What is the most important information I should know about rituximab?
Rituximab may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have changes in your mental state, decreased vision, weakness, or problems with speech or walking. These symptoms may start gradually and get worse quickly.
Tell your doctor if you have ever had hepatitis B. Rituximab can cause this condition to come back or get worse.
Severe skin problems can also occur during treatment with rituximab. Call your doctor if you have painful skin or mouth sores, or a severe skin rash with blistering, peeling, or pus.
Some side effects may occur during the injection or within 24 hours afterward. Tell your caregiver right away if you feel dizzy, weak, light-headed, short of breath, or if you have chest pain, wheezing, sudden cough, or pounding heartbeats or fluttering in your chest.
What is rituximab?
Rituximab is a cancer medicine that interferes with the growth and spread of cancer cells in the body.
Rituximab is used to treat non-Hodgkin's lymphoma or chronic lymphocytic leukemia. Rituximab is also used in combination with another drug called methotrexate to treat symptoms of adult rheumatoid arthritis.
Rituximab is also used in combination with steroid medicines to treat certain rare disorders that cause inflammation of blood vessels and other tissues in the body.
Rituximab may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before receiving rituximab?
Rituximab may cause a serious brain infection called progressive multifocal leukoencephalopathy (PML). This infection may be more likely if have used an immunosuppressant drug in the past, or if you have received rituximab with a stem cell transplant.
You should not be treated with rituximab if you are allergic to it.
To make sure rituximab is safe for you, tell your doctor if you have:
- liver disease or hepatitis (or if you are a carrier of hepatitis B);
- kidney disease;
- lung disease or a breathing disorder;
- a weak immune system (caused by disease or by using certain medicines);
- a recent or active infection, including herpes, shingles, cytomegalovirus, chickenpox, parvovirus, West Nile virus, or hepatitis B or C;
- a history of heart disease, angina (chest pain), or heart rhythm disorder; or
- a history of using rituximab in the past.
Using rituximab during pregnancy could harm the unborn baby. Tell your doctor if you are pregnant or if you become pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 12 months after your last dose.
It is not known whether rituximab passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How is rituximab given?
Your doctor will perform blood tests to make sure you do not have conditions that would prevent you from safely using rituximab.
Rituximab is injected into a vein through an IV. A healthcare provider will give you this injection. Rituximab is not given daily. Your schedule will depend on the condition being treated. Follow your doctor's dosing instructions very carefully.
Before each injection, you may be given other medications to prevent certain side effects of rituximab.
While using rituximab, you may need frequent blood tests.
If you have ever had hepatitis B, rituximab can cause this condition to come back or get worse. You will need frequent liver function tests during treatment and for several months after you stop using this medicine.
If you need surgery, tell the surgeon ahead of time that you are using rituximab.
What happens if I miss a dose?
Call your doctor if you miss an appointment for your rituximab injection.
What happens if I overdose?
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid while receiving rituximab?
Do not receive a "live" vaccine while using rituximab, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
What are the possible side effects of rituximab?
Get emergency medical help if you have signs of an allergic reaction: hives; chest tightness, trouble breathing; swelling of your face, lips, tongue, or throat.
Some side effects may occur during the injection (or within 24 hours afterward). Tell your caregiver right away if you feel itchy, dizzy, weak, light-headed, short of breath, or if you have chest pain, wheezing, sudden cough, or pounding heartbeats or fluttering in your chest.
Rituximab may cause a serious viral infection of the brain or spinal cord that can lead to disability or death. Call your doctor right away if you have any of the following symptoms (which may start gradually and get worse quickly):
- confusion, memory problems, or other changes in your mental state;
- weakness on one side of your body;
- vision changes; or
- problems with speech or walking.
Call your doctor at once if you have any of these other side effects, even if they occur several months after you receive rituximab, or after your treatment ends.
- fever, chills, cold or flu symptoms, cough, sore throat, headache, earache;
- pain or burning when you urinate;
- painful skin or mouth sores, or a severe skin rash with blistering, peeling, or pus;
- redness, warmth, or swelling of the skin;
- severe stomach pain, vomiting, constipation, bloody or tarry stools;
- chest pain, irregular heartbeats;
- dark urine, or jaundice (yellowing of the skin or eyes); or
-
signs of tumor cell breakdown --lower back pain, blood in your urine, little or no urinating; numbness or tingly feeling around your mouth; muscle weakness or tightness; fast or slow heart rate, weak pulse, trouble breathing; fainting.
Common side effects may include:
- fever, chills, body aches;
- feeling tired;
- joint pain; or
- cold symptoms such as stuffy nose, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect rituximab?
Tell your doctor about all your current medicines and any you start or stop using, especially:
-
medicines to treat rheumatoid arthritis --adalimumab, certolizumab, etanercept, golimumab.
This list is not complete. Other drugs may interact with rituximab, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Where can I get more information?
Your doctor or pharmacist can provide more information about rituximab.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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