Truxima (rituximab-abbs) is a brand-name drug that’s prescribed for certain blood cancers, rheumatoid arthritis, and other conditions in adults. As with other drugs, Truxima can cause side effects, such as headache, tiredness, and infusion-related reactions.

Truxima has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section.

Truxima can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Truxima in clinical trials:

  • body aches
  • tiredness
  • infection, such as the common cold
  • nausea
  • mild infusion-related reactions (see “Side effect specifics”)

Mild side effects can occur with Truxima use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Truxima’s prescribing information.

Mild side effects that have been reported with Truxima include:

  • tiredness
  • body aches
  • nausea
  • infections, such as the common cold
  • fever or chills
  • joint pain
  • diarrhea
  • headache
  • rash
  • mild infusion-related reactions (see “Side effect specifics”)

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Truxima and want to tell the FDA about it, visit MedWatch.

Truxima may cause serious side effects, although they aren’t common. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Truxima’s prescribing information.

If you develop serious side effects while taking Truxima, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • serious infections, which may include symptoms such as:
    • fever
    • flu-like symptoms such as body aches and cough
    • sores in your mouth or throat
    • pain while urinating
  • kidney problems, which may include symptoms such as:
  • heart problems, which may include symptoms such as:
  • serious stomach or bowel problems, such as a tear or blockage in your intestines, which may include symptoms such as:
    • severe abdominal pain
    • vomiting
  • tumor lysis syndrome (cancer cells release toxic chemicals into the bloodstream), which may include symptoms such as:
    • fatigue (lack of energy)
    • nausea or vomiting
    • diarrhea
  • decrease in white or red blood cells, which may include symptoms such as:
    • tiredness or weakness
    • frequent infections
    • feeling lightheaded or dizzy
    • trouble focusing
  • risk of serious infusion-related reactions*
  • risk of reactivation of past hepatitis B virus (HBV)*
  • risk of progressive multifocal leukoencephalopathy (PML)*
  • risk of serious skin and mouth reactions*

* For more information about this side effect, see “Side effect specifics.”

ALLERGIC REACTION

For some people, Truxima infusions can cause an allergic reaction.

But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Truxima, your doctor may recommend taking a different medication instead.

Truxima may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

How do the side effects of Truxima compare to those seen with Rituxan?

Side effects of Truxima and Rituxan are similar. Truxima is a biosimilar drug, which means it’s made from parts of living organisms. It is a biosimilar of the biologic drug Rituxan. Biosimilars are like generic drugs, but biologics can’t be copied exactly. Therefore, instead of a generic, biologics have biosimilars. Biosimilars are “similar” to the parent drug.

Because of this, these drugs can cause the same side effects, such as nausea, body aches, and tiredness.

They are also both given as an intravenous (IV) infusion by a healthcare professional and can cause infusion-related reactions. These may include headache, dizziness, and fever or chills.

If you have questions about how the side effects of Truxima and Rituxan compare, talk with your doctor.

How long do side effects of Truxima last?

How long the side effects of Truxima last can vary depending on the side effect. Some side effects, such as mild infusion-related reactions, may be temporary. Other side effects, such as infections, may come and go throughout your treatment with Truxima.

Truxima may also cause long-term side effects, which can occur at any time during treatment or even after you stop receiving infusions of Truxima. Examples include heart or kidney problems or reactivation of the HBV.

If you have side effects that are bothersome or don’t go away, talk with your doctor. They may be able to recommend ways to manage your side effects.

Does Truxima cause hair loss?

No, hair loss wasn’t reported as a side effect in clinical trials of Truxima.

In some cases, Truxima may be prescribed with another medication, such as chemotherapy. Chemotherapy or other drugs that are often used with Truxima may cause hair loss.

If you experience unusual hair loss during treatment with Truxima, talk with your doctor. They may be able to help identify the cause of hair loss and recommend ways to help manage it.

Learn more about some of the side effects that Truxima may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Truxima.

Risk of severe infusion-related reactions

Truxima has a boxed warning for the risk of severe infusion-related reactions. Boxed warnings are the most serious warnings from the FDA. They alert doctors and patients about drug effects that may be dangerous.

Mild infusion-related reactions were common in clinical trials of Truxima. But, serious, and even fatal, infusion-related reactions can occur. Reactions are more likely to occur within 30 minutes to 2 hours of your first infusion, with the risk of a reaction decreasing with each following dose you receive. Infusion-related reactions have been reported to occur up to 24 hours after your first infusion.

