Rituxan

Generic Name: rituximab (ri TUX i mab)
Brand Name: 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. This medicine 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 about Rituxan

You should not receive Rituxan if you have ever had a severe allergic reaction to rituximab.

Some people receiving a Rituxan injection have had a reaction to the infusion (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.

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If you have hepatitis B you may develop liver symptoms after you stop using Rituxan, even months after stopping.

Call your doctor right away if you have symptoms of a serious viral infection of the brain, such as: confusion, trouble concentrating, problems with speech or walking, vision problems, or weakness on one side of your body.

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 you can safely use Rituxan, tell your doctor if you have any of these other conditions:

• 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 that were not effective, 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 Rituxan and for at least 12 months after your treatment ends.

See also: Rituxan 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. Do not receive Rituxan without telling 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.

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

If you need surgery, tell the surgeon ahead of time that you are using Rituxan.

While using Rituxan, you may need frequent blood tests at your doctor's office.

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 for several months after you stop using this medicine.

What happens if I miss a dose?

Call your doctor if you miss an appointment for your Rituxan injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving Rituxan?

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), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, yellow fever, varicella (chickenpox), zoster (shingles), oral typhoid vaccine, 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 people receiving a Rituxan injection have had a reaction to the infusion (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 increases the risk of a serious viral infection of the brain that can lead to disability or death. Call your doctor right away if you have symptoms such as confusion, trouble concentrating, problems with speech or walking, vision problems, or weakness on one side of your body.

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

• fever, chills, body aches, flu symptoms, feeling weak or tired;

• ongoing cold symptoms such as stuffy nose, sneezing, sore throat;

• headache, earache, painful mouth ulcers, skin sores, warmth or swelling with skin redness;

• pain or burning when you urinate, urinating less than usual;

• severe skin rash with blistering, itching, peeling, or pus;

• weak pulse, fainting, overactive reflexes;

• muscle weakness, tightness, or contraction; or

• lower back pain, blood in your urine, numbness or tingly feeling around your mouth.

Less serious Rituxan side effects may include:

• mild stomach pain, nausea, or diarrhea;

• muscle or joint pain;

• back pain; or

• night sweats.

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: Rituxan side effects (in more detail)

What other drugs will affect Rituxan?

Tell your doctor about all medications you use, and those you start or stop using during your treatment with Rituxan, especially:

• other medications to treat rheumatoid arthritis or ankylosing spondylitis; or

• medications to treat psoriasis, ulcerative colitis, or Crohn's disease.

This list is not complete. Other drugs may interact with Rituxan, including prescription, over-the-counter, vitamin, 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 Rituxan.