What is Hyaluronidase and Rituximab?
Combination medicine combining rituximab and hyaluronidase is used to treat follicular leukemia, diffuse large B-cell lymphoma, or chronic lymphocytic lymphoma.Sometimes, rituximab and hyaluronidase are used in combination with other cancer medications.This combination medicine should only be given after receiving at least one injection of rituximab.This medication guide does not list all possible uses for rituximab and hyaluronidase.
Side effects of Hyaluronidase and Rituximab
If you experience symptoms of an allergic reaction, such as hives, difficulty breathing, swelling on your face or in your throat, or a severe reaction to the skin (fever or sore throat with burning eyes, severe skin pain or blisters, or a red or purple rash), seek emergency medical attention.Some side effects can occur immediately after the injection or within 24 hours. You should tell your caregiver if you experience any of the following symptoms: itching, weakness, lightheadedness, shortness of breath, chills, fever, chest pain, wheezing, or a sudden cough.It is possible that rituximab can cause a severe brain infection, which could lead to death or disability. If you experience problems with your speech, thoughts, vision, or muscle movements, call your doctor immediately.
Serious and even fatal infections can occur when hyaluronidase or rituximab are used.If you notice any signs of infection, including:
- Fever, sore throat, or cold symptoms
- Sores or white patches on your throat or mouth
- Pain or burning after urinating;
- Earaches, headaches,
- Painful skin lesions with swelling, redness, or warmth
If you experience any other side effects, call your doctor immediately. This is true even if the symptoms occur months after your last doses of rituximab and hyaluronidase.
- Severe stomach pain, severe vomiting;
- Right-sided upper abdominal pain, loss of appetite, yellowing skin or eyes, and feeling unwell
- Little or no urination
- Skin or mouth sores or severe rashes with blistering, peeling, or pus
- Chest pain and irregular heartbeats
- Low red blood cells (anemia): pale skin, unusual fatigue, feeling lightheaded or short of breath, cold hands and/or feet
- Low white blood cell count—fevers, mouth sores, and skin sores; sore throats, coughs, difficulty breathing
- Signs of tumor cell breakdown include fatigue, weakness, muscle cramps, nausea, vomiting, diarrhea and fast or slow heart rates; as well as tingling in hands and feet or around the mouth area.
Some of the common side effects associated with hyaluronidase or rituximab include:
- Low blood cell count
- Nausea, vomiting, constipation;
- Hair loss;
- Feeling tired
- Cough;
- Redness at the injection site.
There may be other side effects.For medical advice regarding potential side effects, always contact your physician first. The FDA can be reached at 1-800-FDA-1088 in order to report possible adverse events.
Warnings
Do not use it if you are pregnant. Avoid becoming pregnant for 12 months following the cessation of hyaluronidase or rituximab.The use of Rituximab can cause serious brain infections that may lead to death or disability. If you experience problems with your speech, thoughts, vision, or muscle movements, call your doctor immediately.If you have ever had hepatitis B, then using rituximab may cause the virus to become active again or worsen.
Serious skin problems may also develop during treatment with rituximab. If you experience painful mouth or skin sores or a severe rash that is blistering, peeling, or has pus, call your doctor.Some side effects can occur immediately after the injection or even during it. Inform your caregiver immediately in case you experience any of the following symptoms: itching, weakness, lightheadedness, shortness of breath, chills, fever, chest pain, wheezing, or sudden coughing.
Before you take this drug
Inform your physician of any of the following issues:
- Kidney disease
- Lung disease;
- A severe reaction to either rituximab or hyaluronidase;
- A weak immune system, caused by illness or certain medications.
- A severe infection, such as herpes shingles, cytomegalovirus chickenpox, parvovirus West Nile virus, or hepatitis C or B;
- Heart disease, angina pectoris (chest pain), or heart rhythm disorders.
- If you have recently received a vaccination or are scheduled to get one, you should contact us.
Use an effective contraceptive during the time you use this medication and for 12 months following your last dose. Inform your doctor as soon as you become pregnant.Do not breastfeed for 6 months after the last dose of this medication.
How are Hyaluronidase and Rituximab?
Rituximab and hyaluronidase are injected beneath the skin in your stomach. The hyaluronidase/rituximab injection must be done slowly, over 5-7 minutes. This injection will be given by a healthcare provider.After receiving hyaluronidase or rituximab, you will be closely monitored for 15 minutes to ensure that you don't have an allergic response.You may receive other medications before each injection to help prevent certain side effects. Read all the instructions and directions that come with your prescription. Follow the directions on the label.You may need to take antibiotics to prevent infection if you have chronic lymphocytic leukemia. This medicine may be needed for up to a year after the last dose of hyaluronidase or rituximab.Both rituximab and hyaluronidase can reduce the number of blood cells, which helps your body fight infection. You will need to test your blood often.Rituximab may cause the virus to become more active or worse if you have ever had hepatitis B. You may require frequent liver function testing while taking this medication and for several months afterwards.
What happens if I miss the dose?
If you missed a dose of either rituximab or hyaluronidase, call your doctor to get instructions.
What happens if I overdose?
Overdoses are unlikely because hyaluronidase is administered by a health care professional in a medical environment.
What should be avoided?
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Interaction with other drug
Other drugs, such as vitamins and herbal remedies, may also affect hyaluronidase or rituximab. Inform your doctor of all the medicines you are currently taking and those that you will begin or stop using.
