CV: ARRHYTHMIAS, CARDIOGENIC SHOCK, MI, chest pain, hypertension, peripheral edema.
Derm: MUCOCUTANEOUS SKIN REACTIONS, alopecia, pruritus.
GI: BOWEL OBSTRUCTION/PERFORATION, HEPATITIS B REACTIVATION, abdominal pain, constipation, diarrhea, nausea, vomiting, ↓ appetite, dyspepsia, stomatitis.
GU: RENAL FAILURE.
Hemat: neutropenia, anemia, thrombocytopenia, leukopenia, lymphopenia.
Local: injection site reactions.
Metab: ↓weight.
MS: arthralgia, muscle spasms, myalgia.
Neuro: peripheral neuropathy , PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY, headache, dizziness, insomnia.
Resp: cough, dyspnea.
Misc: infection, infusion reactions, CYTOKINE RELEASE SYNDROME, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA), TUMOR LYSIS SYNDROME, fatigue, fever.
Follicular Lymphoma
All patients must receive 1 full dose of rituximab by IV infusion before starting treatment with subcutaneous product.- SC (Adults): Relapsed or refractory disease rituximab 1,400 mg/hyaluronidase 23,400 units once weekly starting Week 2 (one wk after receiving treatment with full dose of IV rituximab) for 3 or 7 wk (4 or 8 wk, respectively, of total therapy including IV rituximab); Retreatment for relapsed or refractory disease rituximab 1,400 mg/hyaluronidase 23,400 units once weekly starting Week 2 (one wk after receiving treatment with full dose of IV rituximab) for 3 wk (4 wk of total therapy including IV rituximab); Previously untreated disease rituximab 1,400 mg/hyaluronidase 23,400 units on Day 1 of Cycles 28 of chemotherapy (every 21 days) for up to 7 cycles following treatment with full dose of IV rituximab (given on Day 1 of Cycle 1 of chemotherapy) (total of 8 cycles including IV rituximab); if complete or partial response achieved, give rituximab 1,400 mg/hyaluronidase 23,400 units (as monotherapy) every 8 wk for 12 doses (initiate 8 wk after completion of combination treatment with chemotherapy); Non-progressing disease after firstline CVP chemotherapy rituximab 1,400 mg/hyaluronidase 23,400 units once weekly for 3 wk following completion of 68 cycles of CVP chemotherapy and a full dose of IV rituximab at Week 1; administer at 6 month intervals to a maximum of 16 doses.
Diffuse Large B-Cell Lymphoma
All patients must receive 1 full dose of rituximab by IV infusion in combination with CHOP chemotherapy before starting treatment with subcutaneous product.- SC (Adults): Rituximab 1,400 mg/hyaluronidase 23,400 units on Day 1 of Cycles 28 of CHOP chemotherapy for up to 7 cycles; full dose of IV rituximab should be administered on Day 1 of Cycle 1 of CHOP chemotherapy.
CLL
All patients must receive 1 full dose of rituximab by IV infusion in combination with fludarabine and cyclophosphamide chemotherapy before starting treatment with subcutaneous product.- SC (Adults): Rituximab 1,600 mg/hyaluronidase 26,800 units on Day 1 of Cycles 26 (every 28 days) for a total of 5 cycles; full dose of IV rituximab should be administered on Day 1 of Cycle 1 of fludarabine/cyclophosphamide chemotherapy.
Therapeutic Classification: antineoplastics
Pharmacologic Classification: monoclonal antibodies
Absorption: 64% absorbed following subcutaneous administration.
Distribution: Well distributed to tissues.
Metabolism/Excretion: Unknown.
Half-life: 3234 hr.
ri-TUX-i-mab/hye-al-yoor-ON-i-dase