Rituximab

Immunotherapy

Brand names:

Rituxan®, Riabni®, Ruxience®, Truxima®

Other names:

Anti-CD20 Monoclonal Antibody, C2B8 Monoclonal Antibody

Often used for:

Autoimmune disorders; certain types of leukemia and lymphoma

What is rituximab?

Rituximab is a type of medicine called a monoclonal antibody. It is used to treat certain types of cancer and autoimmune diseases, including immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA).

Rituximab works by suppressing the immune system. It prevents B-cells in the immune system from attacking healthy cells. Disorders that cause the body’s own antibodies to attack healthy cells are called autoimmune disorders.

Rituximab is called immunotherapy because it uses the patient’s immune system to attack targeted cells. It is also called targeted therapy because it targets specific cells.

Rituximab may be used along with other medicines. This medicine may be given in the hospital.

It may take several hours to receive a rituximab infusion. The care team will check your child’s blood pressure, heart rate, breathing, and temperature during the infusion. This helps the care team watch for side effects.

Your child will have regular blood tests to check for changes in liver function and blood counts.

Given into a vein by IV

Possible side effects

Flu-like symptoms such as chills, shortness of breath, aches, headache, or fever which may happen during or shortly after receiving the medicine.
Diarrhea
Nausea or vomiting
Low blood pressure
Joint or muscle pain
Rash
Trouble sleeping
Tired or lack of energy
Low blood counts, which may increase risk of infection, bleeding, anemia, and fatigue
Decreased liver function
Tumor lysis syndrome, in patients with cancer

Symptoms of an allergic reaction may include rash, hives, itching, runny nose, fever, chills, headache, muscle ache, shortness of breath, coughing, tightness in the throat, dizziness, low blood pressure, pain in the chest, side, or back, swelling of the face or neck.

Not all patients who take rituximab will have these side effects. Common side effects are in bold, but there may be others. Please report any symptoms or side effects to your care team. Find more information on side effects.

In rare cases, there can be severe side effects. If your child experiences the following, tell your care team right away. 

Signs of an infection such as fever, chills, mouth sores, or wounds that will not heal
Signs of liver problems such as yellow skin or eyes, dark urine, light colored stools, stomach pain, vomiting
A change in the amount or color of urine (pee)
Swelling
Changes in heart rhythm (irregular heart beat)
Muscle pain, weakness or cramps
Dizziness, confusion, or fainting
Severe headache 
Unexplained bruising or bleeding
Rash or peeling of the skin, including inside the mouth

Tips for patients and families

Be sure to discuss all questions and instructions with your care provider or pharmacist.

Some patients may have a reaction to this medicine. Let your care team know about any symptoms during the infusion or the day following the infusion.
Tell all your child's health care providers that your child is taking this medicine. This includes your child's doctors, nurses, pharmacists, and dentists.
This medicine can weaken the immune system and increase the risk of infection. Wash hands often, keep patient areas clean, and avoid contact with people who are sick. Learn more about preventing infection.
Your care provider may ask that your child not take blood pressure medicine 24 hours before and after the rituximab infusion.
Talk with the doctor before your child gets any vaccines.
Make sure your child is up to date with all vaccines before they take this medicine.
Your care team may recommend diphenhydramine (Benadryl®), acetaminophen (Tylenol®), and other medicines to help side effects. They may also prescribe anti-nausea medicines.
Tell your care team if your child has had Hepatitis B or is a carrier of the virus.
Tell your care team if your child is pregnant or breastfeeding.
Let your care team if your child is sexually active. Sexually active patients should take steps to prevent pregnancy during treatment and for 12 months after treatment is complete.

Learn more about rituximab

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Always check the medication label. Many medicines look the same. Do not take any new medicine, including over-the counter medicines or supplements, without checking with your doctor or pharmacist. Talk to your doctor or pharmacist about what to do in the case of a missed dose, allergic reaction, or medical emergency.

This information is not intended to be a complete guide and is not a substitute for talking with your provider. Medicine names, appearance, formulas, or availability may vary by clinic location. Always follow the instructions given by your care team.

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Reviewed: February 2024