Rituxan (rituximab)
Genentech / Roche; biosimilars available · Anti-CD20 Monoclonal Antibody
What is Rituxan? Rituxan (rituximab) is an anti-CD20 monoclonal antibody that is foundational in the treatment of B-cell non-Hodgkin lymphomas, CLL, and certain autoimmune conditions. Multiple FDA-approved biosimilars are available.
About Rituxan
| Brand Name | Rituxan |
| Generic / INN | rituximab |
| Drug Class | Anti-CD20 Monoclonal Antibody |
| Manufacturer | Genentech / Roche; biosimilars available |
| Administration | Intravenous (IV) infusion or subcutaneous injection |
| FDA Approval | 1997 |
FDA-Approved Uses for Rituxan
Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.
- Non-Hodgkin lymphoma — relapsed/refractory low-grade or follicular CD20+
- NHL — first-line follicular with chemotherapy (CVP)
- NHL — first-line DLBCL with CHOP (R-CHOP)
- NHL — maintenance in follicular after first-line chemo
- CLL — with fludarabine and cyclophosphamide
- Rheumatoid arthritis — with methotrexate (anti-TNF failure)
- Granulomatosis with polyangiitis and microscopic polyangiitis — with glucocorticoids
- Pemphigus vulgaris — moderate to severe
How Does Rituxan Work?
Rituximab targets CD20, a phosphoprotein expressed on normal and malignant B cells. Binding to CD20 causes cell death through complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC), and direct induction of apoptosis. CD20 is not expressed on stem cells or plasma cells, so B cell recovery can occur.
Dosage & Administration
NHL: 375 mg/m² IV on day 1 of each chemotherapy cycle, or per weekly dosing schedule. SC (Rituxan Hycela): 1400 mg for NHL, 1600 mg for CLL — fixed dose given over approximately 5 minutes. Infusion reaction premedication required for IV.
Warnings, Precautions & Side Effects
General Warning
BOXED WARNINGS: Fatal infusion reactions. Tumor lysis syndrome (TLS). Severe mucocutaneous reactions. Hepatitis B virus reactivation — can be fatal. Progressive multifocal leukoencephalopathy (PML) — fatal. Embryo-fetal toxicity.
Common Side Effects
- Infusion reactions (very common — first infusion)
- Fatigue
- Nausea
- Fever
- Lymphopenia
- Infections
- Headache
This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.
Storage & Handling
Refrigerate at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light.
BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.
Insurance Coverage, Prior Authorization & Patient Assistance
🛡️ Commercial Insurance
Rituxan is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.
✅ Prior Authorization
Prior authorization is required by virtually all insurance plans for Rituxan. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.
🏥 Medicare Coverage
Medicare Part B covers this IV medication when administered in a clinical setting. Medicaid coverage varies by state.
🆓 Patient Assistance
Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.
Prior Authorization Patient Assistance Insurance & Savings Medication Costs
Frequently Asked Questions — Rituxan
Rituxan was the first monoclonal antibody approved for cancer. It targets CD20 on B cells, destroying malignant B cells in lymphomas and CLL. It is also used in autoimmune diseases (RA, vasculitis, pemphigus).
Yes. FDA-approved rituximab biosimilars include Truxima, Ruxience, and Riabni. They are considered highly similar to Rituxan and are used interchangeably per formulary.
Rituximab can reactivate latent hepatitis B virus (HBV) by depleting B cells that suppress HBV — potentially causing fulminant hepatitis. HBsAg and anti-HBc testing is required before rituximab; HBV-positive patients require antiviral prophylaxis.
Rituxan IV is covered by Medicare Part B. Biosimilars may be preferred on some formularies. Prior authorization required.
Related Medications & Conditions
Related Medications
Gazyva (obinutuzumab) · Velcade (bortezomib) · Revlimid (lenalidomide) · Yescarta (CAR-T — after rituximab failure)
Related Conditions
Diffuse large B-cell lymphoma (DLBCL) · Follicular lymphoma · CLL · Rheumatoid arthritis · Granulomatosis with polyangiitis