Drug-Drug Interactions, Adverse Reactions & Contraindications
Rituximab can cause renal toxicity with cisplatin. Toxicity associated with patients of Non-Hodgkin lymphoma (NHL) are more susceptible. It can cause fatal toxicity if patients experiencing tumor lysis syndrome are administered Rituximab concomitantly with Cisplatin. They can show signs of renal failure with rising serum creatinine level or oliguria. Rituximab with Cisplatin is not approved concomitantly. Rituximab can cause lymphoid malignancy leading to infusion reactions, fever, lymphopenia, infection, asthenia - physical weakness and lack of energy, neutropenia, etc. As per U.S FDA, it doesn’t have any contraindications but it can cause common adverse reactions like upper respiratory infection, bronchitis, nasopharyngitis, urinary tract infection, etc. in patients with rheumatoid arthritis. Moreover, it can cause muscle spasm, peripheral edema, diarrhea, nausea, etc. in patients suffering with microscopic polyangiitis (MPA) and Wegener’s granulomatosis or granulomatosis with polyangiitis (GPA) [29, 33-34].