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Care During Chemotherapy and Beyond

Rituxan



Generic Name: Rituximab

Drug Type:

Rituxan is a monoclonal antibody. (For more detail, see "How Rituxan Works" section below).

What Rituxan Is Used For: 

  • Treatment of certain types of non-Hodgkin's lymphoma.
  • Treatment of chronic lymphocytic leukemia (CLL).

Note:  If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Rituxan Is Given:

  • As an infusion into a vein (intravenous, IV), over about 6 hours.  The time of the infusion may be shortened, depending on whether or not you have received Rituxan in the past, or how well you tolerate Rituxan.
  • Medications may be given just before the infusion to reduce the occurrence of infusion-related symptoms.
  • There is no pill form of Rituxan.
  • The amount of Rituxan you will receive depends on many other factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dosage and schedule.

Rituxan Side Effects:

Important things to remember about Rituxan side effects:

  • Most people do not experience all of the Rituxan side effects listed.
  • Rituxan side effects are often predictable in terms of their onset and duration.
  • Rituxan side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent Rituxan side effects.
  • There is no relationship between the presence or severity of Rituxan side effects and the effectiveness of Rituxan.

The following Rituxan side effects are common (occurring in greater than 30%) for patients taking Rituxan:  

  • Fever and chills (see flu like symptoms)

The following are less common Rituxan side effects (occurring in 10-29%) for patients receiving Rituxan:

  • Weakness 
  • Nausea
  • Headache
  • Cough 
  • Runny nose, shortness of breath, sinusitis (see cold symptoms)
  • Throat irritation (see cold symptoms - pharyngitis)

A serious but rare Rituxan side effect is potential for a severe infusion reaction, typically with the first infusion (during infusion or within 30-120 minutes of infusion).  You will be given medication prior to the infusion to decrease this reaction and monitored carefully during the infusion.  If signs of reaction occur, the infusion is stopped.  In most cases, the infusion can be restarted at a slower rate once symptoms subside.

Other rare but serious Rituxan side effects:

  • Patients who have had heart pain or irregular heartbeats in the past may experience this again.  If these occur tell your doctor or nurse, so that they can be treated. 
  • Rapid destruction of cancer cells can cause disturbances in metabolism leading to kidney problems.  
  • If you have questions about this information ask your doctor.   

Not all Rituxan side effects are listed above.  Some that are uncommon, occurring in less than 10% of patients, are not listed here.  You should always inform your health care provider if you experience any unusual symptoms.

When To Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or chills (possible signs of infection)
  • Shortness of breath, chest pain or discomfort; swelling of your lips or throat
  • Confusion

The following symptoms require medical attention, but are not emergency situations.  Contact your health care provider within 24 hours of noticing any of the following:

  • Develop a rash or sore joints
  • Nausea (interferes with ability to eat and unrelieved with prescribed medications)
  • Vomiting (vomiting more than 4-5 times in a 24-hour period)
  • Other signs of infection, sore throat, cough, redness or inflammation, or pain on urination

Always inform your health care provider if you experience any unusual symptoms.

Rituxan Precautions:

  • Before starting rituxamab treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). 
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking rituxamab.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment.  Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus). 
  • For both men and women: Do not conceive a child (get pregnant) while taking rituxamab. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking Rituxan.

Rituxan Self Care Tips:

  • Rituxan may cause temporary low blood pressure.  If you are taking medication to reduce your blood pressure, check with your doctor or nurse as to whether you should take it as usual or not before the infusion.
  • You may experience shortness of breath, feel flushed or dizzy during the infusion. You will most likely receive medication before the infusion, and you will be closely monitored during the infusion. 
  • For flu-like symptoms, keep warm with blankets and drink plenty of liquids.  There are medications that can help reduce the discomfort caused by chills.
  • Drink 2 to 3 quarts of fluid for the first 48 hours after each infusion, unless you were told to restrict your fluid intake. 
  • Rituxan infrequently causes nausea. But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals. Sucking on lozenges and chewing gum may also help.
  • You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.
  • In general, drinking alcoholic beverages should be avoided.  You should discuss this with your doctor.
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Rituxan:

You will be checked regularly by your health care provider while you are taking Rituxan, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) may also be ordered by your doctor.   

How Rituxan Works:

Rituxan is classified as a monoclonal antibody.  Monoclonal antibodies are a relatively new type of "targeted" cancer therapy.

Antibodies are an integral part of the body's immune system.  Normally, the body creates antibodies in response to an antigen (such as a protein in a germ) that has entered the body.  The antibodies attach to the antigen in order to mark it for destruction by the immune system.

To make anti-cancer monoclonal antibodies in the laboratory, scientists analyze specific antigens on the surface of cancer cells (the targets).  Then, using animal and human proteins, they create a specific antibody that will attach to the target antigen on the cancer cells. When given to the patient, these monoclonal antibodies will attach to matching antigens like a key fits a lock.

Since monoclonal antibodies target only specific cells, they may cause less toxicity to healthy cells.   Monoclonal antibody therapy is usually given only for cancers in which antigens (and the respective antibodies) have been identified already.

Rituxan works by targeting the CD20 antigen on normal and malignant B-cells.  Then the body's natural immune defenses are recruited to attack and kill the marked B-cells.  Stem cells (young cells in the bone marrow that will develop into the various types of cells) do not have the CD20 antigen.  This allows healthy B-cells to regenerate after treatment.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.