Skip to Content
Read about lifestyle tips for your CML here >

hyaluronidase and rituximab

Generic Name: hyaluronidase and rituximab (HYE al ure ON i dase)
Brand Name: Rituxan Hycela

What is hyaluronidase and rituximab?

Hyaluronidase is a genetically designed protein.

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

Hyaluronidase and rituximab is a combination medicine used to treat follicular lymphoma, diffuse large B-cell lymphoma, or chronic lymphocytic leukemia.

Hyaluronidase and rituximab is sometimes used together with other cancer medicines.

Hyaluronidase and rituximab may also be used for purposes not listed in this medication guide.

What is the most important information I should know about hyaluronidase and 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, vision changes, weakness on one side of your body, or problems with speech or walking.

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 itchy, dizzy, weak, light-headed, short of breath, chilled, feverish, or if you have chest pain, wheezing, a sudden cough, or pounding heartbeats or fluttering in your chest.

You should not use hyaluronidase and rituximab if you are pregnant. Avoid getting pregnant for at least 12 months after you stop using this medicine.

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

You should not be treated with this medicine if you are allergic to hyaluronidase or rituximab.

To make sure hyaluronidase and rituximab is safe for you, tell your doctor if you have ever had:

  • kidney disease;

  • lung disease;

  • a weak immune system (caused by disease or by using certain medicines);

  • an infection such as herpes, shingles, cytomegalovirus, chickenpox, parvovirus, West Nile virus, or hepatitis B or C;

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

  • if you recently received any vaccine, or you are are scheduled to receive a vaccine.

Using hyaluronidase and 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 hyaluronidase and rituximab passes into breast milk or if it could harm a nursing baby. Do not breast-feed while using hyaluronidase and rituximab, and for at least 6 months after your last dose.

How is hyaluronidase and rituximab given?

Before you receive a hyaluronidase and rituximab injection, you will receive an intravenous (IV) injection of rituximab (Rituxan).

Hyaluronidase and rituximab is injected under the skin of your stomach area. This medicine must be injected slowly over 5 to 7 minutes. A healthcare provider will give you this injection.

You will be watched closely for at least 15 minutes after receiving hyaluronidase and rituximab, to make sure you do not have an allergic reaction.

Before each injection, you may be given other medications to prevent certain side effects. If you have chronic lymphocytic leukemia, you may also need to take medication to prevent infections. You may need to keep taking anti-infective medication for up to 12 months after your last dose of hyaluronidase and rituximab.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Hyaluronidase and rituximab can lower blood cells that help your body fight infections. Your blood will need to be tested often.

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.

Hyaluronidase and rituximab can have long-lasting effects on your body. You may need frequent medical tests for several months after you stop using this medicine.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of hyaluronidase and rituximab.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving hyaluronidase and rituximab?

Do not receive a "live" vaccine while you are being treated with hyaluronidase and rituximab. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Hyaluronidase and rituximab side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult 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, chilled, feverish, or if you have chest pain, wheezing, a sudden cough, or pounding heartbeats or fluttering in your chest.

Serious and sometimes fatal infections may occur during treatment with hyaluronidase and rituximab. Call your doctor right away if you have signs of infection such as:

  • fever, sore throat, cold or flu symptoms;

  • sores or white patches in your mouth or throat;

  • pain or burning when you urinate;

  • earaches, headaches; or

  • painful skin sores with redness, warmth, or swelling.

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 are treated with hyaluronidase and rituximab, or after your treatment ends.

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

  • severe stomach pain, severe vomiting;

  • chest pain, irregular heartbeats;

  • little or no urination;

  • low blood cell counts--fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed; or

  • signs of tumor cell breakdown--vomiting, diarrhea; little or no urination; numbness or tingly feeling; muscle weakness or twitching; fast or slow heart rate; confusion, hallucinations, seizure, feeling restless or irritable.

Common side effects may include:

  • low blood cell counts;

  • nausea, vomiting, constipation;

  • hair loss;

  • feeling tired;

  • cough; or

  • redness where the injection was given.

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.

