hyaluronidase and rituximab

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Pronunciation: HYE al ure ON i dase

Brand: Rituxan Hycela

What is the most important information I should know about hyaluronidase and rituximab?

Rituximab may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have changes in your mental state, vision changes, weakness on one side of your body, or problems with speech or walking.

Tell your doctor if you have ever had hepatitis B. Rituximab can cause this condition to come back or get worse.

Severe skin problems can also occur during treatment with rituximab. Call your doctor if you have painful skin or mouth sores, or a severe skin rash with blistering, peeling, or pus.

Some side effects may occur during the injection or within 24 hours afterward. Tell your caregiver right away if you feel itchy, dizzy, weak, light-headed, short of breath, chilled, feverish, or if you have chest pain, wheezing, a sudden cough, or pounding heartbeats or fluttering in your chest.

You should not use hyaluronidase and rituximab if you are pregnant. Avoid getting pregnant for at least 12 months after you stop using this medicine.

What is hyaluronidase and rituximab?

Hyaluronidase is a genetically designed protein.

Rituximab is a cancer medicine that interferes with the growth and spread of cancer cells in the body.

Hyaluronidase and rituximab is a combination medicine used to treat follicular lymphoma, diffuse large B-cell lymphoma, or chronic lymphocytic leukemia.

Hyaluronidase and rituximab is sometimes used together with other cancer medicines.

Hyaluronidase and rituximab may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before receiving hyaluronidase and rituximab?

You should not be treated with this medicine if you are allergic to hyaluronidase or rituximab.

To make sure hyaluronidase and rituximab is safe for you, tell your doctor if you have ever had:

  • kidney disease;
  • lung disease;
  • a weak immune system (caused by disease or by using certain medicines);
  • an infection such as herpes, shingles, cytomegalovirus, chickenpox, parvovirus, West Nile virus, or hepatitis B or C;
  • heart disease, angina (chest pain), or heart rhythm disorder; or
  • if you recently received any vaccine, or you are are scheduled to receive a vaccine.

Using hyaluronidase and rituximab during pregnancy could harm the unborn baby. Tell your doctor if you are pregnant or if you become pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 12 months after your last dose.

It is not known whether hyaluronidase and rituximab passes into breast milk or if it could harm a nursing baby. Do not breast-feed while using hyaluronidase and rituximab, and for at least 6 months after your last dose.

How is hyaluronidase and rituximab given?

Before you receive a hyaluronidase and rituximab injection, you will receive an intravenous (IV) injection of rituximab (Rituxan).

Hyaluronidase and rituximab is injected under the skin of your stomach area. This medicine must be injected slowly over 5 to 7 minutes. A healthcare provider will give you this injection.

You will be watched closely for at least 15 minutes after receiving hyaluronidase and rituximab, to make sure you do not have an allergic reaction.

Before each injection, you may be given other medications to prevent certain side effects. If you have chronic lymphocytic leukemia, you may also need to take medication to prevent infections. You may need to keep taking anti-infective medication for up to 12 months after your last dose of hyaluronidase and rituximab.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Hyaluronidase and rituximab can lower blood cells that help your body fight infections. Your blood will need to be tested often.

If you have ever had hepatitis B, rituximab can cause this condition to come back or get worse. You will need frequent liver function tests during treatment.

Hyaluronidase and rituximab can have long-lasting effects on your body. You may need frequent medical tests for several months after you stop using this medicine.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of hyaluronidase and rituximab.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving hyaluronidase and rituximab?

Do not receive a "live" vaccine while you are being treated with hyaluronidase and rituximab. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

What are the possible side effects of hyaluronidase and rituximab?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some side effects may occur during the injection (or within 24 hours afterward). Tell your caregiver right away if you feel itchy, dizzy, weak, light-headed, short of breath, chilled, feverish, or if you have chest pain, wheezing, a sudden cough, or pounding heartbeats or fluttering in your chest.

Serious and sometimes fatal infections may occur during treatment with hyaluronidase and rituximab. Call your doctor right away if you have signs of infection such as:

  • fever, sore throat, cold or flu symptoms;
  • sores or white patches in your mouth or throat;
  • pain or burning when you urinate;
  • earaches, headaches; or
  • painful skin sores with redness, warmth, or swelling.

Rituximab may cause a serious viral infection of the brain or spinal cord that can lead to disability or death. Call your doctor right away if you have any of the following symptoms (which may start gradually and get worse quickly):

  • confusion, memory problems, or other changes in your mental state;
  • weakness on one side of your body;
  • vision changes; or
  • problems with speech or walking.

Call your doctor at once if you have any of these other side effects, even if they occur several months after you are treated with hyaluronidase and rituximab, or after your treatment ends.

  • skin or mouth sores, or a severe skin rash with blistering, peeling, or pus;
  • severe stomach pain, severe vomiting;
  • chest pain, irregular heartbeats;
  • little or no urination;
  • low blood cell counts --fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed; or
  • signs of tumor cell breakdown --vomiting, diarrhea; little or no urination; numbness or tingly feeling; muscle weakness or twitching; fast or slow heart rate; confusion, hallucinations, seizure, feeling restless or irritable.

Common side effects may include:

  • low blood cell counts;
  • nausea, vomiting, constipation;
  • hair loss;
  • feeling tired;
  • cough; or
  • redness where the injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect hyaluronidase and rituximab?

Other drugs may interact with hyaluronidase and rituximab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about hyaluronidase and rituximab.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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