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Rituximab (Mabthera)

Find out what rituximab is, how you have it and other important information about having rituximab.

What it is

Rituximab is a monoclonal antibody, which is a type of biological therapy.

Rituximab is a treatment for chronic lymphocytic leukaemia (CLL) and some types of non Hodgkin lymphoma. It is also used for some non cancer related illnesses. 

How it works

Rituximab targets a protein called CD20 on the surface of the leukaemia and lymphoma cells. The antibody sticks to all the CD20 proteins it finds. Then the cells of the immune system pick out the marked cells and kill them.

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

For non Hodgkin lymphoma 

You usually start by having rituximab once a week for 4 weeks. You may have treatment every 3 weeks if you have the rituximab with other medicines.

You often have rituximab with CHOP chemotherapy to make R-CHOP. You usually have 8 of the treatments, so the treatment lasts 6 months.

If the initial treatment works well, you may then go on to have further rituximab treatment as maintenance therapy. You have this treatment every 2 or 3 months for 2 years.

For CLL 

You usually have rituximab treatment alongside chemotherapy once a month for 6 months.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

Rituximab could harm a developing baby, so talk about contraception to your doctor or nurse before having treatment. You need to use reliable contraception during treatment with rituximab and for a year afterwards. 

Breast feeding

Breastfeeding is not advisable during this treatment and for a year afterwards. The drug may come through in the breast milk.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

Hepatitis and rituximab

Hepatitis means inflammation (swelling) of the liver. It can be due to a viral infection or because the liver comes into contact with harmful substances such as alcohol.

Rituximab can make hepatitis infection active again. Tell your doctor know if you have had hepatitis in the past. They will do tests to check whether you currently have hepatitis. They call this hepatitis screening.

People with active hepatitis B infection should not have rituximab treatment. People with other types of hepatitis need to see a liver disease expert before starting treatment. The doctor advises on how to prevent damage to the liver during treatment.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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