Side Effects (complete list)

Hyaluronidase and rituximab dosing information

Usual Adult Dose for Follicular Lymphoma:

Relapsed or Refractory, Follicular Lymphoma: 23,400 Units hyaluronidase human and 1400 mg rituximab subcutaneously once a week for 3 or 7 weeks following a full dose of a rituximab product by IV infusion at week 1 (4 or 8 weeks total)

Retreatment for Relapsed or Refractory, Follicular Lymphoma: 23,400 Units hyaluronidase human and 1400 mg rituximab subcutaneously once a week for 3 weeks following a full dose of a rituximab product by IV infusion at week 1 (4 weeks total)

Previously Untreated, Follicular Lymphoma: 23,400 Units hyaluronidase human and 1400 mg rituximab subcutaneously on Day 1 of Cycles 2 through 8 of chemotherapy (every 21 days), for up to 7 cycles following a full dose of a rituximab product by IV infusion on Day 1 of Cycle 1 of chemotherapy (up to 8 cycles total); in patients with complete or partial response, initiate maintenance treatment 8 weeks following completion of hyaluronidase-rituximab in combination with chemotherapy; administer 23,400 Units hyaluronidase human and 1400 mg rituximab subcutaneously as a single agent every 8 weeks for 12 doses

Non-progressing, Follicular Lymphoma after first line CVP chemotherapy: Following completion of 6 to 8 cycles of CVP chemotherapy and a full dose of a rituximab product by IV infusion at week 1, administer 23,400 Units hyaluronidase human and 1400 mg rituximab subcutaneously once a week for 3 weeks (4 weeks total) at 6 month intervals to a maximum of 16 doses

Comments:
-All patients must receive at least one full dose of a rituximab product by IV infusion before starting therapy with hyaluronidase-rituximab.
-Premedicate before each dose with acetaminophen and an antihistamine. Premedication with a glucocorticoid should also be considered.

Use: For the treatment of adult patients with:
-Relapsed or refractory, follicular lymphoma as a single agent
-Previously untreated follicular lymphoma in combination with first line chemotherapy and, in patients achieving a complete or partial response to rituximab in combination with chemotherapy, as single-agent maintenance therapy
-Non-progressing (including stable disease), follicular lymphoma as a single agent after first-line cyclophosphamide, vincristine, and prednisone (CVP) chemotherapy

Usual Adult Dose for Lymphoma:

23,400 Units hyaluronidase human and 1400 mg rituximab subcutaneously on Day 1 of Cycles 2 through 8 of CHOP chemotherapy for up to 7 cycles following a full dose of a rituximab product by IV infusion at Day 1, Cycle 1 of CHOP chemotherapy (up to 6 to 8 cycles total)

Comments:
-All patients must receive at least one full dose of a rituximab product by IV infusion in combination with CHOP chemotherapy before starting therapy with hyaluronidase-rituximab.
-Premedicate before each dose with acetaminophen and an antihistamine. Premedication with a glucocorticoid should also be considered.

Use: For the treatment of adult patients with previously untreated diffuse large B-cell lymphoma (DLBCL) in combination with cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) or other anthracycline-based chemotherapy regimens

Usual Adult Dose for Chronic Lymphocytic Leukemia:

26,800 Units hyaluronidase human and 1600 mg rituximab subcutaneously on Day 1 of Cycles 2 through 6 (every 28 days) for a total of 5 cycles following a full IV dose at Day 1, Cycle 1 (6 cycles total) in combination with fludarabine and cyclophosphamide (FC) chemotherapy

Comments:
-All patients must receive at least one full dose of a rituximab product by IV infusion in combination with CHOP chemotherapy before starting therapy with hyaluronidase-rituximab.
-Premedicate before each dose with acetaminophen and an antihistamine. Premedication with a glucocorticoid should also be considered.

Use: In combination with fludarabine and cyclophosphamide (FC) for the treatment of adult patients with previously untreated and previously treated chronic lymphocytic leukemia (CLL)

What other drugs will affect hyaluronidase and rituximab?

Other drugs may interact with hyaluronidase and rituximab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about hyaluronidase and 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.
  • 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 1996-2012 Cerner Multum, Inc. Version: 1.01.

Date modified: December 03, 2017
Last reviewed: July 11, 2017

Hide