If you have chronic lymphocytic leukemia (CLL), your doctor might suggest Arzerra as a treatment option for you.
Arzerra is a prescription drug used to treat CLL in certain situations, often together with other medications. For this purpose, the drug is used only in adults. The length of treatment can vary depending on the CLL, up to a maximum of 2 years.
The active ingredient in Arzerra is ofatumumab. An active ingredient is what makes a drug work. It’s a kind of biologic medication, which is made from
Arzerra comes as a liquid solution inside vials. A healthcare professional will give Arzerra doses to you by intravenous (IV) infusion (an injection into a vein given over time).
For more information about Arzerra, including details about its uses, see this in-depth article on the drug.
Like other drugs, Arzerra can cause mild to serious side effects. Keep reading to learn more.
Some people may experience mild to serious side effects during their Arzerra treatment. Examples of Arzerra’s commonly reported side effects include:
- upper respiratory infection, such as the common cold
- fever
- low levels of white blood cells
- infusion reaction*
- low level of neutrophils*
* To learn more about this side effect, see the “Side effects explained” section below.
Keep reading to learn about other possible mild and serious side effects reported with Arzerra.
Like most medications, Arzerra can cause mild side effects. Of these, infusion reactions are the most common.
Examples of mild side effects that have been reported with Arzerra include:
- upper respiratory infection, such as the common cold
- pneumonia
- fever
- cough
- diarrhea
- fatigue (low energy)
- shortness of breath
- rash
- nausea
- bronchitis
- weakness
- trouble sleeping
- mild infusion reaction*
- mild allergic reaction*
* To learn more about this side effect, see the “Side effects explained” section below.
In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop receiving Arzerra unless your doctor recommends it.
Arzerra may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Arzerra, visit MedWatch.
Serious side effects are possible with Arzerra, although these are rare.
Serious side effects that have been reported with Arzerra include:
- tumor lysis syndrome, a condition in which cancer cells release harmful chemicals into your blood
- low levels of white blood cells
- low level of platelets (cells that help create blood clots)
- low level of red blood cells
- risk of hepatitis B virus reactivation*
- risk of progressive multifocal leukoencephalopathy (PML)*
- severe infusion reaction†
- low level of neutrophils†
- severe allergic reaction*†
* Arzerra has a
† To learn more about this side effect, see the “Side effects explained” section below.
If you develop serious side effects while receiving Arzerra, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Learn more about some of the side effects Arzerra may cause.
Risk of hepatitis B virus reactivation
If you’ve ever had hepatitis B, treatment with Arzerra may reactivate the virus that causes this infection. Arzerra has a
With reactivation, the hepatitis B virus (HBV) becomes active and causes symptoms again. In rare cases, HBV reactivation can lead to liver failure and may even be fatal.
This side effect may occur up to 12 months after your last dose of Arzerra.
Symptoms of hepatitis B can include:
- fatigue (low energy)
- loss of appetite
- belly pain
- nausea and vomiting
- joint pain
- yellowing of your skin or the whites of your eyes
- dark urine
- pale or clay-colored stool
What might help
Before you begin treatment with Arzerra, your doctor will test you for HBV. If the test is positive, they’ll want to treat the infection first before deciding whether to prescribe Arzerra.
While you’re receiving Arzerra, your doctor will also monitor you for symptoms of hepatitis B. If you develop this infection, they’ll likely have you stop receiving Arzerra and will recommend treatment for the infection. Your doctor will decide whether to restart treatment with Arzerra after the infection is treated.
Risk of progressive multifocal leukoencephalopathy
Arzerra has a
PML is a rare but life threatening brain infection. Symptoms can include:
- trouble speaking
- vision problems
- weakness
- personality changes
What might help
While you’re receiving Arzerra, your doctor will monitor you for symptoms of PML. But if you develop symptoms of this syndrome, immediately notify your doctor. They’ll stop your Arzerra treatment and evaluate your PML symptoms to determine the best way to treat them. Your doctor may also recommend a treatment for CLL other than Arzerra.
Infusion reactions
Mild and serious infusion reactions are possible with Arzerra. Infusion reactions are side effects that occur during or within 24 hours after receiving an Arzerra intravenous (IV) infusion. (This is an injection into your vein given over time.)
Infusion reactions reported with Arzerra include those listed in the following table:
| Mild infusion reactions (more common) | Severe infusion reactions (rare) |
| nausea | temporary high or low blood pressure, which may cause fainting |
| chills | shortness of breath |
| itchiness | heart attack |
| skin rash or hives | irregular heart rhythm |
| flushing (temporary warmth, discoloration, or deepening of skin color) | anaphylaxis (a kind of severe allergic reaction) |
| pain |
Infusion reactions can occur with any Arzerra infusion. But they’re more likely to happen during your first two infusions.
