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Rituximab (Rituxan)
(rih- TUK-sih-mab)
Pregnancy Category: C Rituxan (Rx)

Classification: Antineoplastic agent, monoclonal antibody

See Also: See also Antineoplastic Agents.

Action/Kinetics: Genetically engineered chimeric murine/human monoclonal antibody which binds specifically to CD20 antigen found on surface of normal and malignant B lymphocytes causing cell lysis. Cell lysis may result due to complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity. CD20 regulates early steps in activation process for cell cycle initiation and differentiation and possibly functions as calcium ion channel. Causes significant decreases in both IgM and IgG serum levels from months 5 to 11. Mean serum t 1/2: 59.8 hr after first infusion and 174 hr after 4th infusion.

Uses: Treat relapsed or refractory low-grade or follicular, CD20 positive, B-cell non-Hodgkin's lymphoma.

Contraindications: Use in known Type I hypersensitivity or anaphylactic reactions to murine proteins or any component of product. Lactation.

Special Concerns: Use with caution in preexisting cardiac conditions, including arrhythmias and angina. Infusion-related symptoms may occur from 30 to 120 min at beginning of first infusion and with less frequency with subsequent infusions. Safety of immunization with any vaccine, especially live viral vaccines, has not been studied. Safety and efficacy have not been determined in children.

Side Effects: Infusion-related events: Fever, chills, and rigors are most common. Also, nausea, urticaria, fatigue, headache, pruritus, bronchospasm, hypotension, angioedema, dyspnea, rhinitis, vomiting, flushing, and pain at disease sites. Retreatment events: Asthenia, throat irritation, flushing, tachycardia, anorexia, leukopenia, thrombocytopenia, anemia, peripheral edema, dizziness, depression, respiratory symptoms, night sweats, pruritus.
General side effects. CV: Arrhythmias, including ventricular tachycardia and supraventricular tachycardias; trigeminy, angina, hypotension, hypertension, tachycardia, postural hypotension, bradycardia. Hematologic: Thrombocytopenia (up to 30 days following last dose), severe anemia, neutropenia, leukopenia, coagulation disorder. Body as a whole: Asthenia, arthralgia, pain, chills, malaise. GI: Abdominal pain, N&V, diarrhea, dyspepsia, taste perversion. CNS: Headache, paresthesia, anxiety, agitation, insomnia, hypesthesia, nervousness. Respiratory: Bronchospasm increased cough, rhinitis, dyspnea, bronchiolitis obliterans, hypoxia, asthma, sinusitis, respiratory disorder, bronchitis. Dermatologic: Pruritus, rash, urticaria, flushing. Miscellaneous: Angioedema, lacrimation disorder, back pain, peripheral edema, chest pain, anorexia, abdominal enlargement, conjunctivitis, tumor pain, pain at injection site, hypertonia.

Laboratory Test Alterations: LDH. Hyperglycemia, hypocalcemia.

How Supplied: Injection: 10 mg/mL

?IV infusion Non-Hodgkin's lymphoma.
375 mg/m 2 as IV infusion once a week for four doses (days 1, 8, 15, 22). Do not administer as IV push or bolus.

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