Browser does not support script.
Skip to main content
search here
Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
This information is about rituximab, which is used to treat non-Hodgkin lymphoma (NHL)| and chronic lymphocytic leukaemia (CLL)|.
Rituximab belongs to a group of cancer drugs known as monoclonal antibodies|.
Monoclonal antibodies recognise and lock on to specific proteins on the surface of cancer cells. This helps the body's immune system recognise the cancer cells and destroy them. Monoclonal antibodies are sometimes called targeted therapies because they target cancer cells.
Rituximab locks on to a protein called CD20, which is found on the surface of white blood cells called B-lymphocytes or B-cells. This triggers the body’s immune system to attack the cells and destroy them.
As well as being found on the surface of normal B-cells, CD20 is also present on most of the abnormal B-cells that occur in many types of non‑Hodgkin lymphoma and on some of the abnormal B-cells found in CLL.
Rituximab destroys both abnormal (malignant) and normal B-cells. However, the body can replace normal B-cells that are damaged so their numbers recover once treatment is over.
Rituximab is used to treat several types of non‑Hodgkin lymphoma. It may also be used to treat chronic lymphocytic leukaemia. It's often given in combination with chemotherapy|, but may be given on its own.
Rituximab may also be given to people with follicular lymphoma| who have no signs of cancer at the end of their treatment (remission). The aim is to keep the lymphoma away for as long as possible.This is called maintenance therapy and is given every three months for up to two years.
Rituximab becomes a colourless fluid after being diluted.
Rituximab is given as a drip into a vein (intravenous infusion). It may be given on its own or with chemotherapy.
Some people have an allergic reaction to rituximab. Reactions are most common with the first infusion so, to reduce the risk of a reaction, the first dose is given slowly over a number of hours. You will be given medicines before the treatment that help to prevent or reduce any reaction.
If you have a reaction, the infusion can be stopped and started again when the symptoms are over. You may need to stay in hospital overnight for the first treatment so you can be monitored. After that, rituximab can usually be given in the outpatients department and over a shorter period of time.
When used by itself, rituximab is usually given weekly over a period of four weeks. The treatment may be repeated later if necessary.
If rituximab is used with chemotherapy, it's given with each course of treatment.
Each person’s reaction to cancer treatment is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone having this treatment.
We've outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your doctor or specialist nurse.
The side effects of rituximab are generally mild and some of these can be reduced with medicines.
Side effects of rituximab fall into two groups:
These are most common with first few infusions. Reactions are usually mild or moderate but sometimes they can be more severe.
If you have a reaction it can usually be treated by slowing or stopping the drip until you feel better. You may also be given treatment such as an antihistamine or paracetamol. When you feel better the infusion can be continued. These reactions are less likely to happen after the second infusion.
You’ll be monitored closely during your infusion, but it's very important to tell your nurse or doctor if you feel unwell or have any of the following symptoms:
Sometimes an infusion-related reaction can happen a few hours after treatment. If you develop these symptoms or feel unwell after you get home, contact the hospital straight away for advice.
Some people's blood pressure drops during the infusion. Your blood pressure will be checked regularly. If you normally take medicines to lower your blood pressure, tell the doctor. You may be given instructions about when it's best to take these before rituximab is given.
Some people experience mild pain in the parts of the body where they have cancer during the infusion. Painkillers| can be given to relieve this.
Rituximab can reduce the number of white blood cells produced by the bone marrow, making you more prone to infection|. Your blood cell numbers (blood count) will be monitored throughout your treatment.
Contact your doctor or the hospital straight away if:
Occasionally it may be necessary to delay your treatment if the number of blood cells (blood count) is low.
Rituximab can reduce the production of platelets, which help the blood clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. They will advise you about this and any precautions you should take.
You may become anaemic while having treatment with rituximab. This may make you feel tired| and breathless|. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion| if the number of red blood cells becomes too low.
Your doctor can prescribe anti-sickness drugs to prevent or greatly reduce nausea| if it occurs.
Rituximab may worsen heart problems for people who already have them. For this reason it's used with caution in anyone who has heart disease.
It is not known what effect rituximab may have on an unborn baby. It's recommended that women able to become pregnant, and men who are sexually active, use effective contraception while having rituximab. It's also important to use effective contraception for at least 12 months after the treatment has ended. Women shouldn't breastfeed during the treatment or for at least 12 months afterwards.
You should avoid having live vaccines during treatment and for at least six months afterwards. Live vaccines include BCG, yellow fever, measles, mumps, rubella, liquid typhoid, poliomyelitis liquid and MMR.
This section has been compiled using information from a number of reliable sources including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.