Rituxan (rituximab)

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Rituxan® (rituximab) is a biologic drug approved to treat adults with moderately to severely active rheumatoid arthritis (RA). It is given in combination with methotrexate. 1

Before starting Rituxan, users must have tried at least 1 tumor necrosis factor (TNF) blocker. If it did not work or the user could not tolerate it, they can start using Rituxan.1

Rituxan is also used to treat other conditions, including:1

  • Non-Hodgkin’s lymphoma
  • Chronic lymphocytic leukemia
  • Granulomatosis with Polyangiitis
  • Pemphigus Vulgaris

What are the ingredients in Rituxan?

The active ingredient in Rituxan is rituximab.1

How does Rituxan work?

Rituxan is a type of drug known as a monoclonal antibody. Our immune system naturally makes antibodies to protect us against bacteria, viruses, and other foreign organisms that invade and pose a threat to our health. But in some people with diseases like RA, our antibodies mistakenly attack healthy tissue. This can lead to RA symptoms like pain, stiffness, and swelling.1

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Rituxan works by targeting the antibodies that play a role in the symptoms and joint damage of RA.1

What are the possible side effects of Rituxan?

The most common side effects of Rituxan include:1

  • Infusion-related reactions
  • Infections that may include fever or chills
  • Body aches
  • Tiredness
  • Nausea

Rituxan has a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). It has this warning because it may cause severe side effects, including:1

  • Fatal infusion-related reactions within 24 hours of the infusion
  • Severe skin and mouth reactions
  • Hepatitis B reactivation, including liver failure and death
  • A rare brain infection called progressive multifocal leukoencephalopathy (PML)

Your doctor will test you for hepatitis B before you start Rituxan. Your doctor will also closely monitor you for signs and symptoms of hepatitis B during and after treatment with Rituxan.1

Contact your doctor right away if you have any signs of severe side effects, such as:1

  • Itching, shortness of breath, dizziness, rash, and swelling of your lips, tongue, throat, or face
  • Blisters, peeling skin, rash, and ulcers on the skin, lips, or the mouth
  • Confusion
  • Dizziness or loss of balance
  • Trouble walking or talking
  • Vision problems

These are not all the possible side effects of Rituxan. Talk to your doctor about what to expect when taking Rituxan. You also should call your doctor if you have any changes that concern you when taking Rituxan.

Other things to know

Before taking Rituxan, tell your doctor if you:1

  • Have a current infection or are prone to recurring infections, including open cuts
  • Have a weakened immune system
  • Have or have had heart, lung, or kidney problems
  • Have or have had any severe infections, including hepatitis B, hepatitis C, shingles, or West Nile Virus

People taking Rituxan should not receive certain vaccines. Talk to your doctor before getting any vaccines.1

Rituxan can harm an unborn baby. If you can become pregnant, you should use birth control during treatment and for some time after the last dose of Rituxan. You should also not breastfeed during treatment with Rituxan and for some time after the last dose. Talk to your doctor about your options for birth control and breastfeeding while taking Rituxan.1

Certain drugs can interact with Rituxan. Before beginning treatment for RA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.1

For more information, read the full prescribing information of Rituxan.