How Is Rituxan Given
Like some other treatments for RA, Rituxan must be given directly into the bloodstream. So instead of being taken as a pill or an injection, it is given as an IV infusion. An IV infusion is a needle placed in a vein by a trained healthcare professional. When you receive your Rituxan infusion, it will be given to you in combination with another medication called methotrexate. Rituxan infusions will be administered 3-5 times a year at your doctorâs office, an infusion center, or a hospital. Each infusion typically lasts 4 to 6 hours, so itâs a good idea to plan accordingly.
You may be given additional medicine before each infusion to reduce the risk of side effects . If you experience any discomfort during the infusion, seek immediate medical attention.
Infusion-related reactions are the most common side effect of Rituxan treatment. Serious infusion-related reactions can happen during your infusion or within 24 hours after your infusion of Rituxan.
Dosage For Granulomatosis With Polyangiitis
Heres some information on the Rituxan dosage for granulomatosis with polyangiitis.
Starting dosage
For GPA, youll first have whats known as a starting dosage . This dosage helps get the drug in your body at high enough levels for it to begin working quickly. Your starting dose of Rituxan is based on your height and weight. The first dose will be an infusion of 375 mg/m2. For example, if youre 5 feet 8 inches tall and weigh 150 lb , your dose would be about 678 mg. Youll receive this dose once a week for 4 weeks.
In addition to premedications , youll be given a glucocorticoid, such as methylprednisolone, about 30 minutes before your dose of Rituxan. A glucocorticoid is a type of steroid, and it helps decrease your risk for having an infusion reaction from the medication.
Youll receive 100 mg of methylprednisolone as an IV injection on days 1 to 3. Then youll switch to prednisone, which you take by mouth.
Also, you may be given medication to help prevent an infection called Pneumocystis jirovecci pneumonia.
Note: Your doctor may decide that using a medication other than Rituxan for induction treatment may be best for you. In this case, youll start taking Rituxan after finishing your induction treatment .
Follow-up dosage
After youve completed the starting doses of Rituxan above, you can begin taking the follow-up doses.
Who Can I Call About My Financial Support Options
Our patient resource center is dedicated to getting patients and caregivers to the right resources. Call 1-877-GENENTECH Monday-Friday, 6 AM – 5 PM PT with questions.
Find more answers to your questions about Rituxan in our patient brochure
*Rituxan Immunology Access Solutions cannot complete or submit an appeal for you.
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What To Expect Post
Rituxan infusions may feel a little draining, especially if it is the first infusion. The infusion may make you feel sick and unwell for a few days. Keep this in mind before scheduling your infusion, because in some cases, you may need to schedule time off work after the infusion.
Rituxan affects different people in different ways, and many of these effects usually occur within hours of receiving the infusion or the following day. They may also require a few days to subside. The more common post-infusion side effects can include:
- Fever or chills
- Nausea or vomiting
Medicines Other Than Chemotherapy May Add To Fatigue
Patients may take medicines for pain or conditions other than the cancer that cause drowsiness. Opioids, antidepressants, and antihistamines have this side effect. If these medicines are taken at the same time, fatigue may be worse.
Taking opioids over time may lower the amount of sex hormones made in the testicles and ovaries. This can lead to fatigue as well as sexual problems and depression.
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Cancer Fatigue Is Different From Fatigue That Healthy People Feel
When a healthy person is tired from day-to-day activities, their fatigue can be relieved with sleep and rest. Cancer fatigue is different. People with cancer get tired after less activity than people who do not have cancer. Also, cancer fatigue is not completely relieved by sleep and rest, interferes with daily activities, and may last for a long time. Fatigue usually decreases after cancer treatment ends, but some people may still feel fatigue for months or years.
Will I Need To Use This Drug Long Term
It depends on what condition youre taking Rituxan for. With some conditions, such as RA, you may use Rituxan as a long-term treatment. If you and your doctor determine that the drug is safe and effective for you, youll likely take Rituxan long term.
However, with other conditions, such as NHL, you may need to take Rituxan for only four or eight doses.
If you have questions about how long youll need to take Rituxan for, talk with your doctor.
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What Are The More Common Side Effects Of Rituxan
Some people may experience mild or serious side effects during their Rituxan treatment. These can vary, depending on what condition the drug is being used to treat.
The following lists include some of the more common side effects reported by people who took Rituxan in studies.
More common side effects in people using Rituxan for non-Hodgkins lymphoma include:
- infusion side effects*
- mild infections, such as upper respiratory tract infections
* To learn more about this side effect, see the Side effects explained section below.
In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And dont stop using Rituxan unless your doctor recommends it.
The drug may cause mild side effects other than the ones listed above. For more information, see the Rituxan medication guide.
