Drug Interactions With Rituximab

Abciximab
If you have taken abciximab in the past, you may be at a higher risk for certain side effects of rituximab (and vice versa as well -- if you have taken rituximab, you might be at a higher risk for certain abciximab side effects). This is due to the formation of antibodies to certain types of monoclonal medications. Your healthcare provider will need to monitor you more closely in this case.
 
Blood Pressure Medications
Taking rituximab with high blood pressure medications can increase the risk of low blood pressure (hypotension). Your healthcare provider might want you to temporarily stop taking your blood pressure medication to avoid this problem, although this may not be necessary in all situations. Check with your healthcare provider before combining rituximab with any blood pressure medicines.
 
Certolizumab Pegol
In general, rituximab should not be combined with certolizumab pegol, due to the risk of life-threatening infections as the result of immune system suppression.
 
Cisplatin
There have been rare cases of kidney failure in people who were given both cisplatin and rituximab. Rituximab is not approved for use in combination with cisplatin.
 
Echinacea
At least theoretically, echinacea may decrease the effectiveness of rituximab. Echinacea may increase the body's production of B lymphocytes, and rituximab works by decreasing B lymphocytes.
 
Leflunomide
Combining leflunomide with rituximab may increase the risk of dangerously low blood counts, such as low blood platelets. If you must take these medications together, your healthcare provider will probably want to monitor your blood counts closely.
 
Live Vaccines
Live vaccines are immunizations that contain live viruses or bacteria. If you receive a live vaccine while taking rituximab, you might become infected with the virus or bacteria from the vaccine. Also, rituximab can make live vaccines less effective. You should not receive live vaccinations while taking this drug.
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