Rituximab is an antitumor agent. It is a chimeric monoclonal antibody from a mouse or human that has a specificity for the CD20 antigen. It is on the surface of normal and cancerous B-lymphocytes.
The structure of the drug can be attributed to immunoglobulins of class G1.
Form release, formulation and packaging
Rituximab is administered in a different dosage. Usually in the form of a concentrate for the preparation of a solution for intravenous infusion. In 1 ml it is 10 mg. Concentrate is sold in a bottle of different volume in a cardboard box with instructions.
Latin name - Rituximab.
Manufacturer
There are several countries producing medicine with this active substance:
- Russia,
- Switzerland,
- India.
In our country the manufacturer is Biocad, in Hoffmann-La Roche Ltd. Switzerland, Dr. Reddy's Laboratories Ltd.- India.
Indications for use
Most often used for the treatment of follicular or minor malignancy of B-cell non-Hodgkin's lymphomas. Can be used with constantly developing or chemically resistant B-cell lymphoma.
Feasibility of use is proven in rheumatoid arthritis, when other methods of exposure did not bring the desired result. Usually used in combination therapy.
Contraindications
Do not use this medication with high sensitivity to one of the components or to mouse proteins.
Contraindications are:
- acute infectious diseases,
- severe immunodeficiency,
- heart failure,
- age younger than 18 years.
This method of treatment is used with extreme caution if there is a history of respiratory failure, thrombocytopenia, chronic ailments or pulmonary infiltrates. Also in the presence of chronic leukemia or lymphoma.
Mechanism of action
Rituximab works immediately in two directions: it fights the tumor and has an immunosuppressive effect.
The substance can bind to cells of the spleen, thymus or lymphocytes, which are located in the peripheral blood and lymph nodes.
Fab fragment binds to CD20 antigen, in lymphocytes and immunological reactions associated with B cell lysis begin. The latter includes complement-dependent cytotoxicity and antibody-dependent cell-mediated.
Instructions for use Rituximab: dosage
The course of treatment is selected individually. It takes into account the stage of the disease, the state of the hematopoiesis system.
Introduced intravenously and drip.
The rate of administration is 50 mg per hour with the first administration. Then the speed increases. Maximum - 400 mg per hour.
Before each manipulation, it is necessary to give a referendum using anesthetics and antihistamines. In some cases, corticosteroids are prescribed.
Side effects of
In the first 12 hours after drug administration, such symptoms as hyperkalemia, hypocalcemia, malfunctioning of the renal system develop.
During treatment, various skin reactions were observed in some patients:
- pemphigus,
- dermatitis,
- Stevens-Jones syndrome,
- toxic epidermal necrolysis.
There are also reports of deaths that were caused by hypoxia, lung infiltration, heart attack and cardiogenic shock.
With the development of renal failure, urgent dialysis is required. There may be other side effects:
- chills,
- GI disorder,
- pallor of the skin,
- edema,
- increased anxiety,
- allergic skin manifestations,
- bronchospasm.
Introduction 8 doses per week increases the likelihood of adverse reactions.
Overdose of
No cases of overdose have been observed, but the use of a dose at a time above 500 mg / sq.m. not studied.
Special instructions
In the treatment it is necessary to conduct a regular blood test on a regular basis, which would include the determination of the number of platelets.
Antihypertensive drugs are canceled 12 hours before the start of the infusion.
A set of the required amount of the drug is carried out in aseptic conditions.
It is diluted to the desired concentration in a specialized package or in a vial with a sterile sodium solution or dextrose. During mixing, the container is turned over with extreme caution to prevent the formation of foam.
There are no preservatives in the composition, so the medicine should be used immediately after preparation.
Drug Interaction
The strongest allergic reaction causes rituximab in combination with monoclonal antibodies. Medications that have the function of suppressing the hemopoiesis of the bone marrow increase the risk of myelosuppression.
Drug tolerability simultaneously or sequentially with medications that can reduce the number of normal B cells is not established.
Feedback on the treatment of
After completion of the course, patients usually feel good. Negative responses are mainly due to the fact that the drug has many side effects, for example, patients often complain in the process of treatment for nausea, vomiting, dizziness.
Price for Rituximab in Moscow
The cost of the medication is quite high - from 12 thousand rubles. The price for bottles with a volume of 500 mg can reach up to 62,000 rubles, 100 ml - 22,000 rubles.
Analogues of the preparation
Drugs with a close mechanism of action: Avastin, Vectibix, Arzerra, Herceptin, Perieta, Gazinva, Cadsil.
Synonyms for
Similar drugs include: MabThera, Acellbia, Rituximab. All of them have one active substance. At the same time, currently there are no genetics at this time.
Terms of dispensing from pharmacies
It is released only by prescription.
Storage Conditions and Shelf Life
The preparation should not be frozen. Store in a dark place at a temperature of 2-8 degrees. Shelf life 2 years and 6 months. Do not use after the end of the date shown on the package.
Video explanation of the mechanism of action of MabThera( Rituximab):