Rituximab; Hyaluronidase injection

What is this medication?

RITUXIMAB; HYALURONIDASE (ri TUX i mab / hye al ur ON i dase) is used to treat non-Hodgkin lymphoma and chronic lymphocytic leukemia. Rituximab is a monoclonal antibody. Hyaluronidase is used to improve the effects of rituximab.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Rituxan Hycela

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• heart disease
• infection (especially a virus infection such as hepatitis B, chickenpox, cold sores, or herpes)
• immune system problems
• irregular heartbeat
• kidney disease
• lung or breathing disease, like asthma
• recently received or scheduled to receive a vaccine
• an unusual or allergic reaction to rituximab, rituximab/hyaluronidase, mouse proteins, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This medicine is for injection under the skin. It is given by a health care professional in a hospital or clinic setting.

A special MedGuide will be given to you before each treatment. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

It is important not to miss your dose. Call your doctor or health care professional if you are unable to keep an appointment.

What may interact with this medication?

This medicine may interact with the following medications:

• cisplatin
• live virus vaccines

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medicine. You may need blood work done while you are taking this medicine.

This medicine can cause serious allergic reactions. To reduce your risk you may need to take medicine before treatment with this medicine. Take your medicine as directed.

In some patients, this medicine may cause a serious brain infection that may cause death. If you have any problems seeing, thinking, speaking, walking, or standing, tell your doctor right away. If you cannot reach your doctor, urgently seek other source of medical care.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

Do not become pregnant while taking this medicine or for 12 months after stopping it. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine or for at least 6 months after stopping it.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives; swelling of the face, lips, or tongue
• breathing problems
• chest pain
• changes in vision
• diarrhea
• dizziness
• headache with fever, neck stiffness, sensitivity to light, nausea, or confusion
• fast, irregular heartbeat
• loss of memory
• low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.
• mouth sores
• problems with balance, talking, or walking
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
• signs and symptoms of kidney injury like trouble passing urine or change in the amount of urine
• signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired; yellowing of the eyes or skin
• stomach pain
• swelling of the ankles, feet, hands
• unusual bleeding or bruising
• vomiting

Side effects that usually do not require medical attention (report these to your doctor or health care professional if they continue or are bothersome):

• headache
• joint pain
• muscle cramps or muscle pain
• nausea
• pain, redness, or irritation at site where injected
• tiredness

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This drug is given in a hospital or clinic and will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.