Rituximab is a medication in a class of medications called monoclonal antibodies and given by infusion. It is used in the treatment of non-Hodgkins lymphoma and also in the treatment of rheumatoid arthritis.
Perceived effectiveness for Systemic Lupus Erythematosus:
Perceived effectiveness for RA (Rheumatoid Arthritis):
Advice & Tips:
I use the Scopalamine Patch the night before (helps eliminate the nausea - I have tried Phenergan and Zofran -both used to work, but don't any more). Occasionally I have side effects during the drip (itchiness in throat, ears and head - now they add tagamet and claritin to stop that - last infusion it worked well).
Retuxan has changed my life - I was unable to work before i was on it- after the first infusion about 1 month later I went to EUROPE for a week (I never could have gone before!) and I walked, went to Paris, London, had a blast! Prior to retuxan I had stopped working completely and spend most of my life in bed. I had researched this drug and was waiting for for the FDA to approve. As soon as it did my doc got approval ( had been on EVERYTHING prior to that) and had a needle in my arm! I was the second patient to receive treatment at my clinic! It is a godsend! I'm not "normal" but I am a LOT better (I can tell when I can't afford it- it is pricey but the company has started a program to help you pay for what insurance wont (it's apprx 7-20,000 per infusion)So with a copay or if you get it early in the year you owe all of your out of pocked and deductible (3K for me!).
It is an all day infusion (about 6 hours) and bc of problems years ago with an insurance company that paid for it, then when we moved to a different insurance company they went back and "retroactively denied treatment" I fought but still owed the clinic $8000 which I did NOT have on hand. They have told me I can NEVER get infused at their clinic (which is a problem bc many clinics are with hospitals and they won't let me get infusioned if my doc doesn't have privs, or the hospitals want the doctor to get approval and her office refuses since they aren't getting paid. SO..advice - even if your doctor says you are approved CALL INSURANCE find out how much you will owe. Once it's in your arm you could owe a lot of money. AND some clinics don't actually get authorization (then they will charge you a LARGE fee - your insurance). BUT apart from the cost (LOL) it is brilliant! OH - the typical dose is 2 infusions 2 weeks apart every 4 months (that is NOT ON THE LIST OF CHOICES). You can get it more frequently (and I did once) but you need to get approval from your insurance.
Perceived effectiveness for Neuromyelitis Optica:
Every 3 months
Advice & Tips:
I was diagnosed with NMO in October of 2009, and began chemotherapy using Rituximab almost immediately. The treatments were VERY hard on my body, and I almost invariably had alarming cardiac/respiratory crises with every session. As stated in my previous evaluation of this drug, it reached a point where the drug was so hard on me that my doctor (and my anesthetist parents) stopped treatment after my treatment in June of 2010.
My husband and I moved from South Carolina to North Carolina in October of 2011, where I met with several new doctors in the Asheville area. My new hemotologist convinced me that he could administer my treatments without causing the issues I'd previously experienced. I conceded, and to my surprise, he lived up to his claim immensely. He infused the same drug in the same dosage, but with a totally different method. My side effects (both during treatment and after) were minimized greatly - I had NO cardiac/pulmonary crises, and my recuperation time was cut in half. My opinion on this treatment has improved by leaps and bounds. That being said, however, it is still a VERY powerful drug, and should be used with extreme caution - and only if you have exhausted the less dangerous treatments available.
< $25 monthly
Jun 2, 2010
(Started Oct 15, 2009)
Perceived effectiveness for Neuromyelitis Optica:
Not at all
Every 3 months
Advice & Tips:
If you take Rituxan, be VERY aware of the strength of this drug, and of the possible side effects. Also consider that NMO in itself causes a great deal of fatigue and weakness, and that the Rituxan exacerbates these effects 100-fold. I deteriorated very quickly neurologically speaking, so much so that my parents (who are CRNAs) were truly afraid I would not survive the last treatment. Just be cautious, and be sure your body is physically strong enough to endure such risky treatment.
Rituximab is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body.
Rituximab is used in combination with other cancer medicines to treat non-Hodgkin’s lymphoma. Rituximab is also used in combination with another drug called methotrexate to treat symptoms of adult rheumatoid arthritis.
Rituximab may also be used for purposes other than those listed in this medication guide.
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);
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.
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
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.
Before receiving rituximab, tell your doctor if you are also being treated with any of the following drugs:
cyclosporine (Gengraf, Neoral, Sandimmune);
minocycline (Dynacin, Minocin, Vectrin);
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.
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