What is in this leaflet
This leaflet answers some common questions about Truxima® intravenous infusion. It does not contain all the available information.
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you being given Truxima® against the benefits they expect it will have for you.
If you have any concerns about being given this medicine, ask your doctor or pharmacist.
Keep this leaflet. You may need to read it again.
What Truxima® is used for
Truxima® contains the active ingredient rituximab.
Truxima® belongs to a group of medicines known as anti-cancer agents. There are many different classes of anti-cancer agents. Truxima® belongs to a class called monoclonal antibodies.
Monoclonal antibodies are proteins which specifically recognise and bind to other unique proteins in the body.
Truxima® is used to treat non-Hodgkin's lymphoma and chronic lymphocytic leukaemia.
Truxima® works by binding to a protein on the surface of certain white blood cells known as B lymphocytes. During the process of binding to the protein, the abnormal growth of the B lymphocytes is stopped.
It is the abnormally growing B lymphocytes that are responsible for certain types of non-Hodgkin's lymphoma and chronic lymphocytic leukaemia.
Truxima® may be used on its own or together with chemotherapy.
If your doctor thinks it is appropriate for your circumstances you may continue to receive Truxima® after the initial course of treatment.
Your doctor may have prescribed Truxima® for another reason.
Ask your doctor if you have any questions why Truxima® has been prescribed for you.
This medicine is available only with a doctor's prescription.
Before you are given Truxima®
When you must not be given Truxima®
Do not use Truxima®:
- if you have had an allergic reaction to rituximab or any of the ingredients listed at the end of this leaflet
-
if you have had an allergic reaction to any other proteins that are of mouse origin
Some of the symptoms of an allergic reaction may include severe skin rash, itching, hives, swelling of the face, lips, mouth or throat which may cause difficulty in swallowing or breathing, swelling of the hands, feet or ankles.
If you are not sure if you should start receiving Truxima®, talk to your doctor.
Before you are given Truxima®
Your doctor must know about all the following before you are given Truxima®.
Tell your doctor if:
- you have an infection, or a history of a recurring or long-term infection such as hepatitis B
- you are taking or have previously taken medicines which may affect your immune system, such as chemotherapy or immunosuppressive medicines
If you are taking or have taken medicines which affect your immune system, you may have an increased risk of infections. There have been reports of a rare, serious brain infection called PML (progressive multifocal leukoencephalopathy) usually affecting people with a weakened immune system. Your chance of getting PML may be higher if you are treated with Truxima® and/or other medicines that weaken the immune system. PML can cause severe disability or even death.
- you have a history of heart disease with:
- angina
- cardiac arrhythmias (abnormal beating of the heart)
- congestive heart failure
Your doctor will supervise you closely during treatment with Truxima®.
- you are taking medicine to control blood pressure
Truxima® may cause a reduction in blood pressure at the beginning of treatment. Because Truxima® may cause a temporary drop in your blood pressure, your doctor may advise you to temporarily stop taking your blood pressure medicine before you are given Truxima®.
- you have pre-existing lung disease
You may have a greater chance of breathing difficulties during treatment with Truxima®.
- you intend to have or have had immunisation with any vaccine (e.g. measles, rubella, flu, vaccines for travel purposes)
Some vaccines should not be given at the same time as Truxima® or in the months after you receive Truxima®. Your doctor will check if you should have any vaccines before you receive Truxima®.
- you are allergic to any other medicines or any other substances such as foods, preservatives or dyes
- you are pregnant or intend to become pregnant
It is not known whether Truxima® is harmful to an unborn baby. It is not recommended that you are given Truxima® while you are pregnant.
If you are a woman of child bearing potential, you must use effective contraceptive methods to prevent pregnancy during treatment and for 12 months after completing treatment with Truxima®.
- you are breast feeding or plan to breast feed.
It is not known if Truxima® passes into breast milk. It is recommended that you discontinue breast feeding while you are treated with Truxima®.
If you have not told your doctor about any of the above, tell them before you are given Truxima®.
Use in children
The safety and effectiveness of Truxima® have not been established in children.
Taking other medicines
Tell your doctor if you are taking any other medicines including any that you have bought without a prescription from a pharmacy, supermarket or healthfood shop.
As Truxima® may cause a temporary drop in your blood pressure at the beginning of treatment, your doctor may advise you to temporarily stop taking your blood pressure medicine before you are given Truxima®.
It is not known if Truxima® will affect your normal response to a vaccine
It is possible that after treatment with Truxima® you may experience allergic reactions if you are treated with other medications containing monoclonal antibodies.
Your doctor and pharmacist will have more information on medicines to be careful with or to avoid while undergoing treatment with Truxima®.
How Truxima® is given
Truxima® is given by slow infusion into a vein (intravenous infusion) by a healthcare professional.
Your doctor will decide what dose and how long you will receive Truxima®. The dose of Truxima® depends on your body weight and body height.
Truxima® may be given with or without chemotherapy. When given in combination with chemotherapy, the standard treatment with Truxima® consists of 1 infusion on day 1 of each chemotherapy cycle.
Depending on the circumstances of your disease or response to the drug your doctor may decide to change your treatment.
Maintenance treatment
If you respond to initial treatment your doctor may decide to continue your treatment with Truxima® for up to 2 years.
Overdose
As Truxima® is given to you under the supervision of your doctor, it is very unlikely that you will receive too much. However, if you experience any side effects after being given Truxima®, tell your doctor immediately.
While you are receiving Truxima®
Things you must do
If you are a woman of child bearing potential, you must use effective contraceptive methods to prevent pregnancy during treatment with Truxima® and for 12 months after completing treatment.
