RITUXIMAB (Rituxan®): Patient Information
What is Rituximab?
Rituximab is a biologic agent used for the treatment of Rheumatoid arthritis.Rituximab removes antibody-producing white blood cells called B-cells. Antibodies are proteins that are produced by the body in response to germs, viruses or any other substances, which the body sees as foreign or dangerous. However, in people with rheumatoid arthritis some B-cells produce harmful ‘autoantibodies’, such as rheumatoid factors. The purpose of rituximab is to remove these B-cells.
Why am I taking Rituximab?
Rituximab is used with methotrexate to treat moderate-to-severe forms of rheumatoid arthritis. It is usually used for arthritis only after other medications have not worked. It can decrease joint pain and swelling. It works by attaching to certain blood cells from your immune system (B cells) and killing them.
What are the side effects of Rituximab?
- Headache, fever, chills, nausea, heartburn, flushing, weakness, or dizziness may occur.
- Sore muscles or joints
- Rash, hives, or itchiness
- Increase in blood pressure the medication during or shortlyafter the infusion, most likely during the first infusion and less so with futureinfusions.
- Severe skin reactions have been reported with Rituximab.
- Rituximab has been associated with abnormal heart rhythms.
Do I need to have regular blood tests while taking Rituximab?
Blood tests are not routinely required while you are taking rituximab. However, before your course of treatment and every few months after you should have blood tests to check your B-cell levels.
Is Rituximab safe in pregnancy?
- You should avoid pregnancywhile on rituximab.
- All women of child bearing potential taking rituximab must use reliable contraception.
What about breastfeeding?
- Rituximab is an artificially produced antibody of a sort known to be secreted in breast milk. You should not receive rituximab if you are breastfeeding, and should not breastfeed for 12 months following a course of rituximab, because the baby’s B-cells might be affected.
What is the usual dose of Rituximab?
- Rituximab is given by an intravenous (IV) infusion.
- The normal dose is 1000 mg in each infusion.
- Your doctor may prescribe other medications (e.g., acetaminophen, diphenhydramine, methylprednisolone) for you to take 30 minutes before the start of your treatment to help prevent serious side effects.
Can I have vaccination after a course of rituximab?
- If you think you might benefit from vaccination, it may be best to have them before a course of rituximab, or in between courses when the B-cells have come back.
- It is recommended that you should not be immunized with ‘live’ vaccines such as yellow fever.
- Pneumovax and yearly flu vaccines are safe and recommended.
How often do I take Rituximab?
- You will receive your first dose of rituximab on week 0. The second dose is given two weeks later. This cycle may be repeated again anytime after 6 months depending on your response.
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