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Patient Education
Rituximab (ri-TUK-si-mab)
Brand Names
Rituxan® (There may be other brand names for this medication)
How is it Administered?
Rituximab is given by injection into a vein (intravenously or IV). It
must be given slowly and may take several hours or more for your
first dose. You may receive your medication more quickly during
subsequent doses, depending on how you respond.
What is it Used For?
This drug is used to treat some types of non-Hodgkin's lymphoma.
How Does it Work?
Rituximab is in a class of medications called monoclonal antibodies,
or biologic antineoplastic agents; it is a type of targeted therapy.
When “foreign invaders”, which are called antigens, are detected,
your body makes antibodies. Antibodies attach to antigens like a
key fits in a lock, and the antigen is destroyed. This process is part
of the normal immune response that protects you.
For cancer therapies, scientists use certain proteins to make
antigens that look for, and attach to, a specific type of cell. Your
antibodies attack the cells with the antigen. Monoclonal antibody
therapy is usually given only for cancers in which both the antigens
and antibodies have been identified.
Since monoclonal antibodies target only specific cells, they may
cause less harm to healthy cells. Rituximab works by targeting an
antigen (CD 20) that is on both normal and cancerous B-cells, a
type of white blood cell that plays a part in fighting infections.
Stem cells (immature cells in your bone marrow) do not have CD
20; they can mature and replace the B-cells destroyed by the
rituximab.
What Should I Tell My
Doctor Before I Begin
Receiving Rituximab?
Tell your doctor if you:
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have had an allergic reaction to rituximab or any murines
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have/have ever had chronic lymphocytic leukemia (CLL), mantle
cell lymphoma, an irregular heartbeat, or heart or lung disease
© 2011 Roswell Park Cancer Institute
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have any type of infection or if you have ever had an infection
that wouldn’t go away or an infection that comes and goes
•
have ever had any of these viruses: hepatitis B, chicken pox
(varicella-zoster), herpes, West Nile, or cytomegalovirus (CMV)
•
are pregnant or breastfeeding
This drug may interact with other medications, increasing or
decreasing their effectiveness or causing harmful side effects.
Tell your doctor and pharmacist about any prescription or
over-the-counter medications, vitamins, herbal or diet
supplements that you are taking.
What Are Some Possible
Side Effects I May
Experience?
• Flu-like symptoms: fever and chills
• Runny nose and/or scratchy throat
• Drowsiness, dizziness, and/or weakness
• Headache
• Heartburn, nausea, vomiting, and/or weight gain
• Diarrhea
• Muscle or back pain
• Flushing and/or night sweats
• Numbness, burning or tingling in the hands or feet
How Can I Manage
These Side Effects?
When Should I Call the
Doctor?
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Ask your doctor about medication to help prevent or lessen
fever, nausea, vomiting, diarrhea or pain.
•
For 2 days after your treatment, drink 8-12 cups of water, unless
your doctor has restricted your fluids because of a medical
condition.
•
Avoid driving and other activities that require alertness until you
know how this medication will affect you.
Call your doctor immediately if you experience:
• any sign of infection: fever of 100.5°F (38°C) or higher, chills,
cough, sore throat, pain or burning upon urination; redness or
tenderness along a vein, at an IV site, or at any other wound or
skin irritation
• any sign of an allergic reaction: itching or hives, swelling in your
face or hands, swelling or tingling in your mouth, tongue, or
© 2011 Roswell Park Cancer Institute
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throat; chest tightness, wheezing, or trouble breathing or
swallowing; dizziness/fainting; or (heart) palpitations
severe, painful sores, ulcers, blisters, rash, or peeling skin
pain in or near your stomach
joint pain or soreness
difficulty thinking clearly or walking, loss of strength, vision
problems, or any other unusual symptoms that develop suddenly
a decrease in the amount or frequency of urination
unusual bruising or bleeding: bleeding lasts more than 10-15
minutes or that causes dizziness; black or bloody stools; vomit
that is bloody or that looks like coffee grounds; blood in your
urine or phlegm /mucus, unusually heavy menstrual bleeding,
spontaneous bleeding from your gums or nose, or superficial
bleeding into the skin that appears as a rash of pinpoint-sized
reddish-purple spots (petechiae)
Call your doctor as soon as possible if you have:
• nausea or vomiting that is not relieved by prescribed medication
or that prevents you from eating or drinking
• headache or muscle pain not relieved by prescribed medication
• runny or stuffy nose
What Else Should I Know •
About Rituximab?
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You may experience fever, shaking, chills, tiredness, headache,
or nausea during treatment, especially with your first dose. Tell
your doctor/nurse if you have any of these symptoms.
Check with your doctor before having any vaccinations, such as
the flu shot.
Neither you nor your partner should get pregnant while you are
taking rituximab. This drug may be harmful to a fetus. Use two
forms of birth control during treatment and for twelve months
afterwards. This is very important whether you are a man or a
woman.
Do not breastfeed while you are receiving this medicine.
When rituximab is used to treat non-Hodgkin's lymphoma, it
may cause tumor lysis syndrome (TLS), which can lead to
kidney failure. Tell your doctor if you notice any urinary changes
like urinating less frequently or producing less urine.
If you have surgery, tell your doctor/dentist you’re on rituximab.
Be sure to keep all of your lab and doctor appointments.
Talk to your doctor about the risks of using rituximab or if you
would like more information about the drug.
© 2011 Roswell Park Cancer Institute
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