Table of Contents
- What is Rituxan?
- Rituxan composition
- History behind the Rituxan
- Indications
- How does Rituxan work? (Rituxan Mechanism of Action)
- How to Take Rituxan?
- Common Rituxan Dose
- When to Avoid Rituxan?
- Rituxan Side Effects
- Effects on organs
- Warnings and Precautions
- Reported Allergic Reactions
- Effect of Rituxan on the menstrual cycle
- Drug Interactions To Be Careful About
- Interactions with laboratory procedures
- Shows Effects / Results in (How Long Does the Effect Stay?)
- Is Rituxan Addictive?
- Can I have Rituxan with alcohol?
- Can I have Rituxan When Pregnant?
- Can I have Rituxan when feeding a baby?
- Can I drive after taking Rituxan?
- Effect of an overdose of Rituxan
- Effect of using expired Rituxan
- Effect of missing a dose of Rituxan
- Storage requirements
- Substitutes
What is Rituxan?
Rituxan is a prescription Medicine recommended to treat rheumatoid arthritis and B-cell Non-Hodgkin’s lymphoma and a few more health issues. This medicine is a cancer medicine that is also prescribed in some non-cancer health issues due to its immunosuppression ability. Let’s explore more details about Rituxan such as its uses, side effects, precautions, drug interactions, etc.
Rituxan Composition
Rituximab is the key ingredient in Rituxan. Rituximab belongs to the class of drugs called CD20 monoclonal antibodies.
History behind the Rituxan
Non Hodgkin lymphoma (NHL) is known to be the most common form of blood cancer in adult patients. It is estimated that in 2012, 70,130 new cases were diagnosed with NHL in the United States. In most cases, B Cells which are immune cells responsible for antibodies production are the key cause of Non Hodgkin lymphoma (NHL).
Rituximab was initially developed by Biogen Idec, co-promoted by Genentech, which is a subsidiary of Roche Group. Rituxan got approval by the US Food and Drug Administration (FDA) in the year 1997 for treating Non Hodgkin’s lymphoma. In June 1998 this drug received EU approval.
Indications (Rituxan Uses)
Rituxan is prescribed to treat below-mentioned conditions –
In Adult Patients:
- Non-Hodgkin’s Lymphoma / Chronic Lymphocytic Leukemia
- Rheumatoid Arthritis
- Pemphigus Vulgaris
In Adult Patients and Children of age 2 years and above:
- Granulomatosis With Polyangiitis
- Microscopic Polyangiitis
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How does Rituxan work? (Rituxan Mechanism of Action)
Rituxan works by inhibiting or stopping the growth of cancer-causing cells in the human body.
How to Take Rituxan?
Rituxan is available in the form of intravenous (IV) injection and is given to the patients by medical caregivers in a hospital setup.
Common Rituxan Dose
Dose of Rituxan depends on the condition being treated and is decided by the doctor.
When to Avoid Rituxan?
Rituxan is not advised to use in certain conditions or if the patient had any medical history related to some health conditions like
- Liver Disease
- Hepatitis
- Kidney Disease
- Breathing or Lung Diseases
- Weak Immune System
- Infections like Cytomegalovirus, Chickenpox, Herpes, Shingles, Parvovirus, West Nile Virus, or Hepatitis B or Hepatitis C
- Cardiac Issues
- Had an allergic reaction in case the patient had used the same medicine in the past.
If the patient has received any live vaccine recently, for example, live vaccines like –
- Measles Vaccine
- Mumps Vaccine
- Rubella (MMR) Vaccine
- Rotavirus Vaccine
- Typhoid Vaccine
- Yellow Fever Vaccine
- Varicella (Chickenpox) Vaccine
- Zoster (Shingles) Vaccine
- Nasal Flu (Influenza) Vaccine
Rituxan Side Effects
Some patients may experience some common side effects while receiving Rituxan medicine. It is advised to inform your caregiver, or doctor immediately to avoid further complications. Below mentioned are some possible side effects –
- Stuffy nose
- Sneezing
- Sour throat
- Fever
- Chills
- Body aches
- Pale skin
- Unusual tiredness
- Painful urination
- Muscle spasms
- Nausea
- Diarrhea
- Severe stomach pain
- Vomiting
- Constipation
- Bloody or tarry stools
- Swelling in hands or feet
- Itching at the site of IV
- Dizziness
- Lightheadedness
- Difficulty Breathing
- Hashes
- Hives
- Chest Pain
- Rapid Heart Beat
- Sudden Cough
One of the major side effects of Rituxan is it can cause serious brain infection which can even lead to severe disability or even death. Hence a close observation is needed while receiving the medication. Inform your doctor immediately if you experience any symptoms like –
- Confusion
- Fall in Blood Pressure
- Memory Problems
- Weakness on one side of your body
- Vision changes
- Problems with speech
- Difficulty walking
Effects of Rituxan on organs
Rituxan can cause some serious issues to the vital organs in the body if not addressed on time or treating with it without proper diagnosis of any preexisting health issues. Some possible issues are like –
- Serious side effects called Tumor Lysis Syndrome (TLS) due to which the load on kidneys may increase and lead to kidney failure and need for dialysis.
