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Rituxan Hycela Side Effects

Generic name: hyaluronidase / rituximab

Medically reviewed by Philip Thornton, DipPharm. Last updated on May 10, 2023.

Note: This document contains side effect information about hyaluronidase / rituximab. Some dosage forms listed on this page may not apply to the brand name Rituxan Hycela.

Applies to hyaluronidase / rituximab: subcutaneous solution.


Subcutaneous route (Solution)

Severe, including fatal, mucocutaneous reactions can occur in patients receiving rituximab-containing products, including rituximab and hyaluronidase human, recombinant. Hepatitis B Virus (HBV) reactivation can occur in patients treated with rituximab-containing products, including rituximab and hyaluronidase human, recombinant, in some cases resulting in fulminant hepatitis, hepatic failure, and death. Screen all patients for HBV infection before treatment initiation, and monitor patients during and after treatment with rituximab and hyaluronidase human, recombinant. Discontinue rituximab and hyaluronidase human, recombinant and concomitant medications in the event of HBV reactivation. Progressive Multifocal Leukoencephalopathy (PML), including fatal PML, can occur in patients receiving rituximab-containing products, including rituximab and hyaluronidase human, recombinant.

Serious side effects of Rituxan Hycela

Along with its needed effects, hyaluronidase / rituximab 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 immediately if any of the following side effects occur while taking hyaluronidase / rituximab:

More common

Less common

Incidence not known

Other side effects of Rituxan Hycela

Some side effects of hyaluronidase / rituximab 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

Less common

For Healthcare Professionals

Applies to hyaluronidase / rituximab: subcutaneous solution.


Very common (10% or more): Neutropenia (32%), thrombocytopenia (20% or greater), anemia (15%)

Common (1% to 10%): Febrile neutropenia, leukopenia, lymphopenia

Postmarketing reports: Prolonged pancytopenia, marrow hypoplasia, Grade 3 to 4 prolonged or late onset neutropenia, hyperviscosity syndrome in Waldenstrom's macroglobulinemia, prolonged hypogammaglobulinemia


Frequency not reported: Hypersensitivity[Ref]


Very common (10% or more): Infections (20% or greater)

Common (1% to 10%): Influenza, immunogenicity

Postmarketing reports: Lupus-like syndrome, serum sickness, viral infections (including progressive multifocal leukoencephalopathy [PML], increase in fatal infections in HIV-associated lymphoma, and an increased incidence of Grade 3 and 4 infections)[Ref]


Very common (10% or more): Injection site erythema (13%)

Common (1% to 10%): Injection site pain, injection site edema[Ref]


Very common (10% or more): Arthralgia (13%), bone pain (10%), pain in extremity (10%)

Common (1% to 10%): Back pain, muscle spasms, myalgia

Postmarketing reports: Polyarticular arthritis[Ref]


Common (1% to 10%): Conjunctivitis

Postmarketing reports: Uveitis, optic neuritis[Ref]


Very common (10% or more): Arthralgia (13%)

Common (1% to 10%): Myalgia, anorexia, weight loss

Frequency not reported: Tumor lysis syndrome[Ref]


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


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


Frequency not reported: Hepatitis B reactivation including fulminant hepatitis[Ref]


Postmarketing reports: Disease progression of Kaposi's sarcoma[Ref]


Very common (10% or more): Cough (23%), upper respiratory tract infection (15%), pneumonia (11%), dyspnea (11%), nasopharyngitis (10%)

Common (1% to 10%): Bronchitis, sinusitis, oropharyngeal pain, respiratory tract infection

Postmarketing reports: Pleuritis, fatal bronchiolitis obliterans, fatal interstitial lung disease[Ref]


Very common (10% or more): Fatigue (20%), asthenia (17%), pyrexia (15%)[Ref]

Nervous system

Very common (10% or more): Paresthesia (16%), headache (13%), peripheral neuropathy (12%)

Common (1% to 10%): Chills, dizziness

Frequency not reported: Progressive multifocal leukoencephalopathy[Ref]


Frequency not reported: Renal toxicity


Common (1% to 10%): Flushing, chest pain, peripheral edema, hypertension

Frequency not reported: Cardiac arrhythmias

Postmarketing reports: Fatal cardiac failure, systemic vasculitis[Ref]


Very common (10% or more): Alopecia (16%), pruritus (10%), rash (10%)

Common (1% to 10%): Erythema

Frequency not reported: Mucocutaneous reactions

Postmarketing reports: Vasculitis with rash[Ref]


Very common (10% or more): Nausea (31%), constipation (25%), diarrhea (18%), abdominal pain (14%), vomiting (14%)

Common (1% to 10%): Dyspepsia, stomatitis, upper abdominal pain, throat irritation, mucosal inflammation

Frequency not reported: Bowel obstruction and perforation[Ref]

Frequently asked questions


1. (2017) "Product Information. Rituxan Hycela (hyaluronidase-rituximab)." Genentech

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.