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rituxan patient assistance form

by Ryder Wyman Published 2 years ago Updated 1 year ago
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What is the Rituxan immunology co-pay program?

Rituxan Immunology Access Solutions can refer eligible patients to the Rituxan Immunology Co-pay Program for help with the out-of-pocket costs associated with Rituxan.* For eligible patients with commercial or public health insurance, Rituxan Immunology Access Solutions offers referrals to independent co-pay assistance foundations.†

Where can I get Rituxan for free?

The Genentech Patient Foundation provides free Rituxan to people who don't have insurance coverage or who have financial concerns and meet eligibility criteria.*

What should I do if I have a reaction to Rituxan?

Your healthcare provider should give you medicines before your infusion of Rituxan to decrease your chance of having a severe infusion-related reaction. Tell your healthcare provider or get medical help right away if you get any of these symptoms during or after an infusion of Rituxan: Swelling of your lips, tongue, throat, or face

What infections can happen with Rituxan?

Types of serious infections that can happen with Rituxan include bacterial, fungal, and viral infections. After receiving Rituxan, some people have developed low levels of certain antibodies in their blood for a long period of time (longer than 11 months). Some of these patients with low antibody levels developed infections.

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What does RITUXAN do to your body?

RITUXAN targets and attaches to the CD20 protein found on the surface of blood cells with cancer and some healthy blood cells. Once attached to the CD20 protein, RITUXAN is thought to work in different ways including: By helping your own immune system destroy the cancer cells. By destroying the cancer cells on its own.

How do you feel after RITUXAN?

After a Rituxan (rituximab) infusion you may experience certain side effects or adverse reactions that make you feel unwell. Rituxan affects different people in different ways, but the more common side effects include: Fever (high temperature), muscle aches, headaches and chills, which are signs of infection.

Can you drink after rituximab infusion?

Alcohol. There's no need to avoid alcohol while taking rituximab. You're advised to stick within the guidelines of drinking no more than 14 units a week and that they should spread them out over the course of the week. In some cases, your doctor may advise lower limits.

Does RITUXAN lower immune system?

Rituxan can increase your risk of getting infections and can lower the ability of your immune system to fight infections. People with serious infections should not receive Rituxan. Heart Problems: Rituxan may cause chest pain, irregular heartbeats, and heart attack.

Why am I so tired after Rituxan?

Serious side effects that can occur with Rituxan include: tumor lysis syndrome (nausea, vomiting, diarrhea, and tiredness that happen due to tumor cells breaking down and releasing their contents into your blood)

What is the success rate of rituximab?

Even with a short follow-up, overall survival rates improved in the group receiving chemotherapy and rituximab (P = 0.016)....Table 1.StudyRegimenEfficacyForstpointner, 200427R-FCM vs. FCMORR: 79% vs. 58%* Median PFS: 16 months vs. 10 months* OS (2 years): 90% vs. 70%7 more rows

Will I lose my hair with rituximab?

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.

Can rituximab cause weight gain?

In one study, people with low-grade, B-cell NHL had chemotherapy with the drugs cyclophosphamide, vincristine, and prednisone. Some people took Rituxan afterward and some people didn't take any medication. Of the people who took Rituxan after chemotherapy, 11% gained weight.

How many times can rituximab be given?

Rituxan is typically given every 6 months, or based on your doctor's evaluation of your symptoms. If your symptoms return before it's time for your next course, you and your healthcare provider may decide to treat earlier (but no sooner than 4 months).

What are the long term side effects of Rituxan?

Does Rituxan cause any long-term side effects?Heart problems, including heart attack. Heart attacks can cause long-term problems with your heart.Kidney problems, including kidney failure.Blood cell problems, such as anemia (low levels of red blood cells) and low levels of white blood cells.

How long does it take for B-cells to heal after Rituxan?

Treatment with rituximab results in complete B cell-depletion within 72 h. Recovery of B cell counts usually starts only 6-9 months after the completion of therapy, and normal levels are obtained after 9-12 months (5).

How long is your immune system compromised after Rituxan?

Immune reconstitution starts usually after six months with recovery to normal between nine to twelve months. Extended rituximab treatment results in a prolonged recovery of B-cells without an increase of clinically relevant infections.

How long does it take to recover from rituximab?

Immune reconstitution starts usually after six months with recovery to normal between nine to twelve months. Extended rituximab treatment results in a prolonged recovery of B-cells without an increase of clinically relevant infections.

What is the most common side effect of Rituxan?

The most common side effects during treatment with Rituxan are: infusion-related reactions. infections (may include fever, chills) body aches.

How do you feel after an infusion?

After the infusion, some people may have pain, bleeding, bruising, soreness, or swelling in the place where the needle went in. In some cases, this may lead to more serious problems, like an infection.

How long does it take Rituxan to start working?

How long does Rituxan treatment take to work? Rituxan begins working after the first dose is given. But it may take weeks to months to see a response. In one study of people who received Rituxan for FL, the median time to notice a response to the medication was 50 days.

Prescriber Service Form

The Prescriber Service Form includes patient, insurance and prescription information and is used when Genentech Access Solutions contacts a patient’s health insurance plan to determine his or her coverage.

Patient Consent Form

This form is signed and dated by your patient giving written permission for Genentech Access Solutions to discuss his or her health information with you and the patient’s health insurance plan.

Formulario de Consentimiento del Paciente

A version of the Patient Consent Form for your Spanish-speaking patients.

Combined Prescriber Service Form and Patient Consent Form

Download or print the Prescriber Service Form and the Patient Consent Form together in a single packet.

