Rituximab is an immunomodulatory monoclonal antibody (a protein that attaches to a specific target) that was approved for its medical use on 26th November 1997.

A study reveals that rituximab significantly improves progression-free survival in patients with chronic lymphocytic leukaemia (CLL), low-grade or follicular lymphoma, and diffuse large B-cell lymphoma. It works well both as monotherapy and in combination with chemotherapy. Rituximab also prolongs survival in maintenance therapy for certain lymphoma patients and is generally well tolerated, with infusion reactions being the most common side effect.

Rituximab Injection has been developed to treat non-Hodgkin’s lymphoma, mature B-cell acute leukemia, chronic lymphocytic leukemia, granulomatosis, rheumatoid arthritis, and pemphigus vulgaris in patients who have not responded adequately to other treatments.

Rituximab is available as a single-use vial of injection intended for administration as an intravenous infusion. It is available in doses of 100mg and 500mg. The usual recommended starting dose is 375mg/m2. Your doctor will decide the dose, dosage, and duration of the treatment based on your medical condition. 

Common side effects of Rituximab include:

• Infusion-related reactions
• Fever
• Lymphopenia (low lymphocyte count)
• Chills
• Infection
• Asthenia (weakness)
• Upper respiratory tract infection
• Muscle spasms
• Headache
• Nausea
• Diarrhea
• Bronchitis
• Depression
• Changes in liver enzyme values

Serious side effects of Rituximab include:

• Severe infusion reactions (breathing difficulties, low blood pressure, heart problems)
• Serious infections (bacterial, fungal, or viral)
• Skin reactions (blisters, severe rashes, or peeling skin)
• Hepatitis B reactivation
• Tumor lysis syndrome (kidney failure, electrolyte imbalances)
• Progressive multifocal leukoencephalopathy (PML, a brain infection)
• Cardiovascular issues (life-threatening arrhythmias)
• Kidney problems (severe toxicity or failure)

• Infusion reactions: Rituximab can cause severe reactions, including breathing difficulties, low blood pressure, and heart problems. You should pre-medicate patients and stop Rituximab if a severe reaction occurs.
• Severe skin reactions: Serious skin reactions, such as blisters and skin peeling, can occur and may be fatal. Discontinue Rituximab if any severe skin reactions develop.
• Infections: Serious infections, including bacterial, fungal, and viral infections, can occur during treatment. Stop Rituximab and administer appropriate anti-infective treatment.
• Kidney problems: Severe kidney toxicity, especially with tumour lysis syndrome, can occur. Monitor kidney function closely, and stop Rituximab if kidney issues arise.
• Bowel obstruction and perforation: Bowel obstruction and perforation can occur, especially when Rituximab is combined with chemotherapy. Evaluate patients immediately and treat abdominal pain appropriately.
• Vaccinations: You should not give live vaccines during Rituximab treatment due to reduced effectiveness and increased infection risk. Administer non-live vaccines at least 4 weeks before treatment.
• Laboratory monitoring: Regular blood tests, including CBC and platelet counts, are required during Rituximab treatment. Monitor blood counts closely if they decrease significantly.

Rituximab can affect the fertility of males and females. Ask your healthcare provider for advice if you are pregnant, think you might be pregnant, planning to have a baby, or breastfeeding your baby. It is probably unsafe during pregnancy it has the ability to cross the placental barrier and harm an unborn baby. It is mostly unsafe to breastfeed while on treatment with this injection. Discuss with your healthcare provider and either discontinue the treatment with this medicine or discontinue breastfeeding while on treatment with this injection. Discuss effective contraceptive methods with your healthcare provider and consider using them for 12 months after the last dose of Rituximab.

Check with your healthcare provider before receiving any vaccines and inform them if you are taking any other medications or herbal supplements.

1. Keating GM. Rituximab: a review of its use in chronic lymphocytic leukaemia, low-grade or follicular lymphoma and diffuse large B-cell lymphoma.

https://pubmed.ncbi.nlm.nih.gov/20614951/

2. Genentech Inc., U.S. Food and Drug Administration, [Revised on Dec 2021] [Accessed on 15th Oct 2022], https://www.gene.com/download/pdf/rituxan_prescribing.pdf

3. Ahmed A. Negm & Daniel E. Furst, Nonsteroidal Anti-Inflammatory Drugs, Disease-Modifying Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout, Lange's Basic & Clinical Pharmacology, 14th Edition, 2018, 642-666.

The drug information on this page is not a substitute for medical advice, it is meant for educational purposes only. For further details consult your doctor about your medical condition to know if you are eligible to receive this treatment.