All About Rituxan Hycela

What is Rituxan Hycela?

If you’re considering treatment options for certain cancers, your doctor may suggest Rituxan Hycela.

It’s prescribed for adults with the following types of cancer:

• chronic lymphocytic leukemia (CLL), which is a cancer that affects lymphocytes (a type of white blood cell)
• diffuse large B-cell lymphoma, which is a cancer that affects bone marrow and blood cells
• follicular lymphoma, which is a cancer that affects white blood cells

To learn more about these cancers and how Rituxan Hycela is used for them, see the “What is Rituxan Hycela used for?” section below.

Rituxan Hycela basics

Rituxan Hycela is a form of immunotherapy. It contains the drugs rituximab and hyaluronidase. Rituxan Hycela is a biologic medication, meaning it’s made from parts of living organisms.

Rituxan Hycela isn’t available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.) Instead, rituximab and hyaluronidase come together only as the brand-name drug Rituxan Hycela.

Rituxan Hycela comes as a liquid that’s given as an injection under your skin. Your healthcare professional will inject Rituxan Hycela under the skin of your belly. Each injection lasts 5 to 7 minutes. You’ll receive Rituxan Hycela injections in a hospital, doctor’s office, or clinic.

In this article, we describe Rituxan Hycela’s uses, side effects, and more.

What should I know about Rituxan Hycela vs. Rituxan?

You may wonder how Rituxan Hycela and Rituxan are alike and different.

Rituxan Hycela and Rituxan are used to treat certain cancers. Both drugs are given as injections by a healthcare professional. Rituxan Hycela is given as an injection under your skin, while Rituxan is given as an intravenous (IV) infusion. (An IV infusion is an injection given into your vein over a period of time.)

Both Rituxan Hycela and Rituxan contain rituximab as an active ingredient. But Rituxan Hycela also contains the active ingredient hyaluronidase. Hyaluronidase allows the drug to be given under your skin instead of into your vein.

To learn more about these two drugs, see this detailed comparison. And talk with your doctor if you have more questions about Rituxan Hycela and Rituxan.

How is Rituxan Hycela administered?

Your doctor will explain how Rituxan Hycela will be given to you. They’ll also explain how much you’ll be given and how often. Be sure to follow your doctor’s instructions.

Below are commonly used dosages. Your doctor will prescribe the dosage that’s best for you.

Receiving Rituxan Hycela

Rituxan Hycela comes as a liquid that’s given as an injection under your skin. It’s given by a healthcare professional, usually under the skin of your belly.

Each Rituxan Hycela injection lasts 5 to 7 minutes. You’ll receive Rituxan Hycela injections in a hospital, doctor’s office, or clinic.

Dosage

Your exact dosage of Rituxan Hycela depends on:

• the condition you’re using Rituxan Hycela to treat
• other medications you’re currently using or have used in the past

The usual dosages of Rituxan Hycela are as follows:

• For chronic lymphocytic leukemia (CLL), you’ll receive an injection of Rituxan Hycela weekly if you’re using the drug by itself. Or, you’ll be given Rituxan Hycela injections on the first day of each of your chemotherapy cycles. (See “Receiving Rituxan Hycela with other drugs” for more information about using chemotherapy with Rituxan Hycela.)
• For diffuse large B-cell lymphoma and follicular lymphoma, you’ll receive a Rituxan Hycela injection on the first day of each of your chemotherapy cycles.

To learn more about these cancers and how Rituxan Hycela is used for them, see the “What is Rituxan Hycela used for?” section below.

Receiving Rituxan Hycela with other drugs

Before your first Rituxan Hycela injection, you’ll receive at least one dose of Rituxan. Rituxan is a form of rituximab that’s given as an intravenous (IV) infusion. (An IV infusion is an injection into your vein over a period of time.) Keep in mind that rituximab is one of the active drugs in Rituxan Hycela.