Other Important Documents

The Genentech Patient Foundation gives free Genentech medicine to people who don't have insurance or who have financial concerns and meet eligibility criteria. Two forms are needed to enroll in the Genentech Patient Foundation:

Send it via fax

Your doctor also has to fill out a form called the Prescriber Service Form. Once we have both these forms, we can begin working with you and your doctor's office. You do not need to fill out anything on the Prescriber Service Form.

Patient Consent Form

This form lets us discuss your health information with your doctor and your health insurance plan.

What to tell your healthcare provider before taking Rituximab?

Before receiving Rituxan, tell your healthcare provider if you: have had a severe reaction to Rituxan or a rituximab product. have a history of heart problems, irregular heartbeat, or chest pain. have lung or kidney problems. have had an infection, currently have an infection, or have a weakened immune system.

What are the symptoms of Rituxan?

Tell your healthcare provider or get medical help right away if you get any of these symptoms during or after an infusion of Rituxan: Hives (red itchy welts) or rash. Itching. Swelling of your lips, tongue, throat, or face. Sudden cough. Shortness of breath, difficulty breathing, or wheezing. Weakness.

How long after Rituxan infusion can you have a reaction?

Serious infusion-related reactions can happen during your infusion or within 24 hours after your infusion of Rituxan. Your healthcare provider should give you medicines before your infusion of Rituxan to decrease your chance of having a severe infusion-related reaction.

How long after Rituxan can you use birth control?

You should use effective birth control (contraception) during treatment with Rituxan and for 12 months after your last dose of Rituxan. Talk to your healthcare provider about effective birth control.

How long after Rituxan can you give birth?

Females who are able to become pregnant should use effective birth control (contraception) during treatment with Rituxan and for 12 months after the last dose of Rituxan.

How to report side effects of Genentech?

Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at (800) FDA‐1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835‐2555.

What does it feel like to be on Rituxan?

Severe Skin and Mouth Reactions: Tell your healthcare provider or get medical help right away if you get any of these symptoms at any time during your treatment with Rituxan: Painful sores or ulcers on your skin, lips, or in your mouth. Blisters.

How long after Rituxan infusion can you have a reaction?

Infusion-Related Reactions: Infusion-related reactions are very common side effects of Rituxan treatment. Serious infusion-related reactions can happen during your infusion or within 24 hours after your infusion of Rituxan. Your healthcare provider should give you medicines before your infusion of Rituxan to decrease your chance of having a severe infusion-related reaction.

How to report side effects of Genentech?

Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at (800) FDA‐1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835‐2555.

Can you test if you are pregnant before taking Rituxan?

Your healthcare provider should do a pregnancy test to see if you are pregnant before starting Rituxan.

Does Rituxan cause heart problems?

Heart Problems: Rituxan may cause chest pain, irregular heartbeats, and heart attack. Your healthcare provider may monitor your heart during and after treatment with Rituxan if you have symptoms of heart problems or have a history of heart problems. Tell your healthcare provider right away if you have chest pain or irregular heartbeats during treatment with Rituxan

What is the most common infection with Rituxan?

The most common serious infection was pneumonia. Hypogammaglobulinemia: Hypogammaglobulinemia (IgA, IgG, or IgM below the lower limit of normal) has been observed in patients with GPA and MPA treated with Rituxan in GPA/MPA Study 1.

What is the rate of serious infections with Rituxan?

In the experience with Rituxan in 2578 RA patients, the rate of serious infection was 4.31 per 100 patient-years. The most common serious infections (≥0.5%) were pneumonia or lower respiratory tract infections, cellulitis, and urinary tract infections. Fatal serious infections included pneumonia, sepsis, and colitis. Rates of serious infection remain stable in patients receiving subsequent courses.

How long after Rituxan infusion do you have an adverse reaction?

Infusion-Related Reactions: In the Rituxan RA pooled, placebo-controlled studies, incidence of any adverse event within 24 hours of an infusion was 32% vs 23% after the first infusion, and 11% vs 13% after the second infusion in the Rituxan-treated patients and placebo group, respectively. Incidence of acute infusion-related reactions was 27% vs 19% after the first infusion, 9% vs 11% after the second infusion in the Rituxan-treated patients and placebo group, respectively. Serious acute infusion-related reactions were experienced by <1% of patients in either treatment group. Acute infusion-related reactions required dose modification (stopping, slowing, or interruption of the infusion) in 10% and 2% of patients receiving Rituxan or placebo, respectively, after the first course.

How long does it take for a patient to reactivate HBV?

HBV reactivation has been reported up to 24 months following completion of Rituxan therapy.

How long before a course of Rituxan can you administer non live shots?

For patients treated with Rituxan, physicians should review the patient’s vaccination status and patients should, if possible, be brought up to date with all immunizations in agreement with current immunization guidelines prior to initiating Rituxan and administer non-live vaccines at least 4 weeks prior to a course of Rituxan.

How long does it take for a PV to test positive for Rituximab?

Using a new ELISA assay, a total of 19/34 (56%) patients with PV treated with the Ritux 3 regimen tested positive for anti-rituximab antibodies by 18 months. The clinical relevance of anti-rituximab antibody formation in Rituxan treated PV patients is unclear.

How many patients tested positive for anti-rituximab?

A total of 273/2578 (11%) patients with RA tested positive for anti-rituximab antibodies at any time after receiving Rituxan. Anti-rituximab antibody positivity was not associated with increased infusion-related reactions or other adverse reactions. Upon further treatment, the proportions of patients with infusion-related reactions were similar between anti-rituximab antibody positive and negative patients, and most reactions were mild to moderate. Four anti-rituximab antibody positive patients had serious infusion-related reactions, and the temporal relationship between anti-rituximab antibody positivity and infusion-related reaction was variable. The clinical relevance of anti-rituximab antibody formation in Rituxan-treated patients is unclear.

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