Rituximab
Are you a clinician? See the clinical version of this page.
Given as a drip into a vein at the clinic, usually as two infusions two weeks apart, then repeated about every 6 months. You will be given medicines beforehand to reduce reactions. You will be checked for hepatitis B first.
- Rheumatoid arthritis: Two infusions two weeks apart, repeated about every 6 months.
- ANCA-associated vasculitis: Weekly infusions for a month, or the arthritis-style two doses.
Tests while you take it
Watch for infusion reactions during and after the drip. Report signs of infection. Rarely, a serious brain infection (PML) can occur, so report any new confusion, weakness, or vision or speech changes.
What to know
How it is used in lupus
Rituximab is generally used when lupus has not settled with other medicines, including kidney lupus that has been hard to treat.
Common side effects
Reactions during the drip are the most common effect, and there is a higher chance of infections. With repeated courses, the level of antibodies in your blood can fall, which your team keeps an eye on.
Tests and monitoring
You will have blood count tests at about 3 months, then every 6 months, and your antibody levels checked every 6 months.
Before you start
Before starting, your team checks for hepatitis B, tuberculosis, and HIV, and makes sure your vaccines are up to date. Because this medicine removes B cells, hepatitis B needs extra care, and a protective antiviral may be used if you carry the virus.
Important cautions
There is limited information about rituximab in pregnancy, so the decision is made with you case by case. Your reviewed pregnancy guidance is on the separate pregnancy page.
What to watch for
- A reaction during or after the drip, such as rash, wheeze, chills, or feeling faint.
- Signs of infection with a fever while on treatment. Contact your team.
- New or worsening breathlessness, or feeling generally unwell after a course.