What might help
To lower your risk of infusion reactions, your doctor will prescribe certain medications that you take before an Arzerra infusion. These include:
- acetaminophen (Tylenol), which helps prevent pain and fever
- an antihistamine, such as diphenhydramine (Benadryl)
- a corticosteroid, such as prednisone
If you develop an infusion reaction, the healthcare professional giving you Arzerra will stop the infusion. They can also treat your reaction.
Depending on the severity of your reaction, your doctor may recommend switching to a different treatment.
Low level of neutrophils
Arzerra can cause certain blood cell problems, including a decrease in neutrophils (a kind of white blood cell). This condition is called neutropenia, and it can raise your risk of infection. While this side effect wasn’t common in studies of the drug, it can be serious and should be treated right away.
Neutropenia can occur up to 42 days after your last dose of Arzerra. It’s also possible for this side effect to persist for some time even if you stop receiving the drug.
Neutropenia doesn’t cause symptoms you would notice. Because of this, you should watch for symptoms of infection during Arzerra treatment. These include:
- fatigue
- fever
- chills or sweats
- shortness of breath
- sore throat
What might help
During treatment with Arzerra, your doctor will order tests to check your blood cell levels, including your neutrophil count. If they notice your neutrophil level is low, they can prescribe a treatment to help this level increase. An example is a granulocyte colony-stimulating factor (G-CSF) medication such as Neupogen (filgrastim) or Neulasta (pegfilgrastim).
Allergic reaction
Like most drugs, Arzerra can cause an allergic reaction in some people. But these reactions weren’t common in studies of the drug.
Symptoms can be mild to serious and can include:
- skin rash
- itchiness
- flushing
- swelling under your skin, usually in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:
- an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
- a product you apply to your skin, such as hydrocortisone cream
If your doctor confirms you’ve had a mild allergic reaction to Arzerra, they’ll decide whether you should continue receiving it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Arzerra, they may have you switch to a different treatment.
Keeping track of side effectsDuring your Arzerra treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were receiving when you had the side effect
- how soon you had the side effect after starting that dose
- what your symptoms were
- how it affected your daily activities
- what other medications you were taking
- any other information you feel is important
Keeping notes and sharing them with your doctor will help them learn more about how Arzerra affects you. They can then use this information to adjust your treatment plan if needed.
Arzerra comes with several warnings, which may affect whether the drug is a good treatment option for your condition.
Boxed warnings
Arzerra has
- Risk of HBV reactivation. If you’ve ever had hepatitis B, treatment with Arzerra may reactivate the virus that causes this infection. In rare cases, HBV reactivation can lead to liver failure and may even be fatal.
- Risk of PML. Treatment with Arzerra increases your risk of PML, a rare but life threatening brain infection.
To learn more, see the “Side effects explained” section above.
Other warnings
Arzerra may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Arzerra is a good treatment option for you.
Talk with your doctor about your health history before starting Arzerra. The list below includes factors to consider.
Allergic reaction. If you’ve had an allergic reaction to Arzerra or any of its ingredients, your doctor will likely not prescribe Arzerra. Ask them what other medications are better options for you.
Alcohol and Arzerra
There is no known interaction between drinking alcohol and being treated with Arzerra.
Talk with your doctor if you have questions about Arzerra and consuming alcohol.
Pregnancy and breastfeeding while receiving Arzerra
It isn’t known whether it’s safe to receive Arzerra while pregnant or breastfeeding.
If you’re pregnant or breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor. They can discuss the risks and benefits of treatment options for your condition, including Arzerra, during this time.
Like most medications, Arzerra can cause mild or serious side effects. Mild side effects are more common, especially infusion reactions. Before each Arzerra infusion, you’ll receive a few medications that help prevent these reactions.
If you have questions about side effects and treatment with Arzerra, talk with your doctor. They can review the risks and benefits you may have from receiving this medication for your condition.
Here are some examples of questions you might want to ask:
- Will I need to receive Arzerra with other medications? If so, how do their side effects compare with Arzerra’s?
- Will any of the other medications I take raise my risk of side effects from Arzerra?
- How does my risk of side effects from Arzerra change over time?
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Q:
Is it safe to get vaccines while I’m receiving Arzerra?
AnonymousA:
It depends on the vaccine. Some vaccines are considered safe to get while you’re receiving Arzerra. But there are others you need to avoid.
Specifically, it’s recommended that you avoid live vaccines during your Arzerra treatment. Live vaccines contain a weakened version of the germ that causes the disease they’re meant to prevent. This means it’s possible to get the disease from the vaccine if you have a weakened immune system. (Arzerra works by weakening the immune system.)
Examples of live vaccines include the chickenpox, yellow fever, and typhoid vaccines.
Before you start treatment with Arzerra, talk with your doctor about vaccinations. They can make sure your vaccinations are up to date before you begin treatment. You should also talk with your doctor before receiving any vaccine during treatment. They can advise you on whether it’s safe for you to get the vaccine.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.