What Rituximab is and what it is used for?
- Rituximab is a monoclonal antibody that targets to a protein called CD20 on the surface of white blood cells known as B lymphocytes. When rituximab sticks to the surface of these cells, the abnormal growth of the B lymphocytes is stopped and triggers cell death.
- Rituximab can be used alone or in combination with other medicines to treat non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL). This medicine may also be used to certain autoimmune diseases such as rheumatoid arthritis (RA) and granulomatosis with polyangiitis (GPA), as determined by your doctor.
How is Rituximab given?
- Rituximab is given as a slow infusion into the vein. It may take up to 4 to 6 hours or more.
What should I know while receiving Rituximab?
- An infusion-related reaction may happen during or shortly after the infusion, causing rash, dizziness, fever and chills, swelling of hands, feet or face, breathing difficulties, and a drop in blood pressure. Tell your nurse right away if you feel unwell during an infusion.
- Do not use this drug when you are pregnant. Men and women should use effective contraception during treatment and for at least 1 year after the treatment ends.
- Do not breastfeed and for 6 months after treatment has ended.
- Do not receive any kind of vaccination without doctor's approval.
- You will have regular blood tests to check that you have enough blood cells and have adequate organ functions to receive this drug. The timing and dosing of your treatment may be changed based on the test results or other side effects.
- The existing health problems may affect the use of rituximab. You should let your doctor know if you have any other medical problems, especially heart diseases, lung or kidney problems.
- Rituximab may make hepatitis B become active again. Your doctor will check you for Hepatitis B virus infection before starting rituximab treatment. If you have active hepatitis B, you will not receive rituximab. If you have ever had hepatitis B, you will have regular liver function tests while using this medicine and for several months after you stop treatment.
- There are many drugs may affect how rituximab works. Tell your doctor about all the medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Common side effects
- Low white blood cell count
You may have a higher risk of getting infections. Try to stay away from crowds and wash hands often. Tell your doctor right away if you have repeated fevers, coughing, stuffy nose, a painful urination or wound that becomes red and swollen.
- Flu like symptoms
Symptoms such as fever, headache, muscle pains and shivering may occur a few hours after treatment. This is temporary and can be improved by pain relievers. Seek medical help if these symptoms do not get better after a day.
- Weakness and fatigue
Try to pace yourself and rest as much as you need to. Speak to your doctors if you are feeling very tired. They can help you to manage it and might give you treatment.
Less common side effects
- Low red blood cell count
You may look pale and get tired more easily. Let your doctor know if you experience any difficulty breathing or dizziness when changing positions.
- Low platelet count
You may have a higher risk of bleeding. Let your doctor know if you find red or purple dots on the skin, bleeding from the nose or gums, or any bruising or bleeding that you cannot explain.
Talk to your doctor and ask for advice. Drinking plenty of water and dietary changes can improve diarrhea.
Medicines may be given before the treatment to prevent it happening. Eating and drinking often in small amounts may reduce the discomfort.
- Skin rash
A rash can be itchy, red, or painful. Tell your doctor about any skin changes that you have, they can give you medicines and advices that help you feel better.
Rare but serious side effects
- Tumor lysis syndrome (TLS)
TLS is a life-threatening condition that happens when the large amount of cancer cells die too quickly and their wastes release into the blood stream. Symptoms of TLS include general fatigue, muscle cramps, abnormal heartbeat, decreased urination, throwing up, or confusion. Your doctor will monitor you closely and prescribe medicines to prevent its development.
- Drink at least 6 to 8 glasses of water every day during treatment can help make your recovery a smoother process.
- Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarette smoking during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.