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What should I discuss with my healthcare provider before receiving rituximab (Rituxan)?

You should not receive this medication if you have ever had a severe allergic reaction to rituximab, or if you are allergic to mouse protein.

To make sure you can safely use rituximab, tell your doctor if you have any of these other conditions:

• liver disease or hepatitis B (or if you are a carrier of hepatitis B);
• kidney disease;
• systemic lupus erythematosus (SLE);
• lung disease or a breathing disorder;
• a weak immune system;
• a history of heart disease, angina (chest pain), or heart rhythm disorder; or
• a recent or active infection, including herpes, shingles, cytomegalovirus, chickenpox, West Nile virus, hepatitis C, or any infection that keeps coming back or does not clear up.

FDA pregnancy category C. It is not known whether rituximab will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether rituximab passes into breast milk or if it could harm a nursing baby. Do not take rituximab without telling your doctor if you are breast feeding a baby.

Older adults may be more likely to have side effects from rituximab, causing breathing difficulty or heart rhythm problems.

How is rituximab given (Rituxan)?

Rituximab is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting.

Before you receive rituximab, you may be given other medications to prevent certain side effects that rituximab can cause.

The medicine is usually given once per week for 4 to 8 weeks. In the treatment of rheumatoid arthritis, you may receive only two injections of rituximab, with 2 weeks in between treatments.

To be sure this medication is not causing harmful effects, your blood may need to be tested often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

If you have hepatitis B you may develop liver symptoms after you stop using this medication, even months after stopping. Your doctor may want to check your liver function at regular visits for several months after you stop using rituximab. Do not miss any scheduled visits.

If you need surgery, tell the surgeon ahead of time that you are using rituximab.

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