Home » Notes » Nursing Pharmacology » Immunostimulants (Interferons, Interleukins)

Immunostimulants (Interferons, Interleukins)

Updated on
By Iris Dawn Tabangcora, RN

Immunostimulants or immune stimulants are drugs that energize the immune system when it is exhausted from fighting prolonged invasion or when the immune system needs help fighting a specific pathogen or cancer cell. It is one of the classifications of drug class called immunomodulators.

Immunomodulators, as the name implies, are drugs that modify the actions of the immune system. The other classification is immune suppressants, drugs utilized to block the normal effects of the immune system in cases of organ transplantation and autoimmune disorders.

Immune stimulants include interferons, interleukins, and colony-stimulating factors (utilized to stimulate bone marrow to produce more white blood cells especially for patients at serious risk for infection).

Table of Contents

Immunostimulants: Generic and Brand Names

Here is a table of commonly encountered immune stimulants, their generic names, and brand names:

  • Interferons
    • interferon-alpha-2b (Intron-A)
    • interferon-alfacon-1 (Infergen)
    • interferon-alfa-n3 (Alferon N)
    • interferon-beta-1a (Avonex)
    • interferon-beta-1b (Betaseron)
    • interferon-gamma-1b (Actimmune)
    • peginterferon alfa-2b (Peg-Intron)
  • Interleukins
    • aldesleukin (Proleukin)
    • oprelvekin (Neumega)
  • Colony-Stimulating Factors
    • filgrastim (Neupogen)
    • pegfilgrastim (Neulasta)
    • sargramostim (Leukine)


  • Interferons are substances naturally produced and released by human cells that have been invaded by the viruses. They may also be released from cells in response to other stimuli, e.g. cytotoxic T-cell activity.
  • Through the advent of recombinant DNA technology, a number of interferons are now available for use.

Therapeutic Action

The desired and beneficial actions of interferons are as follows:

  • Preventing virus particles from replicating inside cells.
  • Stimulating interferon receptor sites on non invaded cells to produce antiviral proteins, which prevent viruses from entering the cell.
  • Others include inhibiting tumor growth and replication, stimulating cytotoxic T-cell activity, and enhancing inflammatory response.
  • Interferon gamma-1b also acts like an interleukin, stimulating phagocytes to be more aggressive.


Interferons are indicated for the following medical conditions:

  • Treatment of chronic hepatitis C in adults
  • Treatment of multiple sclerosis in adults
  • Treatment of leukemias, Kaposi sarcoma, warts, AIDS-related complex, and malignant melanoma

Here are some important aspects to remember for indication of immune modulators in different age groups:


  • Most immune modulators are not recommended for use in children or have not been tested.
  • Exceptions include interferon alfa-2b, azathioprine, cyclosporine, tacrolimus, and palivizumab which should be used cautiously because of their toxic effects on GI, renal, hematological, or central nervous system.
  • Active children should be protected from infection and injury.


  • Emphasize the importance of avoiding exposure to infection. Regular follow-up and medical care should be stressed.
  • Educate about proper technique for injection, disposal of needles, and special storage precautions for the drug.
  • Immune modulators are contraindicated for pregnancy and lactation because of potential adverse effects to neonate or fetus (e.g. fetal abnormalities, increased maternal and fetal abnormalities, and increased maternal and fetal infections, suppressed immune responses in nursing babies).
  • Women of childbearing age should be advised to use barrier contraceptives while taking these drugs. Some drugs may also impair fertility.

Older adults

  • The aging immune system of this population makes them more susceptible to the effects of immunomodulators.
  • Monitor closely for GI, CNS, renal, and hepatic toxic effects.
  • Extensive health education on avoiding infection and injury is necessary.


Here are the characteristic interactions of interferons and the body in terms of absorption, distribution, metabolism, and excretion:

IM, subcutaneousRapid3-12 h
IVRapidEnd of infusion
Half-life (T1/2)MetabolismExcretion
2-3 hKidneyUnknown

Contraindications and Cautions

The following are contraindications and cautions for the use of interferons:

  • Allergy to any interferons or product component. Prevent hypersensitivity reaction.
  • Pregnancy and lactation. Potential adverse effects on the neonate or mother.
  • Cardiac disease. Hypertension and arrhythmias have been reported with the use of these drugs.
  • Myelosuppression. These drugs may suppress the bone marrow.
  • Central nervous system (CNS) dysfunction of any kind. Potential for CNS depression and personality changes have been reported.