Your doctor may also prescribe drugs that help lower your risk for redness or deepening of skin color around Rituxan Hycela injection sites. These drugs include:

• antihistamines, such as diphenhydramine (Benadryl)
• acetaminophen (Tylenol)
• corticosteroids, such as prednisone (Rayos)

Rituxan Hycela may also be used with other cancer drugs. Examples of other cancer drugs that may be used with it include:

• cyclophosphamide (Cytotoxan)
• fludarabine
• doxorubicin (Doxil)
• vincristine (Marqibo)
• yttrium-90 ibritumomab tiuxetan (Zevalin)

Questions about receiving Rituxan Hycela

Here’s a list of common questions related to receiving Rituxan Hycela:

• What if I miss a dose of Rituxan Hycela? Call your healthcare professional right away to reschedule a missed appointment for your Rituxan Hycela injection. They’ll tell you if you should adjust your dosing schedule because of the missed dose.
• Will I need to use Rituxan Hycela long term? The condition you’re using Rituxan Hycela to treat will help determine how long you’ll need to use this drug. For some conditions, you can receive a maximum of 16 doses of Rituxan Hycela. But for other conditions, you may receive fewer doses. Your doctor will recommend the length of time that’s right for you to use this drug.
• How long does Rituxan Hycela take to work? Rituxan Hycela starts working right away to treat cancer. You might not notice the drug working in your body, especially if your cancer isn’t causing any symptoms. Your doctor will occasionally order certain tests to make sure Rituxan Hycela is working to treat your cancer.

Questions for your doctor

You may have questions about Rituxan Hycela and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

• Before your appointment, write down questions like:
  • How will Rituxan Hycela affect my body, mood, or lifestyle?
• Bring someone with you to your appointment if doing so will help you feel more comfortable.
• If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

What are Rituxan Hycela’s side effects?

Like most drugs, Rituxan Hycela may cause mild or serious side effects. The lists below describe some of the more common side effects that Rituxan Hycela may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Rituxan Hycela. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Rituxan Hycela can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Rituxan Hycela’s medication guide.

Mild side effects of Rituxan Hycela that have been reported include:

• low level of neutrophils (a type of white blood cell)
• low level of red blood cells
• mild infections, such as pneumonia and the common cold
• nausea and vomiting
• constipation
• cough
• fatigue (lack of energy)
• hair loss
• low level of platelets (cells that help your blood to clot)
• fever
• redness or deepening of skin color around Rituxan Hycela injection sites

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Rituxan Hycela can occur, but they aren’t common. If you have serious side effects from Rituxan Hycela, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Rituxan Hycela that have been reported include:

• serious infections, such as shingles and hepatitis C
• perforation (tearing) or obstruction (blockage) in your intestines
• heart problems, such as chest pain, abnormal heart rhythms, and heart attack
• kidney problems, such as kidney failure
• tumor lysis syndrome (a condition that occurs when tumor cells release their contents into your blood after they’re broken down in your body)
• boxed warnings:*
  • severe mouth and skin reactions
  • hepatitis B virus (HBV) reactivation
  • progressive multifocal leukoencephalopathy (PML)
• allergic reaction*

* For more information on these side effects, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Rituxan Hycela may cause.

Boxed warnings

Rituxan Hycela has boxed warnings. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Severe mouth and skin reactions. Rituxan Hycela may cause severe reactions in your mouth or on certain areas of your skin.

This side effect wasn’t reported in studies of the drug. But these reactions can still happen and may be life threatening.

Symptoms can include:

• peeling skin
• blisters
• pustules (fluid-filled bumps on your skin)
• other types of painful sores

Hepatitis B virus (HBV) reactivation. If you’ve had hepatitis B in the past, Rituxan Hycela can cause the virus to become active again. (This condition is called HBV reactivation.)

This side effect wasn’t reported in studies of the drug. But HBV reactivation can still happen when using Rituxan Hycela.

Hepatitis B can lead to liver problems, including liver failure. Rarely, hepatitis B may also lead to death. Symptoms of hepatitis B include tiredness and jaundice (yellowing of your skin or the whites of your eyes).

Progressive multifocal leukoencephalopathy (PML). PML is a rare but serious infection in your brain and central nervous system.

PML was a rare side effect in studies of Rituxan Hycela. But one person developed fatal PML after using Rituxan Hycela in these studies.

