Rituximab Injection

What is this medication?

RITUXIMAB (ri TUX i mab) is a monoclonal antibody. It is used to treat certain types of cancer like non-Hodgkin lymphoma and chronic lymphocytic leukemia. It is also used to treat rheumatoid arthritis, granulomatosis with polyangiitis, microscopic polyangiitis, and pemphigus vulgaris.

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

COMMON BRAND NAME(S): RIABNI, Rituxan, RUXIENCE

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

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

• chest pain
• heart disease
• infection especially a viral infection such as chickenpox, cold sores, hepatitis B, or herpes
• immune system problems
• irregular heartbeat or rhythm
• kidney disease
• low blood counts (white cells, platelets, or red cells)
• lung disease
• recent or upcoming vaccine
• an unusual or allergic reaction to rituximab, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This medicine is injected into a vein. It is given by a health care provider 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 health care provider about the use of this medicine in children. While this drug may be prescribed for children as young as 6 months for selected conditions, precautions do apply.

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?

Keep appointments for follow-up doses. It is important not to miss your dose. Call your health care provider if you are unable to keep an appointment.

What may interact with this medication?

Do not take this medicine with any of the following medicines:

• live vaccines

This medicine may also interact with the following medicines:

• cisplatin

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 infusion reactions. To reduce the risk your health care provider may give you other medicines to take before receiving this one. Be sure to follow the directions from your health care provider.

This medicine may increase your risk of getting an infection. Call your health care provider for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.

Call your health care provider if you are around anyone with measles, chickenpox, or if you develop sores or blisters that do not heal properly.

Avoid taking medicines that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your health care provider. These medicines may hide a fever.

This medicine may cause serious skin reactions. They can happen weeks to months after starting the medicine. Contact your health care provider right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

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 healthcare professional right away. If you cannot reach your healthcare professional, urgently seek other source of medical care.

Do not become pregnant while taking this medicine or for at least 12 months after stopping it. Women should inform their health care provider if they wish to become pregnant or think they might be pregnant. There is potential for serious harm to an unborn child. Talk to your health care provider for more information. Women should use a reliable form of birth control while taking this medicine and for 12 months after stopping it. Do not breast-feed 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 health care provider as soon as possible:

• allergic reactions (skin rash, itching or hives; swelling of the face, lips, or tongue)
• diarrhea
• edema (sudden weight gain; swelling of the ankles, feet, hands or other unusual swelling; trouble breathing)
• fast, irregular heartbeat
• heart attack (trouble breathing; pain or tightness in the chest, neck, back or arms; unusually weak or tired)
• infection (fever, chills, cough, sore throat, pain or trouble passing urine)
• kidney injury (trouble passing urine or change in the amount of urine)
• liver injury (dark yellow or brown urine; general ill feeling or flu-like symptoms; loss of appetite, right upper belly pain; unusually weak or tired, yellowing of the eyes or skin)
• low blood pressure (dizziness; feeling faint or lightheaded, falls; unusually weak or tired)
• low red blood cell counts (trouble breathing; feeling faint; lightheaded, falls; unusually weak or tired)
• mouth sores
• redness, blistering, peeling, or loosening of the skin, including inside the mouth
• stomach pain
• unusual bruising or bleeding
• wheezing (trouble breathing with loud or whistling sounds)
• vomiting

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

• headache
• joint pain
• muscle cramps, pain
• nausea

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 medicine is given in a hospital or clinic. It 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.