Note: After the Food and Drug Administration approves a drug, it tracks side effects of the medication. If youd like to notify the FDA about a side effect youve had with Rituxan, visit MedWatch.
Permission To Use This Summary
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The best way to cite this PDQ summary is:
PDQ® Supportive and Palliative Care Editorial Board. PDQ Fatigue. Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .
Images in this summary are used with permission of the author, artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.
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Pregnancy And Breastfeeding While Receiving Rituxan
Heres some information about pregnancy, breastfeeding, and Rituxan.
Pregnancy. Your doctor will likely recommend that you do not receive Rituxan while youre pregnant. The drug may cause harm to a developing fetus. If you can become pregnant, your doctor should order a pregnancy test for you before prescribing the drug. This is to confirm youre not pregnant.
You should use an effective form of birth control during your Rituxan treatment and for at least 12 months after your last dose. If you become pregnant or think youre pregnant during your treatment, talk with your doctor right away.
Breastfeeding. It is not recommended to breastfeed during your Rituxan treatment and for at least 6 months after your last dose. The drug may pass into human breast milk. And it isnt known if Rituxan can cause serious side effects in a child who is breastfed. Talk with your doctor about safe feeding options for your child during your Rituxan treatment.
What To Ask Your Doctor
Rituxan is an effective treatment for certain cancers or autoimmune conditions. If youre considering Rituxan as a treatment option, its helpful to learn about its possible side effects.
If you have questions about your risk of side effects from Rituxan, talk with your doctor. Here are some questions you may want to ask them:
- What can I do to lower my risk of serious side effects from Rituxan?
- Is it safe for me to continue my other medications and dietary supplements with Rituxan?
- Do I have a higher risk of any of Rituxans side effects compared with other people?
- Are there any vaccines that I should get before starting Rituxan treatment?
If you use Rituxan for rheumatoid arthritis , sign up for Healthlines RA newsletter to get the latest information about treatments, pain management, and more.
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Rituxan Generic Or Biosimilar
Rituxan is a brand-name medication. It has two biosimilar versions: rituximab-pvvr and rituximab-abbs .
A biosimilar medication is a drug thats similar to a brand-name biologic drug . Rituxan is a biologic medication, which is also called a biologic. Biologic drugs are made from living cells. Its not possible to copy these drugs exactly. A generic, on the other hand, refers to drugs made from chemicals. A generic is an exact copy of the active drug in a brand-name medication.
Biosimilars are considered to be just as safe and effective as their parent drug. And like generics, biosimilars tend to cost less than brand-name medications.
Rituxan contains one active drug ingredient: rituximab.
How To Take Rituximab
Rituximab is given by intravenous infusion. It may take several hours or longer to receive your first dose of rituximab. Depending on how you tolerate the medication, you may receive subsequent doses more quickly. The dosage and schedule is determined by the person’s body size, type of cancer, and treatment regimen. Prior to each dose, the patient may be given medications, including acetaminophen and an antihistamine , to decrease the risk of an infusion reaction.
You, or anyone you live with, should avoid having live or live-attenuated vaccines while receiving this medication. These include herpes zoster for shingles prevention, oral polio, measles, nasal flu vaccine , rotovirus and yellow fever vaccines.
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Side Effects In Children
The only conditions Rituxan is approved to treat in children is granulomatosis with polyangiitis and microscopic polyangiitis . GPA and MPA are conditions in which blood vessels become swollen and damaged in areas such as the kidneys, lungs, skin, and nose.
In clinical trials, children who took Rituxan for GPA or MPA had side effects that were the same as those that occurred in adults who took Rituxan for GPA or MPA.
Rituxan For Rheumatoid Arthritis
Rituxan is approved to be used in adults with moderate to severely active rheumatoid arthritis. For this purpose, Rituxan is used with methotrexate .
Before taking Rituxan for your RA, you must have tried a type of drug known as a tumor necrosis factor antagonist. However, you werent able to tolerate the side effects of the TNF antagonist or the medication didnt relieve your symptoms. Examples of TNF antagonists include adalimumab , infliximab , and etanercept .
RA explained
RA is an autoimmune disease, which means it causes your immune system to mistakenly attack your own body. RA specifically damages joints, causing them to become painful and swollen. RA can attack any joints, but it often affects feet and hands.
Rituxan is for RA thats moderate to severely active. Moderate to severe means that the cartilage between your joints has become affected and may become damaged. When RA is active, youre currently having symptoms, such as painful or swollen joints.
