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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

riTUXimab

( rit-TUCKS-ee-mab )
Funding:
New Drug Funding Program
  • Rituximab (Biosimilar IV) and Rituximab SC in Combination with Chemotherapy - Indolent B-cell Lymphoma
  • Rituximab (Biosimilar IV) and Rituximab SC - Second Line - Chronic Lymphocytic Leukemia
  • Rituximab (Biosimilar IV) and Rituximab SC - Retreatment - Indolent Lymphoma
  • Rituximab (Biosimilar IV) and Rituximab SC - Retreatment - Aggressive Histology Lymphoma
  • Rituximab (Biosimilar IV) and Rituximab SC - Previously Untreated Chronic Lymphocytic Leukemia
  • Rituximab (Biosimilar IV) and Rituximab SC - Maintenance Treatment - Lymphoma
  • Rituximab (Biosimilar IV) and Rituximab SC - In Combination with Venetoclax - Relapsed Chronic Lymphocytic Leukemia
  • Rituximab (Biosimilar IV) and Rituximab SC - HIV-Related Aggressive Histology B-cell Lymphoma
  • Rituximab (Biosimilar IV) and Rituximab SC - Aggressive Histology Lymphoma
  • Rituximab (Biosimilar IV) - Single Agent - Indolent Lymphoma
  • Rituximab (Biosimilar IV) - In Combination with Idelalisib - Relapsed Chronic Lymphocytic Leukemia
  • Rituximab (Biosimilar IV) - As Part of the MATRix Regimen in Newly Diagnosed Previously Untreated PCNSL
Other Name(s): Rituxan®, Truxima™, Riximyo™, Ruxience™
Appearance: Clear, colourless solution mixed into larger bags of fluids

Medication Information Sheet
riTUXimab (IV) (rit-TUCKS-ee-mab)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Rituxan®, Truxima™, Riximyo™, Ruxience™

Appearance:
Clear, colourless solution

mixed into larger bags of fluids

What is this medication for?
  • For treating blood cancers such as non-Hodgkin's lymphoma or chronic lymphocytic leukemia (CLL)
     
  • Rituximab is available as a biosimilar medication. See our biosimilar pamphlet for more information. 
What should I do before I have this medication?
  • Tell your doctor if you have or had significant medical condition(s) such as:
    • kidney or liver disease (including hepatitis),
    • lung disease (including tuberculosis),
    • heart problems or stroke,
    • or any allergies.
       
  • It is important to tell your doctor if you are taking any other medications. If you take medications to lower your blood pressure, you may need to hold the dose before your treatment visit; check with your health care team before you come for treatment.
     
  • Your doctor may test your blood for exposure to the hepatitis B virus before starting treatment.
     
  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.

     
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must: ► Use 2 effective forms of birth control at the same time while using this drug.  Keep using birth control until 12 months after the last dose. Discuss with your health care team.
     
  • Do not breastfeed while taking this drug and until the drug can no longer be measured in your blood.  Discuss with your health care team.
     
  • This medication may affect fertility (ability to get pregnant).
How is this medication given?
  • This drug is given by injection into a vein (IV).
     
  • If you have no serious reactions to the drug, the next doses can be given over a shorter amount of time.  
     
  • You will always be given drug(s) before your riTUXimab dose to prevent a reaction.
What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain or fever:

    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
       
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

 

What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do When to contact doctor?
Very Common Side Effects (50 or more out of 100 people)

Drug-related reaction

  • The most common symptoms include fever, chills, flushing, itchiness, rash, dizziness, swollen lips, face or tongue, chest and throat tightness. 
  • May happen during or shortly after the drug is given. Usually occurs during the first and second doses.
  • Let you healthcare team know right away if this happens to you.
Get emergency medical help right away

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (10 to 24 out of 100 people)

Fatigue (tiredness)

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

Contact your health care team if no improvement or if severe

Nausea and vomiting (generally mild)

May occur in hours to days after your treatment. 

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Contact your health care team if no improvement or if severe

Headache; mild joint, muscle pain or cramps 

  • Take your pain medication as prescribed by your doctor.
  • You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
  • Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
  • Rest often and try light exercise as it may help.
Contact your health care team if no improvement or if severe

Low platelets in the blood

  • Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
  • Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information

Fever, chills, infection (includes less common infections that happen when the immune system is weakened, such as viral infections)

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Rash; dry, itchy skin

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

  • Use skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
Contact your health care team if no improvement or if severe

Flu-like symptoms

  • You may have fever, chills and muscle pain without any signs of infection, such as a sore throat, cough or skin rash.
  • It may happen at any time after you receive your treatment and it usually goes away as your body gets used to the medication.
  • Check your temperature to make sure you don’t have a fever. If you do not have a fever, you may take acetaminophen (Tylenol®) tablets to help you feel better.  Ask your health care team for the correct dose for you. If you do have a fever, speak to your health care team or go to the nearest emergency room. 
Contact your health care team if no improvement or if severe

Tingling, numb fingers and toes

  • May slowly get better after your treatment ends.
  • Contact your health care team if you have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving.
Contact your health care team if no improvement or if severe

Low blood pressure; dizziness

  • It may happen when the medication is being given to you. Let your healthcare team know right away if it occurs.
  • If you feel dizzy or unwell you should lay down to avoid falling. Try to get up and move slowly once you feel better.
  • Do not drive a motor vehicle or operate machinery if you feel dizzy.
Contact your health care team if no improvement or if severe

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • Irregular heartbeat, chest pain, fainting, swelling
  • shortness of breath or difficulty breathing, coughing up blood
  • Pain, swelling or hardening of a vein in your arm or leg
  • Trouble with speaking, moving, memory, problems with your vision, severe headaches or seizure
  • Sudden, severe belly pain or bloating
  • Signs of kidney problems such as lower back pain, body swelling, passing little or no urine, or recent unusual weight gain
  • Muscle cramps, twitches, unusual weakness, fainting, feeling confused or restless
  • Yellowish skin and eyes, red-brown coloured pee


July 2020 Added Riximyo™; Ruxience™ to Other Names section

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.