Your doctor may prescribe Truxima if you have a certain kind of cancer or another condition that affects your immune system. Truxima is prescribed to treat the following conditions in adults:

To learn more about Truxima’s uses, see “Is Truxima used for rheumatoid arthritis?” and “Is Truxima used for other conditions?” below.

Truxima basics

The active ingredient in Truxima is rituximab-abbs. (The active ingredient is what makes a drug work.) It belongs to a group of drugs called monoclonal antibodies, and it’s a kind of immunotherapy.

Truxima is a biologic drug. A biologic is made from living cells, while other drugs are made from chemicals. Drugs made from chemicals can have generic versions, which are exact copies of the active drug in the brand-name medication. Biologics, on the other hand, can’t be copied exactly.

Therefore, instead of a generic, a biologic has a biosimilar. Biosimilars are “similar” to the parent drug and are considered just as effective and safe. Like generic-name drugs, biosimilars are often less expensive than brand-name drugs. Truxima is a biosimilar version of the brand-name drug Rituxan (rituximab).

Truxima comes as a liquid solution given as an intravenous (IV) infusion (an injection into a vein given over time). A healthcare professional will give you Truxima infusions at a hospital or another healthcare facility.

Truxima is a biosimilar version of Rituxan (rituximab), a brand-name biologic drug. (See “Truxima basics” directly above for more information about biosimilar and biologic drugs.)

While Truxima and Rituxan are very similar, they do have some key differences, such as:

  • Rituxan may be used to treat certain conditions in some children. Truxima is only used in adults.
  • Rituxan is used to treat pemphigus vulgaris, but Truxima is not.

(To learn more about Truxima’s uses, see “Is Truxima used for rheumatoid arthritis?” and “Is Truxima used for other conditions?” below.)

To learn more about Truxima and Rituxan, see this detailed comparison. And for more information about which is right for your condition, talk with your doctor.

Like most drugs, Truxima may cause mild to serious side effects. While the lists below describe some of the more common ones, they do not include all the possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Truxima. They can also suggest ways to help relieve any side effects.

Mild side effects

Below is a list of some of the mild side effects Truxima can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the drug’s prescribing information.

Truxima’s side effects may vary, depending on the condition you’re using the drug to treat.

Mild side effects that have been reported include:

Mild side effects of many drugs go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Truxima are possible, but they aren’t common. If you have serious side effects from this drug, call your doctor right away. But if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects of Truxima that have been reported include:

* For more information, see the “Allergic reaction” section directly below.

Allergic reaction

Some people may have an allergic reaction to Truxima. It isn’t clear if this side effect occurred in studies of the drug, but it can still happen.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat, which can cause trouble breathing

Call your doctor right away if you have an allergic reaction to Truxima. But if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Find answers to some common questions about Truxima below.

Is Truxima used to treat multiple sclerosis (MS)?

Truxima is not approved to treat MS. But the drug can be used off-label for this purpose. (Off-label use is when a drug is used to treat a condition other than those it’s approved for.)

A review of studies has shown that rituximab may be a safe and effective treatment for relapsing-remitting MS and progressive types of MS, such as primary progressive MS.

Truxima belongs to a group of drugs called monoclonal antibodies. Other drugs in this group are FDA-approved for treating MS, such as:

If you’d like guidance about the best treatment option for your MS, talk with your doctor.

Does Truxima cause hair loss?

Alopecia (hair loss) wasn’t reported as a side effect in Truxima’s studies. But it’s a possible side effect of a very similar drug, Rituxan (rituximab).

Hair loss was reported in a study that looked at Rituxan for treating pemphigus vulgaris. (Truxima isn’t approved to treat this condition. To learn more about Truxima’s uses, see the “Is Truxima used for rheumatoid arthritis?” and “Is Truxima used for other conditions?” sections below.)

If you’re having unusual hair loss during treatment with Truxima, talk with your doctor. They may be able to determine why this is happening and suggest ways to manage it.