- Serious brain infection and lead to disability and even death.
- Abnormal heart rhythms
- Liver damage due to existing Hepatitis B or reactivation of Hepatitis B that is resolved earlier.
Warnings and Precautions
- The usage of Rituxan in treating Chronic fatigue syndrome did not show any improvement.
- Its usage intrathecally in CNS related diseases is still under research.
Reported Allergic Reactions
Rituxan possibly shows some allergic reactions like mentioned here. Generally, the patient receiving medicine will be in the hospital environment and close observation. Let your doctor know if you experience any such allergic reactions.
- Itching at the site of infusion
- Hives
- Difficult breathing
- Swelling in facial organs
- Swelling in throat
Effect of Rituxan on the menstrual cycle
Limited data is available on the effect of Rituxan on the menstrual cycle. Consult your gynecologist for more information and guidance.
Drug Interactions to Be Careful About
Rituxan can show drug interactions if used along with some medicine. Patients receiving medicine for conditions like Rheumatoid Arthritis (RA), Crohn’s Disease, Ulcerative Colitis, Psoriasis or patients receiving chemotherapy medication must be very careful and should inform the doctor before receiving the Rituxan. Below mentioned are some examples of medicine that Rituxan can show drug interactions if used together.
- Adalimumab
- Certolizumab
- Cisplatin
- Etanercept
- Golimumab
- Infliximab
- Leflunomide
- Methotrexate
- Sulfasalazine
- Tocilizumab
- Tofacitinib
This is not a full list of medicine that Rituxan can interact with. You must inform your doctor about your current medication including any OTC medicine or health supplements to avoid complications.
Interactions with laboratory procedures
Limited data is available on the interactions of Rituxan on laboratory procedures.
Shows Effects / Results in (How Long Does the Effect Stay?)
The infusion procedure of Rituxan may last on average 4-6 hours since it is administered at a slow pace to make sure there is no allergic reaction while giving it for the first time. It may take up to 6 weeks to show its results.
Is Rituxan Addictive?
Drug addiction of Rituxan is less likely to happen as this medicine is given by a medical professional in a hospital environment under supervision.
Can I have Rituxan with alcohol?
Rituxan is administered by the intravenous (IV) method in a hospital environment. In general, it is advised to limit the quantity of alcohol consumption as per guidelines by your doctor.
Can I have Rituxan When Pregnant?
Not advised to use in pregnant women and advised to use birth control methods to avoid pregnancy during Rituxan and avoid pregnancy until 12 months after taking the final dose.
Can I have Rituxan when feeding a baby?
Not advised to use in nursing mothers. Not advised to breastfeed during Rituxan and until 6 months after taking the final dose.
Can I drive after taking Rituxan?
Antihistamine medicine such as Diphenhydramine is given in some in some cases to address the allergic reactions that may occur while administering the Rituxan intravenous injection. This can cause some dizziness, or some patients may feel week as a side effect. Hence it is not advised to perform activities like driving or operating heavy machinery that needs alertness.
Effect of overdose of Rituxan
There is a minimal chance of overdose as this medicine is administered by the medical professionals under supervision.
Effect of using expired Rituxan
Rituxan is available as an intravenous injection which is given by trained medical staff and the chances of administering expired medicine is rarely possible. However, it is advised to check for the manufactured date and expiry details while purchasing the medicine as a safety measure.
Effect of missing a dose of Rituxan
This medicine is administered by the medical professional and there is very little chance to miss a dose of Rituxan. Follow the schedule as per your doctor’s guidelines. Call immediately if you forget to visit your doctor for your dose of the medicine.
Storage requirements
Rituxan is generally stored at 20C to 80C. It can stay at room temperature for an additional 24 hours. Once the solution is diluted, it must be refrigerated.
Rituxan Alternate Brands
Below mentioned are the medicine containing Rituximab as active ingredients and may be prescribed by the doctors as a substitute to Rituxan.
- Ristova by Roche Products India Pvt Ltd
- Reditux by Dr Reddy s Laboratories Ltd
- Mabtas (different variations available) by Intas Pharmaceuticals Ltd
- Toritz by Torrent Pharmaceuticals Ltd
- Cytomab by Alkem Laboratories Ltd
- Lupiximab by Lupin Pharmaceuticals Ltd
- Maball by Hetero Drugs Ltd
- Rituxirel by Reliance Life Sciences
Ruxience (Rituximab-pvv) Developed and marketed by Pfizer is the second FDA approved bio-similar version of Rituximab
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580676/
- https://www.ncbi.nlm.nih.gov/pubmed/28860080
- https://www.cancer.gov/research/progress/discovery/blood-cancer
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