Effectiveness for RA
Clinical trials used American College of Rheumatology criteria to determine how well People who had a score of ACR50 showed at least a 50% improvement in their RA symptoms. After 24 weeks, an ACR50 was reported in:
- 27% of people who took Rituxan and methotrexate
- 5% of people who took methotrexate and a placebo
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My Health Insurance Plan Will Not Cover Rituxan What Do I Do
If your health insurance plan will not cover Rituxan, you and your doctorâs office can file an appeal. Contact your doctor to ask if you should file an appeal. We have resources to help you and your doctor file one. To learn more about your potential financial assistance options, visit our financial assistance page.*
Rituxan For Granulomatosis With Polyangiitis
Rituxan is approved to treat a condition known as granulomatosis with polyangiitis in adults as well as children ages 2 years and older. The GPA must be moderate to severe. For this purpose, Rituxan is used with drugs called glucocorticoids, such as prednisone.
GPA explained
GPA causes vasculitis and especially affects the lungs and kidneys. The swelling can cause granulomas, which are pockets of cells that can grow and damage organs. GPA may also be called Wegeners granulomatosis.
GPA belongs to a rare group of diseases called ANCA vasculitis. ANCA vasculitis causes swelling in your blood vessels. Symptoms of GPA include swelling in the nose, trouble breathing, coughing, kidney damage, and increased blood pressure.
Effectiveness for GPA
After 6 months of treatment in a clinical trial, symptoms disappeared in:
- 64% of people who took Rituxan and methylprednisolone for either GPA or microscopic polyangiitis
- 53% of people who took cyclophosphamide and methylprednisolone for either GPA or MPA
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Questions Im Frequently Asked
Many people are curious to know how Ive done on Rituxan after all these years. Early on, I didnt talk about it so much because it seemed risky to discuss an off-label use of medication. However, it was approved for rheumatoid arthritis, which I also have, so it was not technically an off-label drug for me.
Your Experience May Differ
Taking a chance on a medication that wasnt commonly used to treat MS was one of the best decisions Ive made on this MS journey. My quality of life is better than it was 11 years ago, and Im out bicycling on a regular basis. I can deal with continuing symptoms that are like old friends now. The ups-and-downs are more predictable and tend to happen most with overheating or exhaustion.
Having finished my 21st full round of Rituxan infusions, I feel a bit like a seasoned MS warrior. I want people to know that MS can and sometimes does get better. The body is always trying to repair itself. Sometimes it just needs a little help.
Be well,
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Your Healthcare Team Will Continue To Look For Patterns Of Fatigue
A fatigue assessment is repeated to see if there is a pattern for when fatigue starts or becomes worse. The same method of measuring fatigue is used at each assessment. This helps show changes in fatigue over time. The healthcare team will check for other causes of fatigue that can be treated. See the Causes of Cancer Fatigue section.
Rituxan Warnings & Precautions
Dont take Rituxan if:
- Are allergic to the active ingredient rituximab
- Are allergic to any of the other ingredients in Rituxan
- Are pregnant or are planning to become pregnant speak to your doctor about using birth control
Rituxan should not be given to children for conditions other than granulomatosis with polyangiitis or microscopic Polyangiitis . It should also not be given to children under the age of 2 for GPA or MPA.
Talk to your doctor before taking Rituxan if you:
- Are taking any of the medications that could interact with Rituxan
- Have or have ever had any heart problems
- Have any kidney problems
- Have a weakened immune system
- Currently have an infection
- Have or have ever had a serious infection. This includes cytomegalovirus, parvovirus B19, herpes, chickenpox or shingles, or hepatitis A, B, or C
- Have lung disease
- Have recently had a vaccination or are due to have one
- Are breastfeeding or are planning to breastfeed It is not known if Rituxan passes into breast milk
You should always check with your doctor or pharmacist before taking any medication, including Rituxan, to make sure it is safe for you.
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Rituxan Side Effects And How To Avoid Them
Rituxan is a brand-name medication manufactured by Genentech. It is classified as a monoclonal antibody and is used to treat cancer. While Rituxan is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Rituxan include tiredness and muscle aches. Less common, but more serious side effects, can include kidney and heart problems.
Learn more about the side effects of Rituxan and what you can do to avoid them.
What Does Rituxan Do To Your Body
The active ingredient in Rituxan is called rituximab. It is a type of antibody protein specifically designed to target white blood cells called lymphocytes. Lymphocyte white blood cells are involved in some cancers and are used by your immune system to trigger inflammation. Rituximab attaches to the surface of lymphocyte white blood cells and destroys them.
For cancers like non-Hodgkins lymphoma, rituximab can reduce the number of cancerous lymphocytes you have. For chronic lymphocytic leukemia, rituximab can prevent the harmful buildup of lymphocytes. In the case of autoimmune diseases, rituximab can cause a fall in your lymphocyte levels. This reduces the amount of inflammation your lymphocyte white blood cells can trigger.
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