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Rituxan, |rituximab Rituximab

rituximab

Generic Name: rituximab (ri TUK si mab)
Brand Names: Rituxan

What is rituximab?

Rituximab is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body.

Rituximab is used in combination with other cancer medicines to treat non-Hodgkin"s lymphoma. Rituximab is also used in combination with another drug called methotrexate to treat symptoms of adult rheumatoid arthritis.

Rituximab may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about rituximab?

Some people receiving a rituximab injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, weak, nauseated, light-headed, itchy, or if you have a fever, chills, muscle pain, sneezing, sore throat, trouble breathing, or pain in your chest or shoulders. Infusion reactions often occur within the first 24 hours after the start of your rituximab infusion.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.

If you have hepatitis B you may develop liver symptoms after you stop using this medication, even months after stopping. Your doctor may want to check your liver function at regular visits for several months after you stop using rituximab. Do not miss any scheduled visits.

What should I discuss with my healthcare provider before receiving rituximab?

Before receiving rituximab, tell your doctor if you are allergic to any drugs, or if you have:

• liver disease or hepatitis B (or if you are a carrier of hepatitis B);

• kidney disease;

• systemic lupus erythematosus (SLE);

• lung disease or a breathing disorder;

• a history of heart disease, angina (chest pain), or heart rhythm disorder; or

• a recent or active infection, including herpes, shingles, cytomegalovirus, or any infection that keeps coming back or does not clear up.

If you have any of these conditions, you may not be able to use rituximab, or you may need a dosage adjustment or special tests during treatment.

Older adults may be more likely to have side effects from rituxmab, causing breathing difficulty or heart rhythm problems.

How is rituximab given?

Rituximab is given as an injection through a needle placed into a vein. The medicine must be given slowly through an IV infusion. You will receive this injection in a clinic or hospital setting.

The medicine is usually given once per week for 4 to 8 weeks. In the treatment of rheumatoid arthritis, you may receive only two injections of rituximab, with 2 weeks in between treatments.

If you take any medications for high blood pressure, your doctor may ask you not to take them within 12 hours before you receive rituximab. This is to prevent your blood pressure from getting too low during your rituximab infusion. Follow your doctor"s instructions.

To be sure rituximab is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.

If you have hepatitis B you may develop liver symptoms after you stop using this medication, even months after stopping. Your doctor may want to check your liver function at regular visits for several months after you stop using rituximab. Do not miss any scheduled visits.

If you need to have any type of surgery, tell the surgeon ahead of time that you are being treated with 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?

What should I avoid while receiving rituximab?

Do not receive a "live" vaccine while you are being treated with rituximab.

Rituximab side effects

Some people receiving a rituximab injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, weak, nauseated, light-headed, itchy, or if you have a fever, chills, muscle pain, sneezing, sore throat, trouble breathing, or pain in your chest or shoulders. Infusion reactions often occur within the first 24 hours after the start of your rituximab infusion.

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• uneven heartbeats, wheezing or trouble breathing; or

• urinating more or less than usual;

• fever, chills, cough, body aches, flu symptoms;

• easy bruising or bleeding;

• a red, raised, blistering, scaly, itchy, or peeling skin rash;

• severe constipation or stomach pain;

• black, bloody, or tarry stools;

• confusion, dizziness, loss of balance, blurred vision, and problems with speech or walking; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Other, less serious side effects may be more likely to occur, such as:

• pain where the IV needle is placed;

• headache, back pain;

• mild stomach pain, nausea, or diarrhea;

• swelling in your hands or feet;

• muscle or joint pain;

• runny or stuffy nose; or

• night sweats.

Other side effects have also been reported. Discuss with your doctor any side effect that occurs during treatment with rituximab.

What other drugs will affect rituximab?

Before receiving rituximab, tell your doctor if you are also being treated with any of the following drugs:

• cisplatin (Platinol);

• adalimumab (Humira);

• azathioprine (Imuran);

• cyclosporine (Gengraf, Neoral, Sandimmune);

• etanercept (Enbrel);

• infliximab (Remicade);

• leflunomide (Arava);

• minocycline (Dynacin, Minocin, Vectrin);

• sulfasalazine (Azulfidine);

• blood pressure medications;

• gold salts such as auranofin (Ridaura), aurothioglucose (Solganal); or

• medication to treat malaria, such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox).

If you are using any of these drugs, you may not be able to receive rituximab, or you may need dosage adjustments or special tests during treatment.

There may be other drugs that can affect rituximab. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your healthcare provider may have additional information about rituximab that you may read.

What does my medication look like?

Rituximab is available with a prescription under the brand name Rituxan. Other brand or generic formulations may also be available. Ask your healthcare provider or pharmacist any questions you have about this medication, especially if it is new to you.

• 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.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.