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In-111 Zevalin Side Effects

Generic name: ibritumomab

Medically reviewed by Last updated on Jul 14, 2022.

Note: This document contains side effect information about ibritumomab. Some dosage forms listed on this page may not apply to the brand name In-111 Zevalin.

Applies to ibritumomab: intravenous solution.


Intravenous route (Solution)

Serious infusion reactions, including fatalities, have occurred within 24 hours of rituximab infusion, an essential component of the ibritumomab tiuxetan therapeutic regimen. Most fatal infusion reactions (80%) occurred with the first rituximab infusion. Administration also results in severe and prolonged cytopenias in most patients. The ibritumomab tiuxetan therapeutic regimen should not be administered to patients with 25% or greater lymphoma marrow involvement and/or impaired bone marrow reserve. Severe cutaneous and mucocutaneous reactions, some with fatal outcome, can occur with therapy. The dose of Y-90 ibritumomab tiuxetan should not exceed the absolute maximum allowable dose of 32 millicurie (1184 megabecquerels).

Serious side effects of In-111 Zevalin

Along with its needed effects, ibritumomab (the active ingredient contained in In-111 Zevalin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking ibritumomab:

More common

  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • cough or hoarseness
  • coughing up blood
  • difficulty with breathing or swallowing
  • dizziness
  • fever or chills
  • headache
  • increased menstrual flow or vaginal bleeding
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lower back or side pain
  • noisy breathing
  • nosebleeds
  • painful or difficult urination
  • pale skin
  • paralysis
  • pinpoint red spots on the skin
  • prolonged bleeding from cuts
  • red or dark brown urine
  • red stools
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • tightness in the chest
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • wheezing

Less common

  • Bloody nose that does not stop after pinching the nose together and holding it for 5 to 10 minutes
  • bluish lips or skin
  • chest pain or discomfort
  • confusion
  • diarrhea
  • fainting
  • fast heartbeat
  • hives
  • itching
  • lightheadedness
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rapid, shallow breathing
  • skin rash
  • small red or purple spots on the skin
  • unusual vaginal bleeding
  • vomiting blood or material that looks like coffee grounds


  • Agitation
  • anxiety
  • back pain
  • bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, or warmth at the injection site
  • blurred vision
  • coma
  • drowsiness
  • fast, pounding, or irregular heartbeat or pulse
  • hallucinations
  • inability to speak
  • irritability
  • mood or mental changes
  • nausea
  • redness of the skin
  • seizures
  • severe headache
  • slurred speech
  • stiff neck
  • temporary blindness
  • vomiting
  • weakness in the arm or leg on one side of the body, sudden and severe
  • welts

Incidence not known

  • Blistering, peeling, or loosening of the skin
  • cracks in the skin
  • joint or muscle pain
  • loss of heat from the body
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • red, swollen skin
  • scaly skin
  • skin blisters

Other side effects of In-111 Zevalin

Some side effects of ibritumomab may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Abdominal or stomach pain
  • bruising
  • constipation
  • difficult or labored breathing
  • difficulty with moving
  • faintness or lightheadedness when getting up from a lying or sitting position
  • fear
  • feeling of warmth
  • full or bloated feeling or pressure in the stomach
  • joint pain
  • lack or loss of strength
  • large, flat, blue or purplish patches in the skin
  • loss of appetite
  • muscle aching or cramping
  • muscle pain or stiffness
  • nervousness
  • pain
  • rash
  • redness of the face, neck, arms and occasionally, upper chest
  • runny nose
  • sleeplessness
  • sneezing
  • stuffy nose
  • sudden or increased sweating
  • swelling of the abdominal or stomach area
  • swelling of the hands, ankles, feet, or lower legs
  • swollen joints
  • throat irritation
  • trouble with sleeping
  • unable to sleep
  • weight loss

Less common

For several months after receiving this therapy, it may still produce some side effects that need attention. During this period of time check with your doctor immediately if you notice any of the following:

  • Bleeding gums
  • bone pain
  • headache, sudden and severe
  • inability to speak
  • increased menstrual flow or vaginal bleeding
  • red or black, tarry stools
  • red or dark brown urine
  • temporary blindness

For Healthcare Professionals

Applies to ibritumomab: intravenous kit.


Common (1% to 10%): Hypertension[Ref]


Common (1% to 10%): Night sweats, petechiae, pruritus, rash

Postmarketing reports: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous dermatitis, exfoliative dermatitis[Ref]


Very common (10% or more): Nausea, abdominal pain, diarrhea[Ref]


Common (1% to 10%): Urinary tract infection[Ref]


Very common (10% or more): Thrombocytopenia, neutropenia, anemia, leukopenia, lymphopenia

Common (1% to 10%): Ecchymosis

Frequency not reported: Cytopenias[Ref]


Postmarketing reports: Infusion site erythema, ulceration following extravasation[Ref]


Common (1% to 10%): Anorexia[Ref]


Common (1% to 10%): Myalgia[Ref]

Nervous system

Common (1% to 10%): Dizziness[Ref]


Frequency not reported: Secondary malignancy[Ref]


Very common (10% or more): Fatigue, asthenia, pyrexia, serious and life threatening infections

Common (1% to 10%): Influenza-like illness

Uncommon (0.1% to 1%): Antibody formation

Postmarketing reports: Radiation injury[Ref]


Very common (10% or more): Nasopharyngitis (19%), cough (11%)

Common (1% to 10%): Pharyngolaryngeal pain, epistaxis, bronchitis, rhinitis, sinusitis[Ref]

More about In-111 Zevalin (ibritumomab)

Patient resources

Professional resources

Other formulations

Related treatment guides


1. "Product Information. In-111 Zevalin (ibritumomab tiuxetan)." IDEC Pharmaceuticals Corporation

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.