Rituximab (Systemic)
   
Rituximab (Systemic)
US Brand Names
• Rituxan
Description
Rituximab (ri-TUX-i-mab) is a monoclonal antibody. It is used to treat a type of cancer called non-Hodgkin's lymphoma.
Rituximab is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:
Parenteral
• Injection (U.S.)
Special Considerations
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For rituximab, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual reaction to rituximab or to mouse proteins.
Pregnancy
Studies on effects in pregnancy have not been done in either humans or animals. However, rituximab is related to immunoglobulin, which affects the baby's ability to fight infection and which does cross the placenta. Women who are able to bear children should use some kind of birth control during treatment with rituximab and for up to 12 months after treatment has ended. Before receiving this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.
Tell your doctor right away if you think you have become pregnant while receiving rituximab.
Breast-feeding
It is not known whether rituximab passes into the breast milk. However, because of the possibility of serious effects, breast-feeding is not recommended while you are receiving this medicine and for a while after you stop receiving it. Discuss with your doctor the proper time to begin breast-feeding after treatment with rituximab.
Children
Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of rituximab in children with use in other age groups.
Older adults
This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.
Other medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking rituximab it is especially important that your doctor and pharmacist know if you are taking any of the following:
• Cisplatin (e.g., Platinol)-This medicine should not be used at the same time as rituximab because it could cause serious kidney problems
Other medical problems
The presence of other medical problems may affect the use of rituximab. Make sure you tell your doctor if you have any other medical problems, especially heart problems (angina; arrhythmias) lung problems, high number of cancerous cells in your body, kidney problems, or sensitivity or a previous severe allergic reaction to rituximab or to mouse proteins.
Administration
Dosing
The dose of rituximab will be different for different patients. The dose that is used may depend on a number of things, including your weight. Rituximab is usually given by a doctor or nurse in the hospital or an outpatient clinic. If you have any questions about the proper dose of rituximab, ask your doctor.
Side Effects
Along with its needed effects, a medicine 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 as soon as possible if any of the following side effects occur:
More common
Black, tarry stools; bleeding gums; bloating or swelling of face, arms, hands, lower legs or feet; blood in urine or stools; blurred vision; cough or hoarseness; dizziness; dry mouth; fatigue; feeling of swelling of tongue or throat; fever and chills; flushed, dry skin; flushing of face; fruit-like breath odor; headache; increased hunger; increased thirst; increased urination; itching; lower back or side pain; nausea; nervousness; pain or tenderness around eyes and cheekbones; painful or difficult urination; pale skin; pinpoint red spots on skin; pounding in the ears; rapid weight gain; runny nose; shortness of breath; skin rash; slow or fast heartbeat; sore throat; sores, ulcers or white spots in mouth or on lips; stuffy or runny nose; sweating; swollen glands; tightness of chest; tingling of hands or feet; troubled breathing; troubled breathing with exertion; unexplained weight gain; unusual bleeding or bruising; unusual tiredness or weakness; unusual weight gain or loss; vomiting; wheezing.
Less common
blistering, peeling, loosening of the skin; blisters in the mouth; blisters on the trunk, scalp or other areas; burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feeling; burning, tingling, numbness or pain in the hands, arms, feet, or legs,; confusion; decreased frequency and amount of urination; diarrhea; difficulty in moving; discouragement; feeling sad or empty; increased thirst; irregular heartbeat; irritability; joint or muscle pain; loss of appetite; loss of interest or pleasure; muscle pain or stiffness; muscle cramps; nervousness; numbness or tingling in hands, feet, or lips; pain at place of injection; pain, swelling, or redness in joints; red, itchy lining of eye; red skin lesions, often with a purple center; stabbing pain; trouble concentrating; trouble sleeping; swelling of face or fingers; swelling of feet or lower legs; weight gain.
Rare
Chest pain.
This medicine may also cause the following side effects that your doctor will watch for:
Less common
High blood pressure; low white blood cell count.
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common
Back pain; fear; increased cough; joint pain; lack or loss of strength; muscle aching or cramping; night sweats; pain; pain in joints; rash; swollen joints; throat irritation.
Less common
Abdominal or stomach pain; agitation or anxiety; change in taste; dry eyes; excessive muscle tone; feeling of constant movement of self or surroundings; feeling of weakness; general feeling of discomfort or illness; heartburn; increase in body movements; lightheadedness; muscle tension; pain at injection site; sensation of spinning; sleepiness or unusual drowsiness; swelling of stomach; trouble in sleeping.
After you stop using this medicine, 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:
Black, tarry stools; blood in urine or stools; painful or difficult urination; pinpoint red spots on skin; unusual bleeding or bruising; unusual tiredness or weakness.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Additional Information
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, rituximab is used in certain patients with the following medical conditions:
• Chronic lymphocytic leukemia (a type of cancer of the blood and lymph system)
• Waldenstrom's macroglobulinemia (a certain type of cancer of the blood)
• Immune or idiopathic thrombocytopenic purpura (ITP) (a blood disease)
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.
March 25, 2004 
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