Symptoms of PML can include:

• weakness
• problems with balance
• trouble using your legs and arms
• vision changes

What might help

Be sure to tell your doctor right away if you have any symptoms of these boxed warning conditions. Your doctor will likely stop your Rituxan Hycela treatment. And they’ll recommend management for your condition as needed.

Both before you start Rituxan and during treatment, your doctor will test you for HBV. If you have HBV in your body, your doctor may prescribe treatment for it before you start using Rituxan. And they’ll closely monitor you for symptoms of HBV reactivation.

It’s important to know that HBV reactivation can happen up to 24 months after your last dose of Rituxan Hycela. Be sure to continue watching for symptoms of hepatitis B, even after your last dose of Rituxan Hycela.

Allergic reaction

Some people may have an allergic reaction to Rituxan Hycela.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Rituxan Hycela. But if you think you’re having a medical emergency, call 911 or your local emergency number.

What does Rituxan Hycela cost?

Costs of prescription drugs can vary depending on many factors, including what your insurance plan covers. Also, you’ll have to consider the cost of your visits to a hospital, doctor’s office, or clinic to receive Rituxan Hycela injections.

To find current prices for Rituxan Hycela in your area, visit WellRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Rituxan Hycela manufacturer’s website to see if it offers any support options.

What is Rituxan Hycela used for?

If you’re considering treatment options for certain cancers, your doctor may suggest Rituxan Hycela.

It’s prescribed for adults with the following types of cancer:

• Chronic lymphocytic leukemia (CLL). CLL is a cancer that affects lymphocytes (a type of white blood cell). CLL usually starts in your bone marrow and moves to your blood. (Bone marrow is the spongy tissue of your bones where blood cells are made.) For CLL, Rituxan Hycela is used in combination with the cancer drugs cyclophosphamide (Cytotoxan) and fludarabine. Rituxan Hycela can be used for CLL that has or hasn’t been treated with other drugs in the past.
• Diffuse large B-cell lymphoma. Diffuse large B-cell lymphoma is a cancer that affects bone marrow and blood. For this condition, Rituxan Hycela is used in combination with prednisone (Rayos) and certain cancer drugs. These cancer drugs include cyclophosphamide (Cytotoxan), doxorubicin (Doxil), vincristine (Marqibo), or other medications in a certain group of drugs. Rituxan Hycela is used for diffuse large B-cell lymphoma that hasn’t been treated with other drugs in the past.
• Follicular lymphoma. Follicular lymphoma is a cancer that affects white blood cells. Rituxan Hycela can be used for follicular lymphoma that either has or hasn’t been treated with other drugs in the past. For this condition, Rituxan Hycela may be used in combination with prednisone (Rayos) and the cancer drugs cyclophosphamide (Cytotoxan) and vincristine (Marqibo). It may also be used on its own. Rituxan Hycela is used for follicular lymphoma that either:
  • is relapsed (has come back after other treatments)
  • is refractory (hasn’t improved with other treatments)
  • has partially or completely improved after other treatments
  • hasn’t been treated in the past

Rituxan Hycela contains the drugs rituximab and hyaluronidase. Rituximab is a form of immunotherapy. It works by boosting certain cells in your immune system to help them fight off cancer. Hyaluronidase helps rituximab be absorbed by your body after it’s given as an injection under your skin.

What should be considered before using Rituxan Hycela?

If you’re considering Rituxan Hycela, talk with your doctor about your health and any medical conditions you may have. Below are a few other important considerations about using this drug.

Interactions

Using medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Rituxan Hycela, be sure to tell your doctor about all medications you take (including prescription and over-the-counter types). Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Rituxan Hycela.

Interactions with drugs or supplements

Rituxan Hycela’s manufacturer didn’t study this medication for drug interactions. But Rituxan Hycela is known to interact with the chemotherapy drug cisplatin.

Keep in mind that cisplatin may not be the only drug that interacts with Rituxan Hycela. Your doctor or pharmacist can tell you more about this interaction and any others that may occur with Rituxan Hycela. So, be sure to tell your doctor about all the drugs you’re taking before starting Rituxan Hycela.

Other interactions

You shouldn’t get any live vaccines while you’re using Rituxan Hycela.

Live vaccines contain a small amount of the bacteria or virus they work to prevent infections from. This is unlike inactivated vaccines, which contain dead or inactive forms of viruses or bacteria.

