Anti-CD20 monoclonal antibody
Rituximab
Brand names: MabThera, Truxima, Rixathon
Adult dose
Dose: RA: 1g IV x2 (2 weeks apart). Lymphoma/leukaemia: 375 mg/m² per protocol. Vasculitis: 375 mg/m² weekly x4 or 1g x2
Route: IV (or SC for some indications)
Frequency: per indication
Clinical pearls
- B-cell NHL/CLL, RA (with methotrexate), ANCA-associated vasculitis, MS, pemphigus
- Screen for HBV/HCV/TB/HIV; pre-medicate (paracetamol + chlorphenamine + steroid)
Contraindications
- Active severe infection
- Active hepatitis B
- Severe HF
- Pregnancy/breastfeeding
- Hypersensitivity
Side effects
- Infusion reactions (severe — pre-medicate)
- Infections (incl. PML, HBV reactivation)
- Hypogammaglobulinaemia
- Cytopenias
- Cardiac arrhythmias
- Severe skin reactions
Interactions
- Live vaccines
- Other immunosuppressives
- Anti-hypertensives (interrupt morning of infusion)
Monitoring
- FBC
- Immunoglobulins
- Infections
- HBV DNA
Reference: BNF; NICE TA561/TA243/TA308; BSR/EULAR; SmPC; https://bnf.nice.org.uk/drugs/rituximab/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Revised Original International Autoimmune Hepatitis Score (IAIHG) · Autoimmune Liver Disease
- Ho Index for Predicting Response to Medical Therapy in IBD · Inflammatory Bowel Disease
- Rh(D) Immune Globulin Dosage for Maternal-Fetal Haemorrhage · Haematology in Pregnancy
- AREDS Classification of Age-related Macular Degeneration · Macular Degeneration
- Diabetic Macular Oedema (DMO) Classification · Diabetic Retinopathy
- Retinopathy of Prematurity — International Classification (ICROP3) · Paediatric Retina
Drugs
Pathways
- Cutaneous Lupus Erythematosus · BAD; EULAR
- Osteoporosis / Fragility Fracture · NOGG 2021; NICE NG147; NG224
- Arteritic AION (Giant Cell Arteritis) · RCOphth; BSR
- Osteoarthritis Hip / Knee Management · NICE NG226 (2022)
- Lupus Nephritis · EULAR/ERA-EDTA 2019; KDIGO 2024
- Rheumatoid Arthritis Management · NICE CG79 2018 / EULAR 2022