Riabni
Riabni (rituximab or rituximab-arrx) is an anti-CD20 monoclonal antibody. It’s used to treat certain blood cancers (e.g., chronic lymphocytic leukemia) and autoimmune conditions (e.g., rheumatoid arthritis). Riabni (rituximab) is given as an infusion through the vein (IV), usually at an infusion center. Your oncologist will give you medications before each Riabni (rituximab) dose to help prevent infusion-related reactions. Other possible side effects include rash and infection. Riabni (rituximab) is a biosimilar to Rituxan (rituximab), but it’s not yet FDA-approved to treat all conditions Rituxan (rituximab) is approved for.
What is Riabni (rituximab)?
What is Riabni (rituximab) used for?
Blood cancers
- Certain types of CD20-positive non-Hodgkin’s lymphoma (NHL) in adults
- CD20-positive chronic lymphocytic leukemia (CLL) in adults
Autoimmune conditions
- Moderate to severe rheumatoid arthritis (RA) in adults
- Granulomatosis with polyangitis (GPA) and microscopic polyangitis (MPA) in adults
How Riabni (rituximab) works
Riabni (rituximab) is an anti-CD20 monoclonal antibody. It targets specific cells in your immune system called B cells. B cells are involved in many different health conditions. For example, sometimes they can turn into cancer cells, and other times they become too active, which can cause autoimmune conditions.
Riabni (rituximab) works by attaching to a specific protein in B cells called CD20. When it attaches to this protein, it signals the body to attack and kill that cell. As a result, these abnormal or overactive B cells can’t grow, spread, or work as well.
Drug facts
More on Riabni (rituximab) essentials
Side effects of Riabni (rituximab)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Fever (up to 53%)
- Lower white blood cell count (48%)
- Chills (up to 33%)
- Infection (31%)
- Weakness (up to 26%)
- Nausea (up to 23%)
- Headache (up to 19%)
- -Diarrhea (up to 17%)
- Muscle spasms (up to 17%)
- Lower red blood cell count (up to 16%)
- Swelling (up to 16%)
- Night sweats (15%)
- Rash (15%)
Less Common Side Effects
- Trouble sleeping
- Stomach pain
- Cough
- Itching
- Vomiting
- Joint stiffness
- Nosebleeds
- Runny nose
- Tiredness
Riabni (rituximab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Infusion-related reaction: swelling, trouble breathing, chest pain, low blood pressure, red skin
- Serious skin reaction: painful blisters, skin wounds, peeling skin, fever, sore throat, body aches
- Tears in the gut: sudden and severe stomach pain, fever, chills, and nausea or vomiting that won’t go away
- Infection: fever, chills, cough, muscle aches, very fast heartbeat, severe tiredness
- Tumor lysis syndrome: seizures, hallucinations, nausea, tiredness, no appetite, dark-colored urine, muscle cramps, numbness
- Serious heart problems: tiredness, weakness, dizziness, feeling faint, trouble breathing, pressure on the chest, pounding heart, irregular heart beat, sweating, feeling anxious, nausea
The following Riabni (rituximab) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Bowel blockage—stomach cramping, unable to have a bowel movement or pass gas, loss of appetite, vomiting
- Dizziness, loss of balance or coordination, confusion or trouble speaking
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Stomach pain that is severe, does not go away, or gets worse
- Tumor lysis syndrome (TLS)—nausea, vomiting, diarrhea, decrease in the amount of urine, dark urine, unusual weakness or fatigue, confusion, muscle pain or cramps, fast or irregular heartbeat, joint pain
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Headache
- Joint pain
- Nausea
- Runny or stuffy nose
- Unusual weakness or fatigue
Pros and cons of Riabni (rituximab)
Pros
- Works in a more targeted, specific way than chemotherapy
- Depending on your condition, doses might only be needed every 6 months, so might be more convenient
- Doesn’t typically cause hair loss
Cons
- Each treatment might take several hours, so might be less convenient
- Might cause infusion reactions
- Can raise your risk of getting sick
Pharmacist tips for Riabni (rituximab)
- How often you need a Riabni (rituximab) infusion depends on your medical condition and how your body responds to the medication. Make sure you know when your infusions are scheduled and mark the dates on your calendar so you don’t miss a treatment. There are also several apps for your phone that can help you keep track.
- Each Riabni (rituximab) infusion appointment can last almost the full day because of the time it takes to receive premedications and Riabni (rituximab) infusion. Please plan accordingly for this time. Make sure you dress comfortably, bring water and food, and have something to help you pass the time, such as a book or music.
- Your oncologist will give you premedications, such as steroids, acetaminophen (Tylenol), and antihistamines, before each Riabni (rituximab) infusion. These medications can help lower the risk of an infusion-related reaction, which can be very serious.
- Check your temperature regularly, such as once a day, when you’re receiving Riabni (rituximab) treatment. Call your care team immediately if your temperature is 100.4 degrees Fahrenheit or higher; this means you have a fever. It’s important for your oncologist to know if you get sick, and sometimes a fever might be the only sign that you’re sick.