Live vaccines won’t usually cause an infection in a person with a healthy immune system. But Rituxan Hycela can weaken the activity of your immune system. And this can increase your risk for getting an infection from a live vaccine.

Examples of live vaccines include:

• chickenpox
• shingles
• measles, mumps, and rubella (MMR)
• yellow fever

Talk with your doctor or pharmacist before getting any vaccines while you’re using Rituxan Hycela.

Boxed warnings

Rituxan Hycela has boxed warnings. These are serious warnings from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Boxed warnings for Rituxan Hycela include:

• Severe mouth and skin reactions. Rituxan Hycela may cause severe reactions in your mouth or on certain areas of your skin. These reactions may be life threatening. Symptoms can include peeling skin, blisters, pustules (fluid-filled bumps on your skin), and other painful sores.
• Hepatitis B virus (HBV) reactivation. If you’ve had hepatitis B in the past, Rituxan Hycela can cause the virus to become active again. Hepatitis B can lead to liver problems, including liver failure. Rarely, hepatitis B may also lead to death. Symptoms of hepatitis B include tiredness and jaundice (yellowing of your skin or the whites of your eyes).
• Progressive multifocal leukoencephalopathy (PML). PML is a rare but serious infection in your brain and central nervous system. In rare cases, PML can be fatal. Symptoms of PML can include weakness, problems with balance, trouble using your legs and arms, and vision changes.

For more information about these warnings, see the “What are Rituxan Hycela’s side effects?” section above.

Other warnings

Rituxan Hycela may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you use Rituxan Hycela. Factors to consider include those in the list below.

• Heart problems. Using Rituxan Hycela can lead to heart problems such as chest pain, abnormal heart rhythms, and heart attack. You’re more likely to have these side effects if you’ve had heart problems in the past. Before starting Rituxan Hycela, tell your doctor about any heart problems you have. They’ll determine whether or not Rituxan Hycela is right for you.
• Kidney problems. Rituxan Hycela can cause kidney problems such as kidney failure for some people. You may have a higher risk for this side effect if you already have kidney problems. If you do, talk with your doctor before using Rituxan Hycela. They may recommend a different treatment for you.
• Current infections. Rituxan Hycela can lower your body’s ability to fight off infections. Make sure your doctor knows about any infections you have before you start using Rituxan Hycela.
• Weakened immune system. Rituxan Hycela can lower your body’s ability to fight off infections. If you have a weakened immune system (also called immunocompromised), you may have a higher risk for infections. Tell your doctor if you have a weakened immune system before starting Rituxan Hycela.
• Allergic reaction. If you’ve had an allergic reaction to Rituxan Hycela or any of its ingredients, you shouldn’t take this drug. Ask your doctor about which other medications are better options for you.

Use with alcohol

There aren’t any known issues with drinking alcohol while using Rituxan Hycela.

If you drink alcohol, talk with your doctor about the amount that’s safe for you to drink while you’re using Rituxan Hycela.

Pregnancy and breastfeeding

You shouldn’t use Rituxan Hycela while you’re pregnant or breastfeeding.

If you’re able to become pregnant, your doctor will have you take a pregnancy test before you start treatment. And they’ll recommend that you use birth control during treatment and for at least 1 year afterward.

Also, you should avoid breastfeeding during treatment and for at least 6 months afterward.

To learn more about the effects of this drug when it’s used while you’re pregnant or breastfeeding, talk with your doctor.

What to ask your doctor

If you have questions about using Rituxan Hycela, talk with your doctor or pharmacist. They can discuss other treatments that may be used for your condition.

Here are a few articles that might be helpful for learning about other treatment options for your condition:

• Current and Breakthrough Treatments for CLL
• Lymphoma Alternative Treatments
• New Treatments for Lymphoma, Leukemia Unveiled at Cancer Conference

Questions you may ask your doctor about Rituxan Hycela treatment include:

• Will Rituxan Hycela cure my condition?
• How soon will Rituxan Hycela start working for me?
• How many doses of Rituxan Hycela are best for treating my condition?
• Do I take any medications that might interact with Rituxan Hycela?