How long does a Truxima infusion take?

A Truxima infusion takes at least 90 minutes. The drug is given as an intravenous (IV) infusion (an injection into a vein given over time). A healthcare professional will give you the infusions at a hospital or another healthcare facility.

You should allow several hours for your appointment, though. Before the infusion, you’ll likely receive drugs to help prevent or minimize infusion-related reactions. And you’ll need to stay for a while after the infusion. This way, a healthcare professional can treat any infusion side effects that might occur.

Costs of prescription drugs can vary, depending on many factors, such as what your insurance plan covers.

Truxima is a biosimilar version of Rituxan (rituximab), a brand-name biologic drug. A biologic is made from living cells, while other drugs are made from chemicals. Drugs made from chemicals can have generic versions, which are exact copies of the active drug in the brand-name medication. Biologics, on the other hand, can’t be copied exactly.

Therefore, instead of a generic, a biologic has a biosimilar. Biosimilars are “similar” to the parent drug and are considered just as effective and safe. Like generic-name drugs, biosimilars are often less expensive than brand-name drugs.

Talk with your doctor if you have questions about the cost of treatment alternatives, such as Rituxan.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the manufacturer’s patient assistance website for information about different support options. And you can check out this article to learn more about saving money on prescriptions.

Truxima is used to treat rheumatoid arthritis (RA) in adults. RA is an autoimmune condition in which your immune system mistakenly attacks your joints and other healthy tissues. This causes inflammation (swelling and damage) throughout your body.

Truxima is used to reduce the symptoms of moderate to severe active RA. For this use, it’s prescribed with another drug called methotrexate (Trexall, Otrexup, others).

Specifically, Truxima is used in adults who have already tried at least one other kind of medication, called a tumor necrosis factor (TNF) antagonist, but it didn’t work well enough for their RA.

Examples of TNF antagonists include:

Truxima is thought to treat RA by targeting a certain protein that’s on some B cells (a type of white blood cell). Truxima attaches to this protein, which tells your immune system to destroy the B cells. This may reduce inflammation, ease related symptoms, and slow the progression of RA.

Truxima is also used to treat the following conditions in adults:

Truxima treats these conditions in specific situations. Find more details below.

Truxima is thought to work by attaching to certain proteins in your body and destroying B cells (a type of white blood cell). This can help reduce the number of cancerous cells in your body and may also reduce inflammation (swelling and damage). To learn more about how the drug works for your condition, talk with your doctor.

Truxima for non-Hodgkin’s lymphoma (NHL)

NHL is a cancer of the lymphatic system, which is part of your immune system. Truxima is used in adults with a certain kind of NHL. To learn more about the drug’s use for this condition, talk with your doctor.

For this use, Truxima is either prescribed alone or along with chemotherapy drugs. Your doctor will tell you more about the kind of NHL you may have and how Truxima can help. They’ll also tell you if you’ll receive any other drugs to treat your cancer.

Truxima for chronic lymphocytic leukemia (CLL)

Truxima is used to treat CLL in adults. This is a kind of blood cancer that begins in the bone marrow, where your body makes blood cells.

Truxima is used in adults with a certain kind of CLL. For this use, Truxima is prescribed together with two chemotherapy drugs: cyclophosphamide (Cytoxan) and fludarabine. Truxima is used in adults who have and those who haven’t had past treatments for their CLL.

Truxima for granulomatosis with polyangiitis (GPA)

GPA is an autoimmune disorder in which your immune system attacks your own blood vessels by mistake. This causes inflammation in your blood vessels.

For treating GPA, Truxima is prescribed along with glucocorticoids (commonly called steroids), such as prednisone (Rayos).

Truxima for microscopic polyangiitis (MPA)

MPA is a kind of necrotizing vasculitis, a condition in which you have inflammation in your blood vessels. It’s a rare autoimmune disorder that can damage your smallest blood vessels, called capillaries. The lungs and kidneys are commonly affected because these organs contain networks of capillaries.

