Rituximab Flashcards
What class of durgs does Rituximab belong to?
Other antineoplastic agents
Immunologic Factors
Antirheumatic Agents
What is Rituximab?
Genetically engineered chimeric murine+human monoclonal IgG antibody.
It is directed against CD20 antigen on the surface of normal and malignant B cells
What is Rituximab indicated for?
severe active Rheumatoid arthritis
follicular CD20+ B cell non hodgkin’s lymphoma
What is the dose of Rituximab given in Rheumatoid Arthritis treatment?
1g every 2 weeks via IV infusion (adult)
Patients should receive premedication of IV methylprednisolone 30 min before each infusion
What is the mechanism of action of Rituximab?
Fab regions of rituximab binds to CD20 antigen on B cells.
The Fc domain of Rituximab recruits antibdies and complements to mediate cell lysis
What is the role of Rituximab on Rheumatoid Arthritis therapy?
Used in combination with Methotrexate for severe active rheumatoid arthritis who have had inadequate response or are intolerant to other DMARDs
What are the characteristic Pharmacokinetic and Pharmacodynamic parameters of Rituximab?
Mean terminal half life: 20.8 days
Mean system CL: 0.23L/day
Mean steady state VD: 4.6L
What are the precautions associated with Rituximab use?
patients with predisposition to infection
history of CVD
progress multifocal leucoencephalopathy
High tumour burden
pulmonary insuffiency or pulmonary infiltrates
Pregnancy class C - avoid unless benefit outweighs risk (B cell depletion in foetus) avoid in breastfeeding
What are some adverse effects associated with rituximab?
dyspepsia, hypertension, hypotension, rhinitis, sore throat, asthenia, paraesthesia, migraine, arthralgia, muscle spasm, urticaria, Stevens Johnson’s syndrome
What are the alarm bells associated with Rituximab?
with antihypertensives, must withold for 12 hours before infusion.
Administration of methylprednisolone/antihistamine/antipyretic/analgesic 30 minutes before infusion decreases risk of adverse effects.
Women of childbearing potnetial to use effective contraception during and for 12 months post treatment.
Report any cognitive, neurological or psychiatric symptoms
What are some interactions with Rituximab?
Rituximab interacts with Alemtuzumab - further information required.
Additive bone marrow suppression when taken with Clozapine
increased INR when taken with warfarin
no interaction with cyclophsphamide or methotrexate
