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Rituximab is a chemotherapeutic which belongs to a group of monoclonal antibodies. This medication is used in non-Hodgkin lymphoma, rheumatoid arthritis and in chronic lymphocytic leukemia. It can be administered alone or in a combination with other chemotherapeutics.

General Side Effects of Rituximab

General side effects are increased body temperature and chills, headache and pain in the abdomen. Asthenia is another general side effect of this medication.

These side effects most commonly affect patients whose tumors are large and bulky and those with higher circulation white counts. There has also been reported small percentage of life threatening occurrences.

Disturbances in blood count may also occur and they include anemia, neutropenia, leucopenia and thrombocytopenia. Low blood pressure, irregular heart beat, urticaria and bronchospasm have been reported as well.

The side effects most commonly develop after the first administration of the drug. The lethal outcome has affected women more than men. The most susceptible patients are those suffering from chronic lymphocytic leukemia and mantle cell lymphoma.

Immunologic Side Effects

The most present immunologic side effect is reduction in B-cells. This condition can be accompanied with low level of serum immunoglubulins. This side effect can lead to reactivation of certain latent viral infections and is enhanced if retuximab is applied together with CHOP therapeutic regime. The viruses that can be reactivated or exacerbated are cytomegalovirus, herpes simplex virus, parvovirus B19, varicella zoster virus, West Nile virus, hepatitis B, and C. Progressive multifocal leukoencelopathy may develop after administration of rituximab. This viral infection is fatal in majority of cases.

Hepatic Side Effects

Rituximab is most commonly combined with different chemotherapeutics. This combination may be a cause of hepatitis. Patients develop inflammatory liver disease approximately four months after the initial treatment with rituximab. Patients who are carriers of hepatitis B virus are administered rituximab under thorough supervision of the doctor and are monitored for possible side effects. If hepatitis has occurred the patient will stop with the treatment.

Cardiovascular Effects

Heart attack and ventricular fibrillation are cardiovascular side effects. A patient may even develop carcinogenic shock if rituximab is administered.

Respiratory Side Effect

As for upper parts of respiratory tract a patient may develop rhinitis and irritation of the throat. Pulmonary infiltrates, pneumonitis and fatal bronchiolitis may occur as well. In all these conditions the supply of oxygen may be reduced resulting in hypoxia.

Gastrointestinal Side Effects

Nausea and vomiting are easily dealt with.

Metabolic Side Effect

The only metabolic complication that has been reported is angioedema.

Musculoskeletal Side effects

Pain in muscles has been reported in small number of patients.

Nervous System Side Effects

Only small percentage of patients have complained about lightheadedness

Dermatologic Complications

Urticaria, itchy skin and rash are most common skin side effects. In rare cases psoriasis has been reported.

Kidney Side Effects

Tumor lysis syndrome was more intensive in those patients whose tumors were large and bulky. This syndrome can affect kidneys and it usually occurs up to a day after the infusion of rituximab. Pyelonephritis is one more possible kidney side effect of rituximab.

Oncologic Side Effects

Rituximab may lead to progression of Kaposi's sarcoma. Even one case of eccrine squamous syringometaplasia has been confirmed.

Ocular Side Effects

Inflammation of conjunctiva is the only potential ocular side effect of rituximab.

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