Truxima (rituximab-abbs) is prescribed to treat certain cancers and immune system conditions. The drug is a liquid that a healthcare professional injects into a vein. Doctors determine the dosing schedule by the condition being treated.

Truxima is used in adults to treat certain types of cancer and immune system conditions, such as:

The active ingredient in Truxima is rituximab-abbs. Truxima belongs to a group of biologic drugs called monoclonal antibodies. It’s an immunotherapy that targets a certain protein that’s on some B cells (a type of white blood cell). Although Truxima is not chemotherapy, it may be given along with chemotherapy for some conditions.

This article describes the dosages of Truxima, as well as its strength and how it’s given. To learn more about Truxima, see this in-depth article.

This section describes the usual dosages and dosing schedule of Truxima. Your dose will be determined by:

  • your height and weight calculated into body surface area in meters squared (m2) (described in the paragraph below)
  • your condition
  • previous treatments you have used for your condition

Body surface area is the total surface area of a person’s body based on a calculation. It’s used to calculate doses of some drugs.

Keep reading to learn more.

What is Truxima’s form?

Truxima is available as a liquid solution that’s given as an intravenous (IV) infusion. This is an injection into your vein over a period of time. Generally, your doctor will start using a low Truxima infusion rate. They may increase the rate depending on whether you experience side effects from the infusion.

What strengths does Truxima come in?

Truxima comes in one strength of 10 milligrams per milliliter of solution (mg/mL).

What are the usual dosages of Truxima?

The information below describes dosages that are commonly used or recommended. Your doctor will determine the best dosage to fit your needs. In some cases, doctors may adjust your dosage from what’s shown below.

Truxima can cause infusion reactions and lower your immune system’s ability to fight infection. So, for some uses of Truxima, your doctor may prescribe additional preventive medications and premedications. Premedications are medications you take before your treatment with some immunotherapy or chemotherapy to help prevent side effects. These side effects might include nausea and allergic reaction.

Dosage for CLL

For CLL in adults, Truxima is given along with cycles of chemotherapy that consists of fludarabine and cyclophosphamide (FC). (A cycle is a period of treatment followed by a rest period.) The typical Truxima dosage by cycle of chemotherapy is:

  • Cycle 1: 375 mg per meter squared (mg/m2) the day before starting FC
  • Cycles 2 through 6: 500 mg/m2 on day 1 of each 28-day cycle of FC

Your doctor may also prescribe premedications, an antiviral medication, and an antibiotic.

See the “Premedication and preventive medications” section below for more information.

Dosage for NHL

Doctors may prescribe Truxima by itself, after chemotherapy, or along with Zevalin to treat NHL.

In some situations, chemotherapy is used before Truxima to reduce the number of cancer cells. Thus, Truxima will have fewer cancer cells to target, making it more effective.

Zevalin is an antibody with radiation. Using it with Truxima can increase the chance of destroying cancer cells.

The typical Truxima dosages for adults are as follows.

Truxima by itself or after chemotherapy: For adults with NHL, the typical dosage of Truxima is according to the following dosing schedules:

  • B-cell NHL that is previously untreated, follicular, and CD20-positive: Give 375 mg/m2 on day 1 of each chemotherapy cycle for up to 8 doses. (Chemotherapy for this type of NHL is based on your health status and age.)
    • Maintenance treatment following a complete or partial response to chemotherapy plus Truxima: Eight weeks after completing chemotherapy plus Truxima, give 375 mg/m2 once every 8 weeks for a total of 12 doses. (Maintenance treatment involves the follow-up doses needed to keep inflammatory cells from returning.)
  • B-cell NHL that is non-progressing, low grade, and CD20-positive after first treatment with chemotherapy: After 6 to 8 cycles of cyclophosphamide, vincristine, and prednisone (CVP) chemotherapy:
    • Give 375 mg/m2 once weekly for 4 weeks in a row every 6 months.
    • Continue 375 mg/m2 once weekly for 4 weeks in a row every 6 months as needed. This may continue until an overall total of up to 16 doses have been given.
  • B-cell NHL that is relapsed or refractory, low grade or follicular, and CD20-positive: Give 375 mg/m2 once weekly for a total of 4 or 8 doses.
  • B-cell NHL that is relapsed or refractory, low grade or follicular, and CD20-positive that is also being re-treated: Give 375 mg/m2 once weekly for a total of 4 doses.
  • Diffuse large B-cell NHL: Give 375 mg/m2 on day 1 of each chemotherapy cycle for up to 8 doses. (Chemotherapy for this type of NHL is based on your health status and age.)

