What is Rituximab?
Rituximab is a biologic agent used to treat rheumatoid arthritis. Rituximab works by removing antibody-producing white blood cells called “B” cells. Antibodies are proteins produced by the body in response to bacteria, viruses, and other substances considered foreign and dangerous to the body. However, in people with rheumatoid arthritis, some B cells produce harmful autoantibodies such as rheumatoid factor. Here, rituximab works by removing these “B” cells.
What are the indications for using Rituximab?
Rituximab is used together with methotrexate to treat moderate to severe rheumatoid arthritis. It is usually used to treat arthritis only when other medications have not been successful. It helps relieve joint pain and swelling. It also works by attaching to certain blood cells in your immune system (B cells) and attempting to destroy them.
What is the usual dose of Rituximab?
Rituximab is given by intravenous infusion. The usual dose is 1000 mg per infusion. Your doctor should prescribe other medications (such as acetaminophen, diphenhydramine, methylprednisolone) for you to take half an hour before starting treatment, as they help avoid serious side effects.
How often should I take Rituximab?
You will receive the first dose of Rituximab in the first week of treatment. The second dose is given two weeks later. This cycle can be repeated again at any time after 6 months depending on the body’s response.
What are the side effects of Rituximab?
-
May be accompanied by headache, fever, chills, nausea, heartburn, vomiting, weakness, or dizziness.
-
Muscle or joint inflammation.
-
Skin rash, blisters, and itching.
-
High blood pressure during or shortly after intravenous infusion, which is the most common and often more likely after the first dose.
-
Severe skin reactions associated with Rituximab.
-
Rarely, it may lead to progressive multifocal leukoencephalopathy (PML).
Can I receive vaccinations after completing a course of Rituximab?
If vaccination would be beneficial for you, it is best to receive the vaccine before the Rituximab course or only during the intervals between courses when B cells have recovered. It is recommended not to receive “live” vaccines, such as the yellow fever vaccine. Pneumovax and annual influenza vaccines are safe and recommended.
Do I need regular blood tests while taking Rituximab?
Routine blood tests are not required while taking Rituximab. However, you should have blood tests before starting a treatment course and every few months thereafter to check your B cell levels.
What about the effect of Rituximab on breastfeeding?
Rituximab is an artificially produced antibody that is excreted in breast milk. Therefore, Rituximab should not be taken during breastfeeding, and you should not breastfeed for 12 months after completing a course of Rituximab, because your child’s B cells may be affected.
Is taking Rituximab safe during pregnancy?
Rituximab should be avoided during pregnancy. All women who are taking Rituximab and could become pregnant should use reliable contraceptive methods.