For treating MPA, Truxima is prescribed with glucocorticoids (commonly called steroids), such as prednisone.

Other uses

Truxima may also be used off-label to treat other conditions. (Off-label use is when a drug is used to treat a condition other than those it’s approved for.) Talk with your doctor for more information.

Below are common dosages, but your doctor will determine the dosage you receive.

Form

Truxima comes in vials of liquid solution. The drug will be prepared and given to you by a healthcare professional as an intravenous (IV) infusion. (This is an injection into a vein given over time.) You’ll receive these infusions at a hospital or another healthcare facility.

Recommended dosages

The dosing schedule for Truxima varies, depending on the condition you’re using it to treat. You may receive your infusion as often as once weekly. Or you may have several weeks or months between infusions. Your doctor will explain how often you’ll receive this drug to treat your condition.

Questions about Truxima’s dosage

Here are some common questions about Truxima’s dosage.

  • What if I miss a dose of Truxima? Call your doctor’s office right away if you miss an infusion appointment. They’ll work with you to reschedule your Truxima infusion as soon as possible.
  • Will I need to use Truxima long term? It depends on the condition you’re using Truxima to treat. If you and your doctor decide that it’s working well for you and doesn’t cause severe side effects, you’ll likely use it long term for certain health conditions. But for other conditions, there’s a recommended number of Truxima infusions. Talk with your doctor to learn more about how long you’ll likely use Truxima.
  • How long does Truxima take to work? Truxima starts working as soon as you receive your first dose. But it may take a few weeks before it begins to relieve your symptoms. In some cases, you may have blood tests to check how well Truxima is working.

Your doctor will explain how Truxima will be given to you, how much you’ll be given, and how often.

Receiving Truxima

Truxima comes in vials of liquid solution. The drug will be prepared and given to you by a healthcare professional as an intravenous (IV) infusion. (This is an injection into a vein given over time.) You’ll receive these infusions at a hospital or another healthcare facility.

It takes at least 90 minutes to receive a Truxima infusion. (For more details about this, see “What are some frequently asked questions about Truxima?” above.)

Using Truxima with other drugs

Depending on the condition Truxima is being used to treat, your doctor may prescribe other drugs for you to take along with it. Your doctor can tell you more about whether Truxima is used with other medications for your condition.

Questions for your doctor

You may have questions about Truxima and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Truxima affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if it will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

This section talks about some important things to discuss with your doctor when you’re considering Truxima treatment. They include any other medical conditions and any ongoing treatments you may have.

Interactions

Using a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Interactions with drugs or supplements

Truxima can interact with the chemotherapy drug cisplatin. Using these drugs together could increase the risk of kidney problems, such as kidney failure.

No other drug interactions with Truxima are known. Still, before starting the treatment, be sure to tell your doctor about all the medications you take, including prescription and over-the-counter kinds. Also describe any vitamins, herbs, or supplements you take. Your doctor or pharmacist can tell you about any interactions these items may cause.

Boxed warnings

Truxima has several boxed warnings, listed below. These are serious warnings from the Food and Drug Administration (FDA) about drug effects that may be dangerous. Truxima’s boxed warnings include:

