Description and Brand Names

US Brand Name

  1. Truxima

Descriptions


Rituximab-abbs injection is used alone or together with other cancer medicines to treat a type of cancer called non-Hodgkin's lymphoma (NHL).

Rituximab-abbs injection is also used together with other cancer medicines (eg, fludarabine and cyclophosphamide) to treat chronic lymphocytic leukemia (CLL).

Rituximab-abbs is a monoclonal antibody. It helps the immune system destroy cancer cells.

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of rituximab-abbs injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of rituximab-abbs injection in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Varicella Virus Vaccine, Live
  • Zoster Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Cholera Vaccine, Live
  • Cisplatin
  • Dengue Tetravalent Vaccine, Live
  • Infliximab
  • Influenza Virus Vaccine, Live
  • Poliovirus Vaccine, Live
  • Smallpox Vaccine
  • Tofacitinib
  • Typhoid Vaccine
  • Yellow Fever Vaccine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Influenza Virus Vaccine (Subvirion)
  • Pneumococcal Vaccine Polyvalent

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angina (chest pain), history of or
  • Heart disease or
  • Heart rhythm problems (eg, arrhythmia), history of or
  • Hepatitis B, or history of or
  • Infection (eg, bacteria, fungus, or virus) or
  • Kidney disease or
  • Lung problems or
  • Stomach or bowel problems (eg, intestinal blockage, perforation, ulcers)—Use with caution. May make these conditions worse.
  • Hypogammaglobulinemia (immune system disorder), prolonged—Use with caution. May increase risk for infections.
  • Infection, severe and active—Should not be used in patients with this condition.

Proper Use

Before receiving this medicine, make sure you understand all the risks and benefits from receiving the medicine. It is important for you to work closely with your doctor during your treatment.

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. The medicine must be given slowly, so the needle will have to remain in place for 30 to 90 minutes.

You may also receive other medicines (eg, fever medicine, allergy medicine) before starting treatment with this medicine to help prevent unwanted side effects.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have questions.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Receiving this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine and for at least 12 months after the last dose. If you think you have become pregnant while receiving this medicine, tell your doctor right away.

This medicine may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving this medicine.

This medicine can cause a hepatitis B infection to come back. Check with your doctor right away if you have any symptoms of liver problems, including skin and eyes turning yellow, dark brown-colored urine, right-sided abdominal or stomach pain, fever, or severe tiredness.

Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are receiving this medicine.

This medicine may cause a rare and serious brain infection called progressive multifocal leukoencephalopathy (PML). The risk for getting this infection is higher if you have rheumatoid arthritis. Talk to your doctor about the benefits of receiving this medicine and the risk for this infection. Check with your doctor right away if you are having more than one of these symptoms: vision changes, loss of coordination, clumsiness, memory loss, difficulty speaking or understanding what others say, and weakness in the legs.

This medicine may cause a serious type of reaction called tumor lysis syndrome (TLS). Your doctor may give you a medicine to help prevent this. Call your doctor right away if you have a decrease or change in urine amount, joint pain, stiffness, or swelling, lower back, side, or stomach pain, a rapid weight gain, swelling of the feet or lower legs, or unusual tiredness or weakness.

This medicine may increase your risk of developing infections (eg, viral, bacterial, or fungal) during or after treatment with this medicine. Avoid being near people who are sick or have infections while you are using this medicine. Wash your hands often. Tell your doctor if you have lupus or if you have any kind of infection before you start receiving this medicine. Also tell your doctor if you have ever had an infection that would not go away or an infection that kept coming back.

Call your doctor right away if you start to have a cough that would not go away, weight loss, night sweats, fever, chills, flu-like symptoms (eg, runny or stuffy nose, headache, blurred vision, or feeling generally ill), painful or difficult urination, or sores, ulcers, or white spots in the mouth or on the lips. These may be signs that you have an infection.

While you are being treated with rituximab-abbs, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Rituximab-abbs may lower your body's resistance, and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not get live vaccines (eg, nasal flu virus vaccine). Try to avoid persons who have taken live vaccines. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should wear a protective face mask that covers the nose and mouth.

This medicine may cause heart and heart rhythm problems (eg, heart attack, arrhythmia, cardiogenic shock). Check with your doctor if you have chest pain or discomfort, pain or discomfort in the arms, jaw, back, or neck, dizziness, fainting, fast, slow, or irregular heartbeat, cool, sweaty skin, or trouble breathing.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, troubled breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

This medicine may cause serious stomach and bowel problems, especially when used with other cancer medicines. Check with your doctor right away if you start having stomach pain while being treated with this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  1. Black, tarry stools
  2. bleeding gums
  3. bloating or swelling of the face, arms, hands, lower legs, or feet
  4. bloody urine
  5. blurred vision
  6. chest pain
  7. chills
  8. confusion
  9. difficulty breathing
  10. dizziness
  11. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  12. dry mouth
  13. fever
  14. flushed, dry skin
  15. fruit-like breath odor
  16. headache
  17. hoarseness
  18. increased cough
  19. increased hunger
  20. increased thirst
  21. increased urination
  22. itching, skin rash
  23. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  24. lower back or side pain
  25. nausea
  26. nervousness
  27. noisy breathing
  28. nosebleed
  29. pain or tenderness around the eyes and cheekbones
  30. painful or difficult urination
  31. pale skin
  32. pinpoint red spots on the skin
  33. pounding in the ears
  34. rapid weight gain
  35. slow or fast heartbeat
  36. sneezing
  37. sore throat
  38. sores, ulcers, or white spots on the lips or in the mouth
  39. stomach pain
  40. stuffy or runny nose
  41. swollen glands
  42. tightness in the chest
  43. tingling of the hands or feet
  44. troubled breathing
  45. troubled breathing with exertion
  46. unexplained weight loss
  47. unusual bleeding or bruising
  48. unusual tiredness or weakness
  49. unusual weight gain or loss
  50. vomiting

Incidence not known

  1. Back pain
  2. blindness
  3. blistering, peeling, or loosening of the skin
  4. blue-yellow color blindness
  5. chest discomfort
  6. cough producing mucus
  7. decreased vision
  8. diarrhea
  9. dilated neck veins
  10. drowsiness
  11. dry cough
  12. extreme tiredness or weakness
  13. eye pain
  14. feeling of discomfort
  15. general feeling of discomfort, illness, or weakness
  16. high fever
  17. irregular breathing
  18. irregular heartbeat
  19. joint pain or swelling
  20. muscle pain
  21. pain or cramping in the abdomen
  22. red skin lesions, often with a purple center
  23. red, irritated eyes
  24. redness, soreness, or itching skin
  25. seizures
  26. sores, welts, or blisters
  27. swelling of the face, fingers, feet, or lower legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Lack or loss of strength
  2. night sweats
  3. throat irritation

Less common

  1. Anxiety
  2. difficulty in moving
  3. feeling of warmth
  4. muscle cramps or stiffness
  5. redness of the face, neck, arms and occasionally, upper chest

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.