Tell your doctor if you become pregnant while receiving Truxima®.
Tell all doctors, dentists and pharmacists who are treating you that you are receiving Truxima®.
Tell your partner or caregiver you are receiving Truxima® and ask them to tell you if they notice any changes in your movement or behaviour. If they notice any changes you should tell your doctor about them immediately. Your doctor may need to perform some tests and alter your treatment.
Be sure to keep all your appointments with your doctor so that your progress can be checked. Your doctor will perform regular blood tests.
Things you must not do
Do not breast feed your infant during treatment with Truxima®. It is not known whether Truxima® crosses into human milk.
Do not take any other medicines whether they require a prescription or not without first telling your doctor or consulting with a pharmacist.
Things to be careful of
Be careful driving or operating machinery until you know how Truxima® affects you. Truxima® generally does not cause any problems with your ability to drive or operate machinery. However, as with many other medicines, Truxima® may cause dizziness in some people.
Side effects
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are receiving Truxima®.
Do not be alarmed by this list of possible side effects. You may not experience any of them. Truxima® helps many people who have either non-Hodgkin's lymphoma or chronic lymphocytic leukaemia but it may have unwanted side effects.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
The following is a list of the more common side effects.
During or after an infusion
Tell your doctor if you notice any of the following during or after receiving an infusion (particularly during the first 2 hours of receiving the first infusion) and they worry you:
- fever, chills and severe shivering (most likely to occur)
- swelling of the tongue, face, lips, mouth or throat which may cause difficulty breathing or swallowing
- itchy rash and/or pinkish, itchy swellings on the skin
- difficulty breathing and/or shortness of breath
- wheezing or coughing
- dizziness or lightheadedness, especially on standing up
- nausea (feeling sick) or vomiting
- headache
- fatigue (feeling tired) and/or feeling weak
- rhinitis (a runny nose)
- flushing
- fast heart beat
- chest pain which may spread to the neck and shoulders
- pain where the cancer is located
- muscle and joint pain
- stomach pain or discomfort
- throat irritation
These side effects are temporary and less likely to occur after the first infusion.
Your doctor may recommend that you take medication to prevent pain or allergy before you receive your Truxima® infusion.
The following is a list of other common side effects. Tell your doctor if you notice any of the following and they worry you:
- sore mouth or mouth ulcers
- bleeding or bruising more easily than normal
- shingles (herpes zoster infection)
- diarrhoea
- increased blood pressure
- indigestion
- loss of appetite
- muscle stiffness
- nervousness, feeling anxious or agitated
- increased cough
- inability to sleep
- pins and needles, or decreased feeling in the skin
- stuffy nose or chest
- sweating or night sweats
- watery, itchy or crusty eyes
- changes to sense of taste
- weight loss
- ear pain and/or buzzing, hissing, whistling, ringing or other persistent noise in the ears
- constipation
- a general feeling of being unwell
- unusual hair loss or thinning
Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice any of the following:
- severe skin rash, itching, hives
- swelling of the face, lips, mouth or throat which may cause difficulty in swallowing or breathing, swelling of the hands, feet or ankles
- one or a combination of the following: severe shortness of breath, severe difficulty breathing, severe wheezing, severe coughing
- vision loss associated with headaches, confusion and seizures
- one or a combination of the following: confusion, disorientation or memory loss, changes in the way you move, walk or talk, decreased strength or progressive weakness in your body, blurred or loss of vision
- yellowing of skin and eyes, light coloured bowel motions, dark coloured urine
These are serious side effects. You may need urgent medical attention. Serious side effects are rare.
In combination with chemotherapy
If you have been given Truxima® in combination with chemotherapy, as well as the side effects listed above, the following additional side effect may also occur:
- bronchitis (inflammation in the lungs)
If you are 65 years of age or over and have been given Truxima® in combination with chemotherapy, the following side effects may occur more commonly:
- frequent infections with symptoms such as fever, severe chills, sore throat or mouth ulcers
These events may be related to Truxima®, but you may get other side effects from your chemotherapy.
Please consult your doctor for possible side effects that may be caused by your chemotherapy.
This is not a complete list of all possible side effects. Your doctor or pharmacist has a more complete list. Others may occur in some people and there may be some side effects not yet known.
Tell your doctor if you notice anything else that is making you feel unwell.
Ask your doctor or pharmacist if you don't understand anything in this list.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
After receiving Truxima®
Storage
Truxima® should be stored in the pharmacy or on the hospital ward.
The concentrated solution for infusion should be kept in a refrigerator at 2-8°C. It should not be frozen.
Truxima® should be stored away from light.
Product Description
Availability
Truxima® is available as 100 mg/10mL and 500 mg/50 mL single dose vials.
Truxima® comes in packs of two vials for the 100 mg/10 mL presentation and packs of one vial for the 500 mg/50 mL presentation.
What Truxima® looks like
Truxima® is available as a clear, colourless, concentrated solution for intravenous infusion. It is diluted before infusion into a vein.
Ingredients
Truxima® contains the active ingredient rituximab (rch). Truxima® comes in two strengths, 100 mg and 500 mg. Each vial of Truxima® also contains the following inactive ingredients:
- sodium citrate
- polysorbate 80
- sodium chloride
- sodium hydroxide and/or hydrochloric acid
Sponsor
Celltrion Healthcare Australia Pty Ltd
Suite 205, Level 2, 1 York Street,
Sydney NSW 2000, Australia
Please check with your pharmacist for the latest Consumer Medicine Information.
Australian Registration Numbers:
- 100 mg vial: AUST R 285816
- 500 mg vial: AUST R 285815
This leaflet was prepared on June 2019.
Published by MIMS October 2020