Adverse Effects

Use of interferons may result to these adverse effects:

  • Flu-like syndrome: lethargy, myalgia, arthralgia, anorexia, nausea
  • CNS: headache, dizziness, bone marrow depression, depression and suicidal ideation
  • GI: liver impairment
  • Others: photosensitivity


There are no reported clinically important drug-drug interactions with interferons.


  • Interleukins are synthetic compounds that communicate between lymphocytes, thereby stimulating cellular immunity and inhibiting tumor growth.
  • Interleukin-2 stimulates cellular immunity by increasing the activity of natural killer cells, platelets, and cytokines.

Therapeutic Action

The desired and beneficial actions of interleukins are as follows:

  • Increasing the number of natural killer cells and lymphocytes, cytokine activity, and circulating platelets.


Interleukins are indicated for the following medical conditions:

  • Treatment of specific renal carcinomas in adults
  • Prevention of severe thrombocytopenia


Here are the characteristic interactions of interleukins and the body in terms of absorption, distribution, metabolism, and excretion:

IV5 min13 min3-4 h
Half-life (T1/2) MetabolismExcretion
85 minKidneyUrine

Contraindications and Cautions

The following are contraindications and cautions for the use of interleukins:

  • Allergy to any interleukins or E-coli-produced product. To prevent hypersensitivity reactions.
  • Pregnancy. These drugs were shown to be embryocidal and teratogenic in animal studies.
  • Lactation. Potential adverse effects to the baby as it is not clear whether drugs can cross into breast milk.
  • Renal, liver, cardiovascular impairment. Adverse effects of the drug.  

Adverse Effects

Use of interleukins may result to these adverse effects:

  • Flu-like effects: lethargy, myalgia, arthralgia, fatigue, fever
  • CNS changes
  • Respiratory difficulties
  • Cardiac arrhythmia
  • Oprelvekin has been associated with severe hypersensitivity reactions, and patients should be instructed to report difficulty breathing or swallowing, chest tightness, or swelling.


There are no reported clinically important drug-drug interactions with interleukins.

Colony-Stimulating Factors

  • Colony-stimulating factors are produced by recombinant DNA technology.
  • These drugs can increase production of neutrophils and can activate mature granulocytes and monocytes.

Therapeutic Action

The desired and beneficial action of colony-stimulating factors is:

  • Increasing the production of white cells.


Colony-stimulating factors are indicated for the following medical conditions:

  • Reduction of incidence of infection in patients with bone marrow suppression
  • Decrease in neutropenia associated with bone marrow transplants and chemotherapy
  • Treatment of various blood-related cancers


Here are the characteristic interactions of colony-stimulating factors and the body in terms of absorption, distribution, metabolism, and excretion:

IV2 h4 d
Subcutaneous8 h4 d
Half-life (T1/2)MetabolismExcretion
210-231 minutesUnknownUnknown

Contraindications and Cautions

The following are contraindications and cautions for the use of colony-stimulating factors

  • Allergy to any interleukins or E-coli-produced product. To prevent hypersensitivity reactions.
  • Sargramostim is contraindicated in neonates because of benzyl alcohol in the solution and with excessive leukemoid myeloid blasts in the bone marrow or peripheral blood which could be worsened by the drug. Caution is also used in patients with hepatic or renal failure which could alter the pharmacokinetics of the drug.
  • Pregnancy and lactation. Effects on the fetus or neonate are not known.  

Adverse Effects

Use of colony-stimulating factors may result to these adverse effects:


These drugs have drug-drug interactions with:

  • Lithium or corticosteroids. Sargramostim’s increase in myeloproliferative effects.

Nursing Considerations

Here are important nursing considerations when administering immune stimulants:

Nursing Assessment

These are the important things the nurse should include in conducting assessment, history taking, and examination:

  • Assess for contraindications or cautions (e.g. history of allergy to the drug, pregnancy and lactating status, hepatic, renal, or cardiac disease, leukemic states, etc.) to avoid adverse effects.
  • Establish baseline physical assessment to monitor for any potential adverse effects.
  • Assess for presence of skin lesions to detect early dermatological effects.
  • Obtain weight to monitor for fluid retention.
  • Monitor temperature to detect any infection.
  • Evaluate CNS status to assess CNS effects of the drug.
  • Monitor laboratory tests like CBC and renal and liver function to determine the need for possible dose adjustment and to identify changes in bone marrow function.

Nursing Diagnoses

Here are some of the nursing diagnoses that can be formulated in the use of these drugs for therapy:

Implementation with Rationale

These are vital nursing interventions done in patients who are taking immune stimulants:

  • Arrange for laboratory tests before and periodically during therapy, including CBC and differential, to monitor for drug effects and adverse effects.
  • Monitor for severe reactions, such as hypersensitivity reactions, and arrange to discontinue the drug immediately if they occur.
  • Administer drug as indicated; instruct patient and significant other if injections are required to ensure that the drug will be given if the patient is not able to administer it.
  • Arrange for supportive care and comfort measures (e.g. rest, environmental control) to help patient cope with drug effects.
  • Provide patient education about drug effects and warning signs to increase knowledge about drug therapy and to increase compliance with drug.


