Rituximab

Pediatric Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Riabni; Rituxan; Ruxience; Truxima

Brand Names: Canada

Riabni [DSC]; Rituxan; Riximyo; Ruxience; Truxima

Warning
  • Very bad and sometimes deadly side effects have rarely happened during and within 24 hours after the infusion. Tell the doctor if your child has any bad effects during or within 24 hours after the infusion.
  • A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if your child has signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.
  • If your child has had hepatitis B before or carries the virus, this drug can cause the virus to become active. This can lead to very bad and sometimes deadly liver problems. Your child will be tested for hepatitis B before starting this drug. You will need to watch for signs of hepatitis while your child takes this drug and for several months after your child stops it. Talk with your child’s doctor.
  • A severe brain problem called progressive multifocal leukoencephalopathy (PML) may happen with this drug. It may cause disability or death. Tell the doctor right away if your child has signs like confusion, memory problems, depression, change in the way your child acts, change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or change in eyesight.

What is this drug used for?

  • It is used to treat types of leukemia and lymphoma.
  • It is used to treat granulomatosis with polyangiitis (GPA).
  • It is used to treat microscopic polyangiitis.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child is allergic to mouse proteins, talk with the doctor.
  • If your child has an infection.
  • If your child has active hepatitis B infection.
  • If your child has had a vaccine in the past month.

If your child is breast-feeding a baby:

  • Be sure your child does not breast-feed a baby while taking this drug or within 6 months after the last dose.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Your child may have more chance of getting an infection. Some infections have been deadly. Have your child wash hands often. Have your child stay away from people with infections, colds, or flu.
  • Talk with the doctor before your child gets any vaccines. Use of some vaccines with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
  • Make sure your child is up to date with all vaccines before treatment with this drug.
  • If your child is of childbearing age, a pregnancy test will need to be done before starting this drug to make sure your child is not pregnant.

If your child is or may be sexually active:

  • This drug may cause harm to the unborn baby if your child takes it during pregnancy.
  • Have your child use birth control while taking this drug and for some time after the last dose. Ask the doctor how long your child must use birth control. If your child becomes pregnant, call the doctor right away.
  • If your child used this drug while pregnant, tell the baby’s doctor.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

For all uses of this drug:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
  • Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Signs of high blood sugar like confusion, feeling sleepy, unusual thirst or hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
  • Chest pain or pressure.
  • Dizziness.
  • Any unexplained bruising or bleeding.
  • Swelling.
  • Kidney problems have happened with this drug, especially in people with lymphoma. Sometimes, these have been deadly. Call the doctor right away if your child is unable to pass urine, has blood in the urine, or has a change in the amount of urine passed.
  • Heart problems like heart failure and certain abnormal heartbeats have happened with this drug. Sometimes, these heart problems have been deadly. Call your child’s doctor right away if your child has a fast, slow, or abnormal heartbeat; severe dizziness or passing out; or shortness of breath, a big weight gain, or swelling in the arms or legs.
  • Some people have had lung problems with this drug. Sometimes, this has been deadly. Call your child’s doctor right away if your child has signs of lung problems like shortness of breath or other trouble breathing, cough that is new or worse, or fever.

Cancer treatment:

  • Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
  • Patients with cancer who take this drug may be at greater risk of getting a severe health problem called tumor lysis syndrome (TLS). This may lead to death. Call your child’s doctor right away if your child has a fast or abnormal heartbeat; any passing out; trouble passing urine; muscle weakness or cramps; upset stomach, throwing up, diarrhea, or not able to eat; or feels sluggish.
  • People who took this drug with some cancer drugs have had bowel block or tears in the bowel. Sometimes this has been deadly. Call the doctor right away if your child has very bad stomach pain; very bad constipation; throwing up, throwing up blood, or throw up that looks like coffee grounds; or black, tarry, or bloody stools.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

For all uses of this drug:

  • Feeling tired or weak.
  • Headache.
  • Upset stomach or throwing up.
  • Stomach pain or diarrhea.
  • Runny or stuffy nose.
  • Muscle spasm.
  • Back, muscle, or joint pain.
  • Trouble sleeping.
  • Night sweats.
  • Throat irritation.
  • Flushing.
  • Anxiety.

Cancer treatment:

  • Mouth irritation or mouth sores.
  • Decreased appetite.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

  • It is given as an infusion into a vein over a period of time.
  • Other drugs will be given with this drug to help avoid side effects.

What do I do if my child misses a dose?

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

  • If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-12-01

Copyright

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Last Updated

Monday, December 12, 2022