Your doctor may also prescribe premedications. See the “Premedication and preventive medications” section below for more information.

Truxima along with Zevalin: The typical dose of Truxima is 250 mg/m2 given on a specific schedule. Learn more about this dosing schedule in the Zevalin prescribing information.

Your doctor may also prescribe premedications. See the “Premedication and preventive medications” section below for more information.

Dosage for GPA or MPA

For adults with GPA or MPA, the typical dosage of Truxima varies. It depends on whether you’re receiving induction or maintenance treatment. Induction treatment aims to destroy as many inflammatory cells as possible and make the disease dormant. Maintenance treatment involves the follow-up doses needed to keep inflammatory cells from returning.

Dosages for each are:

  • Induction treatment: 375 mg/m2 once weekly for 4 weeks with IV methylprednisolone and then oral prednisone as your doctor instructs
  • Maintenance treatment: 500 mg initially, then another 500 mg 2 weeks later, followed by 500 mg every 6 months

Your doctor may also prescribe premedications and an antibiotic. See the “Premedication and preventive medications” section below for more information.

Dosage for RA

Truxima dosing for RA in adults is 1,000 mg followed by another 1,000 mg 2 weeks later. Your doctor will give this full course of Truxima every 16 to 24 weeks based on your symptoms.

Thirty minutes before a Truxima dose, you’ll be given IV methylprednisolone to prevent infusion reactions. While taking Truxima, you’ll also use methotrexate to reduce inflammation and slow joint damage.

Premedication and preventive medications

Truxima can cause infusion reactions and lower your immune system’s ability to fight infection. Because of this, your doctor may also prescribe the following medications with Truxima:

  • Premedications (for CLL, NHL, GPA or MPA, and RA):
    • oral acetaminophen as a pain reliever and fever reducer
    • oral antihistamine (diphenhydramine, Benadryl) to reduce itching, rash, and swelling risks
  • Additional premedication (RA and GPA or MPA):
    • IV glucocorticoid (methylprednisolone) to reduce swelling and allergic reaction risks
  • Preventive medications:

How to use Truxima

Truxima comes as a liquid solution that’s given as an IV infusion. A healthcare professional injects Truxima into your vein over a period of time.

Your dosing schedule depends on the condition Truxima is treating.

Truxima can cause infusion reactions and lower your immune system’s ability to fight infection. So, for some uses of Truxima, your doctor may prescribe additional medications. These might include premedications that will be given prior to infusions. They also might include an antiviral medication and an antibiotic.

Is Truxima used long term?

It depends on the condition you’re using Truxima to treat. You and your doctor can discuss how it’s working. If you agree that it’s working well and doesn’t cause severe side effects, you may use it long term. But for some conditions, the drugmaker recommends a certain number of Truxima infusions.

Talk with your doctor to learn more about how long you’ll likely use Truxima.

Below are answers to some commonly asked questions about Truxima’s dosage.

Will my dosage be lowered if I experience Truxima side effects?

Infusion reactions are the most common side effects that would prompt your doctor to change your Truxima treatment. Infusion reactions may occur 30 to 120 minutes after starting your first dose.

But instead of lowering your dose, your doctor may stop or slow down your Truxima infusion. They’ll do this at the first sign of an infusion reaction, especially if you have a heart or lung condition. It’s also likely that they’ll do this if you have a large number of cancer cells.

Signs and symptoms of infusion reactions include:

Severe, life threatening infusion reactions that will prompt your doctor to stop Truxima treatment include:

Your doctor may also permanently stop your Truxima treatment for other reasons, including:

  • PML
  • severe skin and mucous membrane reactions
  • serious infection
  • pregnancy

If you have questions about dosage changes, check with your doctor or pharmacist.

Does the dose of Truxima need to be adjusted for people over age 65 years?

Studies of Truxima show that dosing changes aren’t necessary for people ages 65 years and older. But side effects can occur more frequently in this age group.

Side effects that occur more frequently and need closer monitoring in older adults include:

  • irregular heartbeat
  • pneumonia and inflammation of the lower lungs
  • serious infection
  • new cancers

If you have questions about the Truxima dosage for your age, talk with your doctor.

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.