What does it do?

Rituximab is used to prevent transplant rejection.

Before you start

• Tell your doctor if you have heart, blood pressure or lung problems.
• Rituximab weakens your immune system, making it harder for your body to fight infections. You may need tests before you start to make sure you don't have any infections like tuberculosis (TB), HIV, or hepatitis B and C.
• Ask your doctor what vaccines you might need before you start and while you are taking rituximab. You should not have a live vaccine while taking rituximab.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Reliable contraception should be used while being treated with rituximab, and for up to 12 months after stopping.

How is it given?

Rituximab is given as an infusion into a vein.

Rituximab can cause a reaction while it is being infused. This usually happens within 30 minutes to 2 hours after starting the first infusion. You may have trouble breathing, or experience fever, chills, flushing, skin rash, itching, dizziness or headache. Tell your health professional immediately if any of these symptoms occur. This reaction is usually mild and can be controlled by giving rituximab more slowly. You will also be given medicines shortly before the infusion to help control this reaction. Once the symptoms have gone away the speed of the infusion can usually be increased again.

Can you take other medicines?

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products or recreational drugs.

What side effects might you notice?

Side Effects	Recommended action
Swollen lips, tongue, throat or face Chest pain, fast or irregular heartbeat Reduced number of blood cells that fight infections or help your blood to clot - symptoms include: fever, chills, sore throat or generally feeling unwell, or easy or unusual bruising or bleeding	Tell your doctor immediately
Loss of co-ordination, muscle weakness, forgetfulness, or vision changes Tingling or numbness, joint, muscle or bone aches and pains	Tell your doctor
Swollen feet or legs Nausea, vomiting, diarrhoea, abdominal pain	Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• Protect yourself from too much sunlight while taking immunosuppressant medicines (they may increase your risk of skin cancer). Always cover up and apply a thick layer of broad spectrum sunscreen (at least SPF30) when outside. Do not use sunbeds.
• Women using rituximab for a long time may need cervical screening more often. Discuss with your doctor.
• It is important to tell anyone who gives you medical or dental treatment that you are taking rituximab.