Rituximab can make it more difficult for your body to fight infections. Therefore, people with active infections should not take rituximab. If you have a fever, think you have an infection or have been prescribed an antibiotic, contact your health-care provider. People who have had frequent infections in the past or a history of tuberculosis should discuss the use of rituximab with their health-care provider.
Also contact your health-care provider if you are having surgery as you may need to stop rituximab until you are healed and there is no sign of infection.
Rituximab has not been studied in pregnant women or nursing mothers so its effect(s) on pregnant women or nursing babies are unknown. You should tell your doctor if you are pregnant or are planning to become pregnant. Women of childbearing age should use effective birth control methods during and for up to 12 months after treatment with rituximab. Because of the potential for adverse reactions in nursing infants, a decision should be made on whether or not to discontinue nursing or the medication, taking into account the importance of the drug to the mother.
If you have ever had a rare infection of the brain called progressive multifocal leukoencephalopathy (PML) or if you have had a previous allergic reaction to rituximab you should not take the medication.
In rare cases, severe skin reactions have been reported in patients receiving rituximab. Get medical help right away if you have signs of redness, swelling, blistering or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
Rituximab has been associated with abnormal heart rhythms. Tell your doctor if you have any such cardiac issues.
All patients should have a blood test to check for hepatitis B before starting rituximab.
Ideally, your vaccinations should be up to date prior to starting ritxuimab. If you have already started therapy with rituximab, your health-care provider will likely recommend most inactive vaccines (e.g., influenza, pneumococcal). Live vaccines are not recommended due to risk of causing infection. Before receiving any vaccinations while taking rituximab, you should speak with your health-care provider.