• Basic Info
• Top Questions
• Clinical Info
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What is rituximab?
Rituximab is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body. Rituximab is used in combination with other cancer medicines to treat non-Hodgkin's lymphoma. Rituximab is also used in combination with another drug called methotrexate to treat symptoms of adult rheumatoid arthritis. Rituximab may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of rituximab?

Some people receiving a rituximab injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, weak, nauseated, light-headed, itchy, or if you have a fever, chills, muscle pain, sneezing, sore throat, trouble breathing, or pain in your chest or shoulders. Infusion reactions often occur within the first 24 hours after the start of your rituximab infusion.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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

• sudden numbness or weakness, especially on one side of the body;

• confusion, dizziness, loss of balance, blurred vision, and problems with speech or walking; or

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• uneven heartbeats, wheezing or trouble breathing;

• urinating more or less than usual;

• fever, chills, cough, body aches, flu symptoms;

• easy bruising or bleeding;

• a red, raised, blistering, scaly, itchy, or peeling skin rash;

• severe constipation or stomach pain;

• black, bloody, or tarry stools; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• pain where the IV needle is placed;

• headache, back pain;

• mild stomach pain, nausea, or diarrhea;

• swelling in your hands or feet;

• muscle or joint pain;

• runny or stuffy nose; or

• night sweats.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How is rituximab given?
Rituximab is given as an injection through a needle placed into a vein. The medicine must be given slowly through an IV infusion. You will receive this injection in a clinic or hospital setting. The medicine is usually given once per week for 4 to 8 weeks. In the treatment of rheumatoid arthritis, you may receive only two injections of rituximab, with 2 weeks in between treatments. If you take any medications for high blood pressure, your doctor may ask you not to take them within 12 hours before you receive rituximab. This is to prevent your blood pressure from getting too low during your rituximab infusion. Follow your doctor's instructions.

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What is the most important information I should know about rituximab?
Do not receive this medication if you have ever had a severe allergic reaction to rituximab, or if you are allergic to mouse protein. Some people receiving a rituximab injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, weak, nauseated, light-headed, itchy, or if you have a fever, chills, muscle pain, sneezing, sore throat, trouble breathing, or pain in your chest or shoulders. Infusion reactions often occur within the first 24 hours after the start of your rituximab infusion.

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What happens if I miss a dose?
Call your doctor if you miss an appointment for your rituximab injection.

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What other drugs will affect rituximab?
Before receiving rituximab, tell your doctor if you are also being treated with any of the following drugs: cisplatin (Platinol); adalimumab (Humira); azathioprine (Imuran); cyclosporine (Gengraf, Neoral, Sandimmune); etanercept (Enbrel); infliximab (Remicade); leflunomide (Arava); minocycline (Dynacin, Minocin, Vectrin); sulfasalazine (Azulfidine); blood pressure medications; gold salts such as auranofin (Ridaura), aurothioglucose (Solganal); or medication to treat malaria, such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox).

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Rituximab has been assigned to pregnancy category C by the FDA. Animal studies have not been conducted. There are no controlled data in human pregnancy. There are no data on whether rituximab can cause fetal harm when administered to a pregnant woman or whether it can affect reproductive capacity. Because human IgG is known to pass the placental barrier, and therefore may potentially cause fetal B-cell depletion, rituximab is only recommended for use in pregnant women when the drug is clearly needed.

The manufacturer has recommended that individuals of childbearing potential use effective contraceptive methods during treatments and for up to 12 months following therapy with rituximab. There has been a case reported of a pregnant woman who used rituximab in combination with CHOP chemotherapy for aggressive B-cell non-Hodgkin's lymphoma. She delivered a healthy girl via caesarean section in the thirty-fifth week of her pregnancy.

There are no data on the excretion of rituximab into human milk. Because human IgG is excreted into human milk and the potential for absorption and immunosuppression in the infant are unknown, breast-feeding is not recommended until circulating drug levels are no longer detectable.

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Who should NOT use this medication?

• Known hypersensitivity (anaphylaxis or IgE-mediated hypersensitivity) to murine proteins or to any ingredient in the formulation.

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What happens if I overdose?
Seek emergency medical attention if you think you have received too much of this medicine. Symptoms of a rituximab overdose are not known.

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What should I discuss with my healthcare provider before receiving rituximab?
Do not receive this medication if you have ever had a severe allergic reaction to rituximab, or if you are allergic to mouse protein. Before receiving rituximab, tell your doctor if you are allergic to any drugs, or if you have: 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 history of heart disease, angina (chest pain), or heart rhythm disorder; or a recent or active infection, including herpes, shingles, cytomegalovirus, or any infection that keeps coming back or does not clear up.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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