| Patients with cardiac disease, such as angina, congestive
heart failure, or arrhythmia, should be closely monitored for worsening
of their clinical condition during initiation and continued treatment
with Avonex ®. While Avonex ® does not have
any known direct-acting cardiac toxicity, during the post-marketing
period infrequent cases of congestive heart failure, cardiomyopathy,
and cardiomyopathy with congestive heart failure have been reported
in patients without known predisposition to these events, and without
other known etiologies being established.
In rare cases, these events have been temporally related to the administration
of Avonex ®.
In some of these instances recurrence upon rechallenge was observed.
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