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What is Rituximab?

Rituximab is a medicine that reduces the number of immune cells in the body. Fewer immune cells lowers the chances of developing inflammation in the body. Rituximab is given by vein through an intravenous (IV) infusion.

How often is an infusion treatment given?

The infusion treatment is usually given every 1-4 weeks. Additional treatments every 4-6 months are sometimes needed.

What are the benefits of Rituximab?

The medication has been used to successfully treat vasculitis and many other diseases that can harm the kidneys. Keeping the kidneys working well can reduce a person’s chances of heart attack or stroke and avoid the need for dialysis or kidney transplantation.

What are the possible risks of Rituximab?

Common infusion reactions include:

  • Rigors (shaking)
  • Chills
  • Fever
  • Rash
  • Low blood pressure
  • Shortness of breath

If any of the above reactions occur, the infusion is stopped and one or more of the medications including steroids, diphenhydramine, and/or acetaminophen are given. After these symptoms are gone, the infusion is then started again at a slower rate.

Less common reactions include:

  • Swelling of the feet
  • High blood pressure
  • Headache
  • Infections
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal (stomach) pain
  • Low blood counts
  • Muscle spasms
  • Weakness
  • Neuropathy (nerve problems)
  • Angioedema (swelling usually of the mouth and throat)
  • Abnormal heart rhythms

Rare reactions include:

The following possible reactions are very serious but are also very rare (less than 1 percent of patients experience these reactions). The physician feels that the benefits related to treating kidney disease are greater than the chances that these reactions will occur:

  • Very rarely, severe infusion reactions can be life threatening due to severe allergic reactions.
  • If you have hepatitis B, there is a possibility that it can become active again. If you have hepatitis B, as the doctor about this potential problem.
  • Very rarely, rituximab has been associated with John Cunningham virus (JCV) infection causing a life threatening degenerative brain disorder called progressive multifocal leukoencephalopathy (PML).

More Information

This UNC podcast, “Treating ANCA Vasculitis with Rituximab” features Dr. Patrick Nachman and Dr. Ron Falk discussing what patients should know about treatment with rituximab for ANCA vasculitis, and what physicians consider when starting a patient on this medication.

This page was reviewed and updated in September 2018 by Koyal Jain, MD.