  • Risk of serious mucous membrane and skin reactions. Truxima may cause severe reactions that affect your skin or mucous membranes. (Mucous membranes are moist inner linings of certain body parts, such as your mouth and nose.) Life threatening reactions, such as Stevens-Johnson syndrome, have rarely occurred, but they can be fatal. Symptoms may include peeling, blisters, or sores on your skin or in your mouth.
  • Risk of severe infusion-related reactions. Truxima may cause serious infusion side effects. (An infusion is an injection given into a vein over time.) These reactions may occur within 24 hours of receiving your first Truxima infusion, and in rare cases, they may be life threatening. Symptoms can include chest pain and trouble breathing.
  • Risk of hepatitis B virus reactivation. Truxima may cause the reactivation of the hepatitis B virus if you’ve had hepatitis B in the past. Hepatitis B can lead to severe liver problems, such as liver failure. In rare cases, it can lead to death. Symptoms of hepatitis B include fatigue (low energy) and jaundice (yellowing of your skin and the whites of your eyes).
  • Risk of progressive multifocal leukoencephalopathy (PML). Truxima may cause PML, a rare but serious infection that affects the brain. It can be fatal in some cases. Symptoms of PML may include vision changes, weakness, and trouble with balance or coordination.

Other warnings

Truxima may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting treatment. Factors to consider include those in the list below.

  • Allergic reaction. If you’ve had an allergic reaction to Truxima, Rituxan (rituximab), or any of their ingredients, your doctor will not prescribe Truxima. Ask what other medications are better options for you.
  • Infections or immune system problems. Be sure to tell your doctor about any infections you have before you start receiving Truxima. Also, tell them if you have any conditions that weaken your immune system. Truxima can increase your risk of serious infections, and either of these factors can further increase your risk.
  • Heart problems. Using Truxima can lead to heart problems, such as a heart attack or an abnormal heart rhythm. If you already have heart problems, you may have a higher risk of these side effects. Tell your doctor about any heart problems you have before the treatment begins. They’ll help you decide if Truxima is the right choice for you.
  • Kidney problems. Truxima may cause kidney problems, such as kidney failure, in some people. If you have kidney problems, you may have a higher risk of this side effect. Talk with your doctor about any kidney problems you have before Truxima treatment begins. They may recommend a different treatment for your condition.

Truxima and alcohol

There are no known interactions between alcohol and Truxima. If you drink alcohol, talk with your doctor about how much, if any, is safe for you during treatment.

Pregnancy and breastfeeding

Truxima is not safe to use during pregnancy or while breastfeeding. If you can become pregnant, your doctor will likely order a pregnancy test to ensure it’s negative before prescribing Truxima.

They’ll also recommend that you use birth control during treatment and for 12 months after your last dose. And you shouldn’t breastfeed for at least 6 months after the treatment ends.

To learn more about the risks of Truxima during pregnancy or breastfeeding, talk with your doctor.

Truxima can be an effective treatment for certain kinds of cancer or some other conditions that affect your immune system. If you and your doctor think Truxima is an option, it’s important to get answers to any questions you have. Here are a few you might consider asking:

  • Do my medical conditions give me an increased risk of infusion reactions from Truxima?
  • Is it safe to take natural remedies to help ease the side effects of this drug?
  • When can we tell if this treatment is working for me?
  • How long will I need to watch for side effects after my first Truxima infusion?

In addition to talking with your doctor, you may find these articles and resources helpful:

Q:

Is Truxima as effective as Rituxan (rituximab) for treating rheumatoid arthritis (RA)? Are biosimilars just as good as brand-name drugs?

Anonymous

A:

Yes, Truxima should be just as safe and effective as Rituxan for treating RA.

Truxima is a biosimilar version of Rituxan, a brand-name biologic drug. Biosimilars are like generic drugs, but for biologic medications. But it isn’t possible to make an exact copy of a biologic drug because it’s made from parts of living cells.

Before the Food and Drug Administration (FDA) will approve a biosimilar drug, a study must show that the drug is similar to the “parent drug.” (This is the original, brand-name biologic drug.) The study must compare the biosimilar to the parent drug and prove there are no significant differences between how the two medications affect the body. If no major differences are found, new studies are not needed to prove the effectiveness of the biosimilar drug.

Compared with Rituxan, Truxima was found to have no major differences in safety or expected effects in studies. So the FDA’s approval of Truxima as an effective treatment option for RA is based on Rituxan’s performance in studies.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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.