Symptoms of a mild infusion-related reaction may include:

  • dizziness
  • weakness
  • fever or chills
  • headache
  • itchy skin
  • rash
  • vomiting

Serious infusion-related reactions are rare, but may include:

What you can do

You’ll likely receive premedications to help prevent or reduce the severity of infusion-related reactions. These include acetaminophen (Tylenol) and diphenhydramine (Benadryl). Some people may also receive an IV corticosteroid, such as prednisone.

Your doctor will monitor you closely during your infusions with Truxima. If you develop an infusion-related reaction, your doctor may slow down the speed your infusion is given. In some cases, your doctor may recommend stopping the infusion until your symptoms improve. If you experience a severe reaction, your doctor will stop your infusion and may recommend a different treatment option.

Risk of reactivation of hepatitis B virus

Truxima has a boxed warning for the risk of reactivation of the HBV.

If you’ve had HBV in the past, the use of medications containing rituximab, including Truxima, may cause the virus to become an active infection again. Reactivation of HBV can lead to serious liver problems, including liver failure and death.

This side effect has been reported in people taking rituximab and other similar medications, but it isn’t clear if this side effect occurred specifically in clinical trials of Truxima. Cases of HBV reactivation have been reported to occur up to 24 months after treatment with Truxima has ended.

Symptoms of hepatitis B may include:

  • abdominal pain
  • nausea or vomiting
  • fatigue
  • loss of appetite
  • jaundice (yellowing of the skin or whites of your eyes)

What you can do

Your doctor will test you for HBV before starting treatment with Truxima. If your doctor determines you have an active HBV infection, your doctor likely won’t prescribe Truxima until your HBV infection is treated. If you’ve had HBV in the past, your doctor will monitor you closely for symptoms of HBV reactivation during and after your treatment with Truxima.

Talk with your doctor if you develop signs of hepatitis B during or after your treatment with Truxima.

Risk of progressive multifocal leukoencephalopathy

Truxima has a boxed warning for the risk of PML. PML is an infection in the central nervous system that affects your brain and spinal cord.

Medications that contain rituximab, including Truxima, may increase the risk of infection with the JC virus, which can lead to PML. Reports of PML are rare but may be fatal.

PML wasn’t seen during clinical trials of Truxima, but have been reported since the drug was approved. Most cases of PML were reported within 12 months after treatment with Truxima was completed.

Symptoms of PML may include:

  • vision changes
  • confusion
  • trouble walking or talking
  • dizziness
  • weakness on one side of your body

Taking Truxima in combination with other medications, such as immunosuppressants or chemotherapy drugs, may increase the risk of developing PML.

What you can do

If you develop symptoms of PML, talk with your doctor right away. They’ll likely want to do tests to determine if PML is the cause of your symptoms.

Risk of serious skin and mouth reactions

Truxima has a boxed warning for the risks of serious mucous membrane and skin reactions. Mucous membranes are the moist linings of some parts of your body, such as the mouth, nose, throat, and stomach.

Serious skin and mucous membrane reactions have occurred in people who have used medications that contain rituximab, including Truxima. Examples include Stevens-Johhnson syndrome (SJS) and toxic epidermal necrolysis (TEN).

It’s not known how many people using Truxima have experienced these side effects, although they appear to be rare. They weren’t seen in Truxima’s clinical studies, but have been reported since the drug was approved.

These reactions may include symptoms that appear on the inside of your mouth, skin, or throat such as:

  • blisters
  • bumps
  • skin rash or discoloration
  • painful sores
  • peeling skin

What you can do

If you have a serious mucous membrane or skin reaction while using Truxima, call your doctor right away. They’ll likely stop treatment with Truxima and recommend you change to another medication to treat your condition.

Below is important information you should consider before taking Truxima.

Truxima has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see the “Side effect specifics” section.

Other precautions

Before taking Truxima, discuss your health history with your doctor. Truxima may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • kidney problems
  • lung problems
  • heart problem, including irregular heartbeat
  • weakened immune system
  • active infections
  • history of severe infections, including hepatitis B or chickenpox
  • previous allergic reaction to this or a similar drug
  • pregnancy
  • breastfeeding

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.