Rituximab Treatment Report

Precautions

Instructions

Side Effects

Interactions

Do not receive this medication if you have ever had a severe allergic reaction to rituximab, or if you are allergic to mouse protein.

Before receiving rituximab, tell your doctor if you are allergic to any drugs, or if you have:

• liver disease or hepatitis B (or if you are a carrier of hepatitis B);
• kidney disease;
• systemic lupus erythematosus (SLE);
• lung disease or a breathing disorder;
• a history of heart disease, angina (chest pain), or heart rhythm disorder; or
• a recent or active infection, including herpes, shingles, cytomegalovirus, or any infection that keeps coming back or does not clear up.

If you have any of these conditions, you may not be able to use rituximab, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether rituximab passes into breast milk or if it could harm a nursing baby. Do not take rituximab without telling your doctor if you are breast feeding a baby.

Older adults may be more likely to have side effects from rituximab, causing breathing difficulty or heart rhythm problems.

Do not receive a "live” vaccine while you are being treated with rituximab.

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Call your doctor if you miss an appointment for your rituximab injection.

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Some people receiving a rituximab injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, weak, nauseated, light-headed, itchy, or if you have a fever, chills, muscle pain, sneezing, sore throat, trouble breathing, or pain in your chest or shoulders. Infusion reactions often occur within the first 24 hours after the start of your rituximab infusion.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects, even if they occur several months after you receive rituximab, or after your treatment ends.

• sudden numbness or weakness, especially on one side of the body;
• confusion, dizziness, loss of balance, blurred vision, and problems with speech or walking; or
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• uneven heartbeats, wheezing or trouble breathing;
• urinating more or less than usual;
• fever, chills, cough, body aches, flu symptoms;
• easy bruising or bleeding;
• a red, raised, blistering, scaly, itchy, or peeling skin rash;
• severe constipation or stomach pain;
• black, bloody, or tarry stools; or
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• pain where the IV needle is placed;
• headache, back pain;
• mild stomach pain, nausea, or diarrhea;
• swelling in your hands or feet;
• muscle or joint pain;
• runny or stuffy nose; or
• night sweats.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

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Before receiving rituximab, tell your doctor if you are also being treated with any of the following drugs:

• cisplatin (Platinol);
• adalimumab (Humira);
• azathioprine (Imuran);
• cyclosporine (Gengraf, Neoral, Sandimmune);
• etanercept (Enbrel);
• infliximab (Remicade);
• leflunomide (Arava);
• minocycline (Dynacin, Minocin, Vectrin);
• sulfasalazine (Azulfidine);
• blood pressure medications;
• gold salts such as auranofin (Ridaura), aurothioglucose (Solganal); or
• medication to treat malaria, such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox).

This is not a complete list and there may be other drugs that can affect rituximab. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Rituxan and rituximab

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