Care During Chemotherapy and Beyond
Generic Name: Rituximab
Rituxan is a monoclonal antibody. (For more detail, see "How Rituxan Works" section
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
- 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.
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
- 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
- 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
- Rapid destruction of cancer cells can cause disturbances in metabolism leading to
- 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
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
Always inform your health care provider if you experience any unusual symptoms.
- 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 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:
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
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.
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