Rituximab Injection

Conditions Treated

Rituximab is used alone or with other medications to treat certain types of non-Hodgkin's lymphoma (NHL; a type of cancer that begins in a type of white blood cells that normally fights infection). Rituximab is also used with another medication to treat the symptoms of rheumatoid arthritis (RA; a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) in people who have already been treated with a certain type of medication called a tumor necrosis factor (TNF) inhibitor. Rituximab is in a class of medications called biologic antineoplastic agents. It treats NHL by causing the death of blood cells that have multiplied abnormally. It treats rheumatoid arthritis by causing the death of certain blood cells that may cause the immune system to attack the joints.

Possible Side Effects

What Side Effects Can This Cause?

Rituximab may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• diarrhea
• heartburn
• weight gain
• muscle or back pain
• flushing
• night sweats
• tiredness
• weakness
• numbness, burning or tingling in the hands or feet
• runny nose

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• stomach area pain
• unusual bruising or bleeding
• sore throat, fever, chills, or other signs of infection
• chest tightness
• joint pain or soreness

Usage Instructions

How Should This Medication Be Used

Rituximab comes as a solution (liquid) to be injected into a vein. Rituximab is administered by a doctor or nurse in a medical office or infusion center. When rituximab is used to treat rheumatoid arthritis, it is usually given as 2 doses spaced 2 weeks apart. When rituximab is used to treat NHL it is either given once a week for 4-8 weeks or on the first day of each chemotherapy cycle. Your dosing schedule will depend on the condition that you have, the other medications you are using, and how well your body responds to treatment. Rituximab must be given slowly. It may take several hours or longer to receive your first dose of rituximab, so you should plan to spend most of the day at the medical office or infusion center. After the first dose, you may receive your medication more quickly, depending on how you respond to treatment. You may experience symptoms such as fever, shaking chills, tiredness, headache, or nausea while you are receiving a dose of rituximab, especially the first dose. Tell your doctor or other healthcare provider if you experience these symptoms while you are receiving your medication. Your doctor may prescribe other medications to help prevent or relieve these symptoms. Your doctor may tell you to take these medications before you receive each dose of rituximab. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What Dietary Instructions Should I Follow

Unless your doctor tells you otherwise, continue your normal diet.

Are There Any Special Instructions

Before using rituximab, tell your doctor and pharmacist if you are allergic to rituximab or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medication in the IMPORTANT WARNING section and either of the following: medications for high blood pressure and other medications for rheumatoid arthritis. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have any of the conditions mentioned in the IMPORTANT WARNING section and if you have or have ever had hepatitis B or other viruses such as chicken pox, herpes (a virus that may cause cold sores or outbreaks of blisters in the genital area), West Nile virus (a virus that is spread through mosquito bites and may cause serious symptoms), or cytomegalovirus (a common virus that usually only causes serious symptoms in people who have weakend immune systems or who are infected at birth). Also tell your doctor if you have any type of infection now or if you have or have ever had an infection that would not go away or an infection that comes and goes. if you are having surgery, including dental surgery, tell the doctor or dentist that you are using rituximab. you should know that you may be drowsy or dizzy after you receive a dose of rituximab. Do not drive a car or operate machinery until you know how this medication affects you. Plan to have someone else drive you home from the medical office or infusion center after you receive your treatment. ask your doctor whether you should receive any vaccinations before you begin your treatment with rituximab. Do not have any vaccinations during your treatment without talking to your doctor.