Here are aspects of care that should be evaluated to determine effectiveness of drug therapy:

  • Monitor patient response to therapy (improvement in condition being treated).
  • Monitor for adverse effects (e.g. flu-like symptoms, GI upset, CNS changes, bone marrow depression).
  • Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
  • Monitor patient compliance to drug therapy.

Our recommended nursing pharmacology resources and books:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase which will help support us. Thank you! For more information, check out our privacy policy.

Pharm Phlash! Pharmacology Flash Cards #1 BEST SELLER!
Test-yourself review cards put critical clinical information for nearly 400 of the top generic medications at your fingertips. And, you can count on them for accuracy, because each card is based on content from Davis’s Drug Guide for Nurses. Increase your test scores in pharmacology class.

Focus on Pharmacology (8th Edition)
Focus on Nursing Pharmacology makes challenging concepts more approachable. Engaging learning features cultivate your clinical application, critical thinking and patient education capabilities. This updated 8th edition builds on your knowledge of physiology, chemistry and nursing fundamentals to help you conceptualize need-to-know information about each group of drugs.

Pharmacology Made Incredibly Easy (Incredibly Easy! Series®)
Nursing pharmacology guide offers step-by-step guidance so you can grasp the fundamentals in enjoyable Incredibly Easy style. This is the perfect supplement to class materials, offering solid preparation for NCLEX® as well as a handy refresher for experienced nurses. Colorfully illustrated chapters offer clear, concise descriptions of crucial nursing pharmacology concepts and procedures.

Lehne’s Pharmacology for Nursing Care (11th Edition)
The Eleventh Edition of Lehne’s Pharmacology for Nursing Care provides a thorough understanding of key drugs and their implications for nursing care. This text, written by renowned nursing educators, helps you comprehend and apply pharmacology principles. A clear and engaging writing style simplifies complex concepts, making even the most challenging pharmacology content enjoyable. We recommend this book if you want a comprehensive nursing pharmacology guide.

Nursing Drug Handbook
Nursing2023 Drug Handbook delivers evidence-based, nursing-focused drug monographs for nearly 3700 generic, brand-name, and combination drugs. With a tabbed, alphabetical organization and a “New Drugs” section, NDH2023 makes it easy to check drug facts on the spot.

Pharmacology and the Nursing Process
The 10th edition of Pharmacology and the Nursing Process offers practical, user-friendly pharmacology information. The photo atlas contains over 100 unique illustrations and photographs depicting drug administration techniques. Updated drug content reflects the most recent FDA drug approvals, withdrawals, and therapeutic uses.

Mosby’s Pharmacology Memory NoteCards: Visual, Mnemonic, and Memory Aids for Nurses
The 6th edition of Mosby’s Pharmacology Memory NoteCards: Visual, Mnemonic, & Memory Aids for Nurses incorporates illustrations and humor to make studying easier and more enjoyable. This unique pharmacology review can be utilized as a spiral-bound notebook or as individual flashcards, making it ideal for mobile study.

See Also

Here are other nursing pharmacology study guides:

We have a pill for that…

Feeling like you need a prescription for success on the NCLEX? Take our nursing pharmacology test banks and we’ll be your ‘study doctors’ – no co-pay required!
Nursing Pharmacology Nursing Test Banks for NCLEX RN

Drug Guides NEW!

Individual drug guides and nursing considerations for the most common medications used in nursing pharmacology:

References and Sources

References and sources for this pharmacology guide for Immunostimulants:

  • Karch, A. M., & Karch. (2011). Focus on nursing pharmacology. Wolters Kluwer Health/Lippincott Williams & Wilkins. [Link]
  • Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.
  • Lehne, R. A., Moore, L. A., Crosby, L. J., & Hamilton, D. B. (2004). Pharmacology for nursing care.
  • Smeltzer, S. C., & Bare, B. G. (1992). Brunner & Suddarth’s textbook of medical-surgical nursing. Philadelphia: JB Lippincott.
Iris Dawn is a nurse writer in her 20s who is on the constant lookout for latest stories about Science. Her interests include Research and Medical-Surgical Nursing. She is currently furthering her studies and is seriously considering being a student as her profession. Life is spoiling her with spaghetti, acoustic playlists, libraries, and the beach.

Leave a Comment

Share to...