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Rituximab

Last updated on 14/07/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions   |   Tips   |   Where To Buy  

GENERIC NAME: Rituximab

CHINESE NAME: 利妥昔單抗

BRAND NAME(S) IN HONG KONG: Mabthera, Truxima

DRUG CLASS: Antineoplastics

SUB CLASS: Monoclonal antibodies

USED FOR: Rheumatoid arthritis, Chronic lymphocytic leukaemia, Treatment of non-Hodgkin’s lymphomas (relapsed/refractory follicular)

AVAILABLE DOSAGE FORMS:
– 100 mg/10mL, 500 mg/50mL (injections)

What is Rituximab for?

Rituximab, which is a monoclonal antibody, belongs to a class of medications called antineoplastics. It targets to bind to CD20 antigen to bring about a mechanism that can kill B-cells. Therefore, it is used to treat rheumatoid arthritis, chronic lymphocytic leukaemia and non-Hodgkin’s lymphomas.

How to use it?

Rituximab is injected under the skin or into the veins. Listed below are the indications and the usual dosages. Premedicate with paracetamol and antihistamine before each administration; glucocorticoid may also be considered.

Advanced follicular non-Hodgkin’s lymphoma
Adult and elderly
Intravenous and Subcutaneous:
Induction: 375 mg/m2 once weekly for 4-8 times.
Maintenance: 375 mg/m2 once every 2 months, starting 2 months after the last dose of induction therapy.

CD20-positive non-progressing low-grade non-Hodgkin’s lymphoma
Adult and elderly
Intravenous and Subcutaneous::
As monotherapy following 6-8 cycles of CVP (Cyclophosphamide, Vincristine, and Prednisone) chemotherapy: 375 mg/m2 via infusion once weekly for 4 doses at 6-month intervals, for up to 16 doses.

Chronic lymphocytic leukaemia
Adult and elderly
Intravenous and Subcutaneous: 375 mg/m2 via infusion on the day before chemotherapy in cycle 1, then 500 mg/m2 on day 1 of each subsequent cycle, for a total of 6 cycles.

Rheumatoid arthritis
Adult and elderly
Intravenous: 1000 mg for 2 doses separated by 2 weeks. Subsequent courses may be given every 24 weeks or according to clinical evaluation, but no sooner than every 16 weeks.

What are the side effects of Rituximab?

Common side effects of Rituximab include cardiac disorders, night sweats, itchiness, low blood phosphate, angioedema and neutropenia.

Who should not take Rituximab?

– People who are allergic to any component of the formulation.
– People who are allergic to murine proteins, Chinese Hamster Ovary or cell proteins.
– Patients with progressive multifocal leukoencephalopathy.
– Patients with severe and active infections.

Pharmacist Tips:

– Premedicate with paracetamol and antihistamine before each administration; glucocorticoid may also be considered.
– Administer intravenous formulation with infusion.
– Rituximab can cause bone marrow suppression, slowing down the formation of white blood cells. Signs like pale skin, lips and nail beds, fatigue and shortness of breath will be observed. This will increase the risk of infection. Report all signs of infection like fever, shortness of breath and sore throat to your physician as soon as possible.

Common dosing schedule:
Rituximab injections are prescribed in institutions by the physicians.

This schedule is for reference only, adjustments may be made according to individual needs.

Some common medications Rituximab may interact with:
– 5-aminosalicylic acid derivatives, e.g. Balsalazide, Mesalamine, Sulfasalazine
Clozapine
Roflumilast
– Antibiotics, e.g. Tacrolimus, Trimethoprim, Vancomycin
– Vaccines, e.g. BCG, Smallpox and Monkeypox, COVID-19

Rituximab may interact with many other medications. Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Rituximab in Hong Kong?

In Hong Kong, Rituximab is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk

Need more information?

For detailed information about the use of Rituximab in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.