- If you experience nausea and vomiting while receiving Riabni (rituximab), contact your oncologist. There are several antiemetic medications, such as ondansetron (Zofran) or promethazine (Phenergan), your oncologist might prescribe to help manage it.
- We don’t know if Riabni (rituximab) passes into human milk. But, because of the risks to a nursing infant, you shouldn’t breastfeed while taking Riabni (rituximab) and for 6 months after the last dose.
Common questions about Riabni (rituximab)
There aren’t any specific foods or drinks you need to avoid after receiving Riabni (rituximab). And similar to receiving Rituxan (rituximab), it’s a good idea to stay home and rest the day after your infusion, especially after the first few doses when you’re still learning how your body might react to the medication. It’s possible that you might experience an infusion-related reaction up to 24 hours after your treatment. Tell your oncology care team right away if you experience symptoms, such as trouble breathing or rash, so you can get immediate medical attention.
People taking Riabni (rituximab) might experience infusion reactions. These reactions are most common during the first infusion. Symptoms might include rash and red skin, chest pain, swelling, and trouble breathing. Some people have reported life-threatening reactions, such as throat swelling, anaphylaxis, or heart attacks. Your oncologist will give you several medications, such as acetaminophen (Tylenol) and diphenhydramine (Benadryl), before your Riabni (rituximab) dose to lower your risk of a reaction. Your nurse will also monitor you very closely, especially during your first dose. You should tell your nurse right away if you have symptoms of a reaction during your treatment.
Nausea isn’t a common side effect when Riabni (rituximab) is taken by itself. But sometimes Riabni (rituximab) is taken with other medications, such as chemotherapy, which are more likely to cause nausea. If you do have nausea while taking Riabni (rituximab) or other medications to treat your condition, your provider might prescribe an antiemetic medication, such as ondansetron (Zofran) or prochlorperazine (Compazine), to help manage it. If you have nausea or vomiting that won’t go away, contact your oncologist.
How long the side effects Riabni (rituximab) last can differ depending on what side effects you’re experiencing. For example, fever, rash, muscle pain from infusion-related reactions can appear quickly, often times within 2 hours of an Riabni (rituximab) infusion. But these side effects are short-lived because your care team can help you manage them quickly with other medications. Other side effects of Riabni (rituximab), such as having a weaker immune system (from low white blood cell counts), can last months after your last dose. Talk to your oncologist if you have questions on any particular Riabni (rituximab) side effect.
Riabni (rituximab) is a biosimilar to Rituxan (rituximab). A biosimilar is a biologic medication that’s very similar to the original biologic that was first approved by the FDA. Biosimilars are as safe and work similarly as well as the original biologic medication. Riabni (rituximab) isn’t approved to treat all the same conditions or all the same age groups as Rituxan (rituximab). Talk to your oncologist if you have questions about biosimilars.
How to save using GoodRx
Risks and warnings for Riabni (rituximab)
Riabni (rituximab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Infusion-related reactions
People taking rituximab products might experience infusion-related reactions. These reactions are most common within the first two hours of the first infusion. Symptoms include rash and red skin, swelling, trouble breathing, chest pain, irregular heartbeat, and low blood pressure. Sometimes, these reactions can be very serious and cause throat swelling, anaphylaxis, or heart attacks. This can be life threatening.
You’ll take several medications before each treatment, such as acetaminophen (Tylenol) and diphenhydramine (Benadryl) to help prevent a reaction. Your nurse will watch you closely during your first treatment, but you should tell them right away if you experience any symptoms during your treatment. If you have a severe reaction to Riabni (rituximab), you might not be able to continue taking the medication.
Serious skin reactions
Some people receiving rituximab products have experienced serious and sometimes life-threatening skin problems, such as Stevens-Johnson syndrome (SJS), paraneoplastic pemphigus, toxic epidermal necrolysis (TEN), and others. Tell your provider right away if you develop painful blisters, skin wounds, peeling skin, or fever as these are signs of a serious skin reaction that need immediate medical attention.
Hepatitis B reactivation
- Risk factors: History of hepatitis B viral infection
Some people who had hepatitis B in the past experienced a new infection (hepatitis B reactivation) after starting medications like rituximab. Your oncologist will test you for hepatitis B virus before you start taking Riabni (rituximab). If you test positive, you might need treatment for hepatitis B before you start taking Riabni (rituximab). If you develop a hepatitis B infection during treatment, you’ll need to stop taking Riabni (rituximab) while your oncologist treats it. Let your oncologist know right away if you experience symptoms of an active hepatitis B infection, such as fever, tiredness, or yellowing of the skin.
Progressive multifocal leukoencephalopathy
- Risk factors: Taking Riabni (rituximab) with chemotherapy | Taking Riabni (rituximab) for stem cell transplant
Rarely, people taking Riabni (rituximab) have developed a serious brain condition called progressive multifocal leukoencephalopathy (PML). PML is caused by a virus called JC virus and can lead to brain damage. Let your oncologist know if you’ve PML symptoms while taking Riabni (rituximab), such as weakness, clumsiness, difficulty speaking, and difficulty walking.
