Rituximab

Rituximab is used in the treatment of non-Hodgkin lymphoma (NHL), rheumatoid arthritis, blood cancer (chronic lymphocytic leukemia), granulomatosis with polyangiitis and microscopic polyangiitis.

Rituximab is given as an injection under the supervision of doctor. You must take it in a dose as advised by the doctor. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.

The most common side effects of this medicine include headache, weakness, edema, infection, and hair loss. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with hepatitis B.

Before taking it, tell your doctor if you have heart disease, liver, or planning surgery or vaccination or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy.

• Non-Hodgkin lymphoma (NHL)
• Rheumatoid arthritis
• Blood cancer (Chronic lymphocytic leukemia)
• Granulomatosis with polyangiitis
• Microscopic polyangiitis

Non-Hodgkin lymphoma (NHL)
Non-Hodgkin's lymphoma is a cancer of the white blood cells in our body, also called mantle-cell lymphoma. White blood cells are those cells that help us to fight infections. Rituximab lowers immune response and helps to reduce pain and inflammation. It also kills the cancer cells and helps prevent their further growth. Avoid being in crowds and wash your hands often to prevent any infections. Have plenty of fluids, unless otherwise advised by the doctor not to.

Rheumatoid arthritis
Rituximab helps treat inflammation, pain and swelling in rheumatoid arthritis by decreasing the immune system response of the patient. It is given in the dose and frequency that suits your condition. This will be decided by the doctor. You must follow your doctor’s instructions carefully and let your doctor know if you have fever, chills or any bothersome side effects after taking this medicine.

Blood cancer (Chronic lymphocytic leukemia)
Blood cancer, also called leukemia, is a cancer of the blood-forming tissues, that decreases the body's ability to fight infection. Rituximab kills or stops the growth of cancer cells and also prevents the multiplication of cancer cells. It is an effective medicine but you should discuss the side effects and benefits of this medicine with your doctor. Let your doctor know if any of the side effects bothers you.

Granulomatosis with polyangiitis
Granulomatosis with polyangiitis is a condition that causes inflammation of the blood vessels of the ears, nose, throat, lungs, and kidneys. In this condition, the blood flow to these areas may be reduced and it can lead to their damage. Rituximab helps reduce inflammation, pain and swelling and prevents further damage. This improves your quality of life.

Microscopic polyangiitis
Microscopic polyangiitis is an autoimmune disease which occurs in the small blood vessels and may be caused due to problems with the immune system. Rituximab reduces immune response and improves inflammation. This helps to heal this condition and improves your discomfort.

Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them

Common side effects of Enfeira

• Headache
• Weakness
• Infection
• Chills
• Decreased white blood cell count (neutrophils)
• Fever
• Infusion site reaction
• Lymphopenia
• Abdominal pain
• Back pain

Your doctor or nurse will give you this medicine. Kindly do not self administer.

Rituximab is a monoclonal antibody. It works by targeting the unwanted activity of immune cells (B cells) in rheumatoid arthritis and certain types of cancers.

• It is given as a drip (intravenous infusion) by your doctor or nurse.
• You may be given some painkillers, antihistamine and possibly steroids before the drip to help prevent infusion reaction.
• Your doctor may get blood tests done to check for hepatitis B before treatment and to monitor your blood cells during treatment with this medicine.
• Inform your doctor immediately if you notice any signs of infection such as fever, sore throat or rash.
• Inform your doctor if you are pregnant, planning to conceive or breastfeeding.
• Inform your doctor if you have any heart rhythm problems, if you are having surgery or if you plan to get any vaccinations.

Chabner BA, Barnes J, Neal J, et al. Targeted Therapies: Tyrosine Kinase Inhibitors, Monoclonal Antibodies, and Cytokines. In: Brunton LL, Chabner BA, Knollmann BC, editors. Goodman & Gilman’s: The Pharmacological Basis of Therapeutics. 12th ed. New York, New York: McGraw-Hill Medical; 2011. pp. 1745-48.

Lake DF, Briggs AD, Akporiaye ET. Immunopharmacology. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic and Clinical Pharmacology. 11th ed. New Delhi, India: Tata McGraw Hill Education Private Limited; 2009. p. 978.

Briggs GG, Freeman RK, editors. A Reference Guide to Fetal and Neonatal Risk: Drugs in Pregnancy and Lactation. 10th ed. Philadelphia, PA: Wolters Kluwer Health; 2015. pp. 1225-27.

Rituximab. Garden City, Hertfordshire: Roche Products Limited; 1998 [revised 18 Dec. 2018]. [Accessed 25 Jan. 2019] (online) Available from:

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006. Rituximab. [Updated 2020 Jan 20]. [Accessed 18 Feb. 2020] (online) Available from: