if needed.

This is not all the information you need to know about Rebif (interferon beta-1a) for safe and effective use and does not take the place of your healthcare provider’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References

American Lung Association. Updated June 2024. Pulmonary Arterial Hypertension Symptoms and Diagnosis. Accessed July 30, 2024 at https://www.lung.org/lung-health-diseases/lung-disease-lookup/pulmonary-arterial-hypertension/symptoms-diagnosis

Cohan, S., et. al. 2015. Results of sustained long-term use of interferon beta-1a in a community-based cohort of patients with relapsing multiple sclerosis. In: Journal of Drug Assessment. DOI: https://doi.org/10.3109/21556660.2015.1010650

Freedman, M. S., et. al. 2024. Twenty Years of Subcutaneous Interferon-Beta-1a for Multiple Sclerosis: Contemporary Perspectives. In: Neurology and Therapy. DOI: https://doi.org/10.1007/s40120-023-00565-7

Rebif [package insert]. Updated August 2023. EMD Serono, Inc. Accessed July 30, 2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c6fcb5d2-8fcd-44fa-a838-b84ee5f44f0f

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