Tumor lysis syndrome
- Risk factors: People taking Riabni (rituximab) for lymphoma
Some people taking medications like Riabni (rituximab) to treat cancer developed a complication called tumor lysis syndrome (TLS) that can cause damage in multiple areas of the body. TLS happens when cancer cells are destroyed and release what’s inside them, such as potassium and uric acid, into your blood. TLS is most common during the first treatment cycle, and symptoms can appear within 24 hours of the Riabni (rituximab) infusion. Your oncologist will closely monitor you with lab tests, and might give you extra fluids or a medication such as allopurinol (Zyloprim) to prevent TLS. Let your oncology care team know if you experience symptoms of TLS, such as nausea, tiredness, and no appetite.
Serious infections
- Risk factors: Taking Riabni (rituximab) with chemotherapy
People who take rituximab products like Riabni (rituximab) can develop serious infections, including viral, bacterial, and fungal infections. If you do get sick, you might need to pause taking Riabni (rituximab) and start taking other medications to treat the infection. If you develop a serious infection you might have to stop taking Riabni (rituximab) altogether. Contact your oncologist if you develop signs and symptoms of an infection such as fever, chills, muscle aches, or severe tiredness or weakness.
Serious heart problems
Serious heart problems have happened during treatment with medications like Riabni (rituximab). These include heart rhythm changes and heart attacks. If your heart rhythm changes during your treatment, your oncologist might recommend closer monitoring with a test called an electrocardiogram (EKG) during your infusions. If you develop serious heart problems during treatment, your oncologist might stop your Riabni (rituximab) infusion.
Kidney problems
Risk factors: Tumor lysis syndrome | Taking cisplatin Some people taking medications like Riabni (rituximab) experienced kidney problems. This was more common in people who developed tumor lysis syndrome or who were taking Riabni (rituximab) together with a chemotherapy medication called cisplatin. Your oncologist will monitor your kidney health with a blood test while you’re taking Riabni (rituximab). Let your oncologist know if you have trouble making urine, notice swelling in your hands and feet; these might be symptoms of kidney problems.
Gut blockage and tears
Some people have reported stomach pain, intestinal blockage, and tears in the lining of the gut after starting medications like Riabni (rituximab) together with chemotherapy for NHL. For some people, these side effects appeared 2 months after the start of treatment. Contact your oncologist right away if you have sudden and severe stomach pain, fever, chills, and nausea or vomiting that won’t go away.
Vaccines
Make sure you’re up-to-date with your vaccines before starting Riabni (rituximab). We don’t know if it’s safe to take live virus vaccines while taking Riabni (rituximab). You should avoid live vaccines during treatment. And you need to receive any non-live vaccines at least 4 weeks before Riabni (rituximab) treatment. Talk to your oncologist before getting any vaccine while you’re taking Riabni (rituximab), even if it’s an inactivated vaccine.
Harm to unborn baby
Based on data from human pregnancies, Riabni (rituximab) can cause harm to an unborn baby. If you’re a female who's able to have babies, you should use effective birth control while taking Riabni (rituximab) and for 12 months after the last dose. Contact your oncologist right away if you become pregnant while taking Riabni (rituximab).
Combination treatment for people with autoimmune conditions
Risk factors: People taking Riabni (rituximab) for autoimmune conditions We don’t know if it’s safe to take other biologic medications or disease-modifying antirheumatic drugs (DMARDs) together with Riabni (rituximab). Because taking these medications together might raise your risk for infection, your provider will closely monitor you if they recommend a combination treatment.
Riabni (rituximab) dosage
Typical dosage for Riabni (rituximab)
Blood cancers
Your oncologist will determine your dose of Riabni (rituximab) based on your body surface area (BSA) in m². Your oncologist might also give you other anticancer medications along with Riabni (rituximab).
-
Non-Hodgkin’s lymphoma
- Adults: The typical dose is 375 mg/m² given as an intravenous infusion. How often you’ll receive a dose usually ranges from weekly to every 8 weeks, depending on the type of NHL you have and where you are in the treatment process.
-
Chronic Lymphocytic Leukemia (CLL)
- Adults: The typical dose is to receive one 375 mg/m² intravenous infusion before the start of chemotherapy. Then, your oncologist will raise your dose to 500 mg/m² infused on Day 1 of a 28-day chemotherapy cycle, for up to 6 cycles.
Autoimmune conditions
Your HCP might also give you other medications along with Riabni (rituximab) to treat your condition.
-
RA
- Adults: The typical starting dose is 1,000 mg infused IV for 2 doses, given 2 weeks apart. The typical maintenance dose is 1,000 mg infused once every 4 to 6 months, depending on your condition.
-
GPA and MPA
- Adults: Your HCP will determine your dose of Riabni (rituximab) based on your body surface area (BSA) in m². The typical starting dose is 375 mg/m² given as an intravenous infusion weekly for 4 weeks. The typical maintenance dose is 500 mg given as 2 doses 2 weeks apart, then 500 mg every 6 months.
What are alternatives to Riabni (rituximab)?
