Generic Name: rituximab (ri TUX i mab)
Brand Names: Rituxan

What is Rituxan?

Rituxan (rituximab) is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Rituxan is used to treat non-Hodgkin's lymphoma or chronic lymphocytic leukemia. It is also used in combination with another drug called methotrexate to treat symptoms of adult rheumatoid arthritis.

Rituxan 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.

Rituxan may also be used for purposes not listed in this medication guide.

Important information

Rituxan may cause a serious viral infection of the brain that can lead to disability or death. Call your doctor right away if you have any change in your mental state, decreased vision, or problems with speech or walking. These symptoms may start gradually and get worse quickly.

If you have ever had hepatitis B, Rituxan can cause this condition to come back or get worse. You will need frequent blood tests to check your liver function during treatment and for several months after you stop using this medicine. Call your doctor at once if you have upper stomach pain, loss of appetite, dark urine, or jaundice (yellowing of the skin or eyes).

Slideshow: Drug Treatment for Rheumatoid Arthritis - What Are Your Options?

Severe skin problems can also occur during treatment with Rituxan. 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 after the medicine is injected into the vein). 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.

Before receiving Rituxan

You should not receive Rituxan if you have ever had a severe allergic reaction to rituximab, or if you are allergic to mouse protein.

To make sure Rituxan is safe for you, tell your doctor 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 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, hepatitis C, or any infection that keeps coming back or does not clear up;

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

  • if you have used certain arthritis medicines in the past, including adalimumab (Humira), certolizumab (Cimzia), golimumab (Simponi), etanercept (Enbrel), or infliximab (Remicade).

FDA pregnancy category C. It is not known whether Rituxan will harm an unborn baby. Rituxan can affect the immune system of a newborn if the mother receives the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant. Use effective birth control while you are using this medication and for at least 12 months after your treatment ends.

See also: Pregnancy and breastfeeding warnings (in more detail)

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 Rituxan given?

Rituxan is injected into a vein through an IV. A healthcare provider will give you this injection. Follow your doctor's dosing instructions very carefully.

Your doctor will perform blood tests to make sure you do not have conditions that would prevent you from safely using Rituxan.

Before you receive this medicine, you may be given other medications to prevent certain side effects that rituximab can cause.

While using Rituxan, you may need frequent blood tests.

If you have ever had hepatitis B, Rituxan can cause this condition to come back or get worse. You will need frequent blood tests to check your liver function 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 Rituxan.

What happens if I miss a dose?

Call your doctor if you miss an appointment for your Rituxan 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?

Do not receive a "live" vaccine while using Rituxan, 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.

Rituxan side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Rituxan: 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 after the medicine is injected into the vein). 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.

Rituxan may cause a serious viral infection of the brain that can lead to disability or death. Call your doctor right away if you have any change in your mental state, thinking problems or confusion, decreased vision, or problems with speech or walking. These symptoms may start gradually and get worse quickly.

Call your doctor at once if you have any of these other side effects, even if they occur several months after you receive Rituxan, or after your treatment ends.

  • fever, chills, flu symptoms, pale skin, easy bruising or bleeding, feeling weak or tired;

  • ongoing cough, sinus pain, wheezing, or breathing problems;

  • ongoing diarrhea and weight loss;

  • headache, earache, warmth or swelling with skin redness;

  • pain or burning when you urinate;

  • severe skin reaction--painful skin or mouth sores, or a severe skin rash with blistering, peeling, or pus;

  • liver problems--upper stomach pain, loss of appetite, 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 Rituxan side effects may include:

  • runny or stuffy nose, sneezing;

  • nausea, diarrhea;

  • muscle pain; or

  • swelling in your hands or feet.

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.

See also: Side effects (in more detail)

What other drugs will affect Rituxan?

Other drugs may interact with rituximab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about Rituxan.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Rituxan only for the indication prescribed.
  • Disclaimer: 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.

Copyright 1996-2014 Cerner Multum, Inc. Version: 10.01. Revision Date: 2013-11-14, 10:03:42 AM.

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