Rituximab

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; Rituxan; Riximyo; Ruxience; Truxima

Warning

  • Very bad and sometimes deadly side effects have rarely happened during and within 24 hours after the infusion. Tell your doctor if you have 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 you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
  • If you have had hepatitis B before or carry the virus, this drug can cause the virus to become active. This can lead to very bad and sometimes deadly liver problems. You will be tested for hepatitis B before starting this drug. You will need to watch for signs of hepatitis while taking this drug and for several months after stopping it. Talk with your doctor.
  • A severe brain problem called progressive multifocal leukoencephalopathy (PML) has happened with this drug. It may cause disability or can be deadly. Tell your doctor right away if you have signs like confusion, memory problems, depression, change in the way you act, 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 rheumatoid arthritis.
  • It is used to treat granulomatosis with polyangiitis (GPA).
  • It is used to treat microscopic polyangiitis.
  • It is used to treat a skin problem called pemphigus vulgaris.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you are allergic to mouse proteins, talk with the doctor.
  • If you have an infection.
  • If you have active hepatitis B infection.
  • If you have had a vaccine in the past month.
  • If you are breast-feeding. Do not breast-feed while you take this drug or within 6 months after your last dose.

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

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

What are some things I need to know or do while I take this drug?

For all uses of this drug:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • You may have more of a chance of getting an infection. Some infections have been severe or deadly. Wash hands often. Stay away from people with infections, colds, or flu.
  • Call your doctor right away if you have any signs of infection like fever, chills, flu-like signs, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or a wound that will not heal.
  • Talk with your doctor before getting any vaccines. Use of some vaccines with this drug may either raise the chance of an infection or make the vaccine not work as well.
  • Make sure you are up to date with all your vaccines before treatment with this drug.
  • Heart problems like heart failure and abnormal heartbeats have happened with this drug. Sometimes, these heart problems have been deadly. Call your doctor right away if you have 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.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • This drug may cause harm to an unborn baby. A pregnancy test will be done before you start this drug to show that you are NOT pregnant.
  • If you may become pregnant, you must use birth control while taking this drug and for some time after the last dose. Ask your doctor how long to use birth control. If you get pregnant, call your doctor right away.
  • If you used this drug when you were pregnant, tell your baby’s doctor.

Cancer treatment:

  • Patients with cancer who take this drug may be at a greater risk of getting a severe health problem called tumor lysis syndrome (TLS). This may lead to death. Call your doctor right away if you have 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 feel 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 your doctor right away if you have 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 side effects that I need to call my 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 doctor or get medical help right away if you have 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 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 your doctor right away if you are unable to pass urine or if you have blood in the urine or a change in the amount of urine passed.
  • Some people have had lung problems with this drug. Sometimes, this has been deadly. Call your doctor right away if you have 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.

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 doctor or get medical help if any of these side effects or any other side effects bother you 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 doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your 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 I miss a dose?

  • Call your 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 doctor, nurse, or pharmacist about how to store it.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • 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 doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, 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

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022