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Rituxan (rituximab)  

Warning: The main adverse reactions of rituxan include breathing problems, heart problems, skin reactions, and very rarely, brain infection. If you have had breathing problems or heart problems in the past, you will want to discuss this with your doctor, as the medication can greatly increase your chance of further problems. However, if you have breathing or heart problems, this does not mean that the medication may not work for you. You will simply need to monitor your health more carefully during treatment, or possibly receive the medication slower than people who do not have previous breathing or heart problems.

 

Typically, the serious side effects of the medication will result after just 2 hours of your first injection. This is convenient because you will likely still be under your doctor’s care. If you have several cancer cells in your body, you may experience kidney failure due to the amount of dead cancer cells that are trying to exit your body rapidly. Due to your kidneys being unable to keep up, it can lead to kidney problems. Make sure to drink plenty of water following the medication and notify your doctor if you notice any signs of kidney failure.

 

Indications: Rituxan is a medication that is used for the treatment of certain types of cancer. The medication can be used alone, or with other cancer medications. The type of cancer you have, as well as the severity, will depend upon your doctor’s decision to use the medication alone or in combination with something else. The medication can also be used for autoimmune disorders as well as arthritis. The dose you receive for these diseases will obviously be lower than the dose you receive for cancer.

 

Rituxan is, most of the times, used alone or in combination with other medications to treat: 

 

  • rheumatoid arthritis   
  • follicular lymphoma stage III-IV that is resistant to chemotherapy or relapse after chemotherapy;  
  • follicular lymphoma Stage III-IV that had never been previously treated, in combination with CVP chemotherapy;  
  • Aggressive diffuse large b-cell CD20-positive Non Hodgkin's lymphoma (DLBCL), in combination with CHOP chemotherapy.   

Dosage:  The medication is injected into a vein under the direction of your doctor. The dose is injected through a slow process, which may last several hours. How often you need the dose will depend upon the amount of living cancer cells within your body, as well as how your body is reacting to other medications and treatment options. If you are being treated for cancer, you will typically receive one dose of the medication every week. For other diseases such as arthritis, you will typically only receive two doses, which will be about two weeks apart.

Mechanism of action (MOA):  Rituxan is a monoclonal antibody, a class of chemotherapy drugs; it slows or stops tumor progression by killing cells that multiply rapidly (cancer cells and some normal cells).  

Contraindications:  Rituxan is contraindicated or should be used with precaution in the following conditions: 

  • respiratory failure
  • fluid in the airspaces (pulmonary oedema)
  • antihypertensive therapy
  • angina
  • heart failure
  • neutropenia
  • thrombocytopenia
  • women who are breast-feeding
  • allergy to Rituximab or one of its ingredients
  • allergy to Chinese hamster ovary (CHO) cells
  • Pregnant women
  • having a high number of circulating malignant cells

Interactions: Autoimmune and high blood pressure drugs may interact with rituxan. Make sure to talk to your doctor about all of the current medications that you are taking, prior to beginning a cycle of rituxan.

 

Before taking the medication, tell you to your doctor before taking aspirin,  vitamins, nutritional supplements, or St. John's wort. Certain medications can interact with  Rituxanb, and increase the risk of side effects. Tell your doctor or pharmacist if you are taking any of these medications:      

  • vaccines   
  • cisplatin  
  • echinacea  
  • Medicines for hypertension.   

Side effects:  In addition to cancer cells, the medication also attack normal cells that multiply rapidly, causing adverse reaction in some patients. Common Rituxan side effects include:  

  • hair loss
  • nausea and vomiting
  • loss of appetite
  • change in taste
  • runny nose
  • heartburn
  • weight gain
  • muscle or back pain
  • flushing
  • night sweats
  • joint pain
  • fatigue
  • sleep disorders
  • Mouth blistering 

You need to see a health care provider immedaitely if you experience any of these symptoms:  

  • cervical cancer  
  • endometrial cancer  
  • stomach pain  
  • unusual bruising or bleeding  
  • sore throat, fever, chills, or other   
  • chest pain or tightness  
  • severe muscle or joint pain   
  • signs of infection such as sore throat, fever and chills  
  • joint pain or soreness 
  • blood in urine or stools  
  • pain in lower back or the side  
  • Painful or difficulty urinating.  

 

References: 

1 - wikipedia.org, Rituximab 

2 - nlm.nih.gov, medlineplus: Important Warning (about Rituximab)  

3 - http://www.rituxan.com/lymphoma/hcp/indications/DLBCL/index.m