Care During Chemotherapy and Beyond
(ri TUK si mab)
Trade name: Rituxan®
Chemocare.com uses generic names in all descriptions of drugs. Rituxan is the trade
name for rituximab. In some cases, health care professionals may use the trade name
rituxan when referring to the generic drug name rituximab.
Drug type: Rituximab is a monoclonal antibody. (For more detail,
see "How this drug works" section below).
What Rituximab 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
How Rituximab 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
this drug in the past, or how well you tolerate this drug.
- Medications may be given just before the infusion to reduce the occurrence of infusion-related
- There is no pill form of rituximab.
- The amount of this medication 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 the side effects of rituximab:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for
patients taking rituximab:
- Fever and chills (see flu like symptoms)
The following are less common 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 side effect of rituximab 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 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 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
- 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 this medication.
- Rituximab 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.
- This medication 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
rituximab, 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 Rituximab Works:
Rituximab 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
Rituximab 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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