How does it work?

Rituximab is a medicine that is known as a monoclonal antibody. Monoclonal antibodies are proteins which specifically recognise and bind to another unique protein called an antigen. Cancers form when some cells within the body multiply uncontrollably and abnormally. There are two types of cancer. Solid cancers where a lump forms e.g. the bone, muscle, brain cells etc. divide and multiply abnormally. The second type are leukaemias and lymphomas where the blood cells divide and multiply abnormally. Rituximab binds to an antigen called CD20 which is found on a type of white blood cell called a B cell lymphocyte. B cell lymphocytes form part of the immune cells responsible for regulating and triggering immune responses and therefore provide defence against infection and foreign cells. In the disease lymphoma, abnormal B cell lymphocytes are produced. Rituximab by binding to these B lymphocytes destroys them and this offers a way of treating the lymphoma in cases where other chemotherapy has not worked. Rituximab is administered by intravenous infusion only.

What is it used for?

Severe lymphoma that is resistant to treatment

Warning!

For use only under specialist medical supervision

People taking this medicine should have regular blood tests to check the levels of their blood components.

Effective contraception is required during treatment and for 12 months after stopping treatment with this medicine.

It is recommended that a pain relieving medicine e.g. paracetamol and an antihistamine e.g. chlorpheniramine, should always be administered before each dose of this medicine. The administration of steroids should also be considered.

Anti-hypertensive (blood pressure lowering) medicines should be stopped 12 hours before administering this medicine.

This medicine may cause the release of molecules called cytokines into the body when the lymphocytes are destroyed by this medicine. This can lead to severe reactions such as shortness of breath, fever, chills, rash and a fall in blood pressure. Patients whose lung function is compromised or where the cancer has invaded the lung, or who have a high number of cancer cells circulating in the blood or large tumours are at greater risk of this syndrome. All patients must be very closely monitored, particularly those with a history of heart disease or a history of breathing problems.

Use with caution in

Heart disease

Lung disease

Not to be used in

Allergy to mouse protein

Known sensitivity or allergy to any ingredient

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should only be used during pregnancy where the advantages to the individual outweigh the potential risks. Seek medical advice from your doctor.

There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache

Rash

Fatigue

Abnormal heart beats (arrhythmias)

Low blood pressure (hypotension)

Severe swelling of lips, face or tongue (angioedema)

Nausea and vomiting

Flushing

An extreme allergic reaction (anaphylaxis)

Breathing difficulties due to a narrowing of the airways (bronchospasm)

Inflammation of the lining of the nose (rhinitis) causing a blocked or runny nose

Shivering (rigors)

Fever (pyrexia)

Chills

Pain within the tumour

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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