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Rituxan Info > What to expect . . . 

Rituxan Printable Checklist

Last updated: 06/27/2016

. . . and how to prepare, for your first treatment with Rituxan

Preparations:

Andy writes: "It seems that most people have a pretty easy time of it. Despite being pretty positive, I had a pretty tough time (fevers, chills, rigors (convulsions) the first time and then progressively easier times (mostly just chest pains).

The best help is that they will pre-medicate to alleviate the side effects. It is standard to get oral Tylenol, oral or IV Benadryl, and with R-CHOP see if they will give the IV prednisone (or Dexamethasone) before the Rituxan. The last one helps a lot and I think has become much more standard since I had Rituxan 4 years ago.

The best thing the two of you can do is to tell the nurses anything you notice right away. This is NOT the time to gut through a reaction. Ask them what to watch for, tell them immediately if it starts, and they can slow down or stop the infusion and/or give extra medication until the reactions subside.

Most people have no problems, some of us are problem cases but with teamwork between us and our nurses get through just fine, and only a very few have serious problems. It is good to be aware of the possibilities but try not to stress too much as you will probably breeze through.
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You may want to review and print
out the
Dosage and Administration Guide for details  Rituxan.com 

This will help you to become familiar with the procedure so that you might ask informed questions and know what to expect.  

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Ask questions of your doctor about specific risk factors you may have.

"Patients requiring close monitoring during first and all subsequent infusions include those with:

pre-existing cardiac and pulmonary conditions,
those with prior clinically significant cardiopulmonary adverse events,
and those with high numbers of circulating malignant cells (<25,000/mm3) with or without evidence of high tumor burden."  Rituxan.com

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Plan to stay most of the day - especially for the first infusion

Which should be given very slowly to minimize infusion-related risks. If you tolerate the first infusion well, you may be done in as little as three hours after that. 

NOTE:  It does not appear to make a difference how long it takes to get the full dose of Rituxan.  You can stop one day, and begin the next, for example.
 
For details, see Multimodality Therapies and Optimal Schedule of Antibodies: Rituximab in Lymphoma as an Example  asheducationbook.org 
 

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Never a bad idea to prepare a thank-you-in-advance gift, such as baked goods, for the nursing staff.  They work very hard and appreciate being appreciated. 

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Arrange to have a friend or relative accompany you, because the therapy can make you drowsy and impact your ability to drive or observe unusual sensations that should be reported to the attending nurse.

If you cannot arrange this, post a request to one of the many online support lists for a patient or caregiver volunteer to accompany you.  See Support Lists

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Bring reading material, or a portable audiotape/CD player with headphones to help pass the time. 

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Bring snacks, bottled water, and a pillow as well. Many centers will have snacks and drink available.

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Be positive! 

Most patients have little problem at all. It's common to experience fatigue for the remainder of the day, and the next day as well. 
 

Monitoring your reactions:

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Talk to the nurse and your doctor about treatment risks

and what they will do to monitor you.  

Indicate that you are in no hurry to complete the infusion and that you will appreciate being monitored closely, especially the first time. 

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Ask the nurse or doctor about sensations

that are to be expected and what to report immediately. Also refer to the Dosage and Administration Guide for details.  When in doubt: ASK
 
Dosage and Administration Guide  Rituxan.com 

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Just before treatment, you may receive Tylenol in pill form.

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You will receive Benadryl to help you tolerate the infusion better. This will make you drowsy. The same IV used to administer the Benadryl will be used to administer the Rituxan. The Benadryl may cause a temporary burning sensation. 

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The rate of administering the Rituxan is very slow at the start; it may be increased when it's determined you are tolerating it well.

IMPORTANT: Benadryl helps to decrease reactions, but it also works against being observant. Watching for and notifying the nurse of changes, such as hives, skin sensations, and difficulty in breathing - especially when the dose increases - can help to head off strong adverse reactions. 

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Your vitals (temperature and blood pressure)  will be taken and monitored throughout the treatment session, as often as every 30 minutes.  Use this time to report unusual sensations.

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Notify the nurse when you have any unusual sensations!

IMPORTANT: When receiving a treatment is not the time to be stoical and brave. Report the sensations you feel. It's much better to pick up on possible adverse reactions sooner. The rituxan can be continued later, and more slowly to overcome problems, and this will not influence the efficacy of the treatment.

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Also, it doesn't hurt to buy some over-the-counter Benadryl and have that on hand at home for any delayed reactions.  AndyM, WebMagic

 
Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
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