Obinutuzumab may cause serious (possibly fatal) liver disease in people who have a current or past infection with hepatitis B. Before starting treatment with this medication, your doctor should order a test to see if you have hepatitis B. Your doctor may also order blood tests and watch for symptoms of liver disease during treatment and for several months after your last dose of medication. Get medical help right away if you have any symptoms of liver damage, including: dark urine, persistent nausea/vomiting/loss of appetite, stomach/abdominal pain, yellowing eyes/skin.
Obinutuzumab may increase your risk of getting a rare but very serious (sometimes fatal) brain infection (progressive multifocal leukoencephalopathy-PML). Get medical help right away if any of these rare but very serious side effects occur: confusion, dizziness, loss of balance, difficulty talking/walking, vision changes.
Obinutuzumab is used in combination with another medication (chlorambucil) to treat a certain type of blood cancer (CLL-chronic lymphocytic leukemia) in people with untreated CLL. Obinutuzumab belongs to a class of drugs known as monoclonal antibodies. It works by stopping the growth of cancer cells.
This medication is given by injection into a vein by a health care professional. It is given as directed by your doctor, usually once a week for the first 3 doses, then once every 28 days for the last 5 doses. The first dose may be split up and given on 2 separate days.
The dosage is based on your medical condition and response to treatment.
Obinutuzumab may cause very serious infusion-related reactions during or up to 24 hours after treatment. These reactions occur more often with the first and second treatments. Your doctor will monitor you closely and increase your dose slowly to reduce the chance of these serious side effects. Your doctor may also prescribe other medications before each treatment, including acetaminophen, an antihistamine (such as diphenhydramine), and a corticosteroid (such as methylprednisolone) to prevent these side effects. If you have a reaction, your treatment may be temporarily stopped. Tell your doctor or nurse right away if any of these side effects occur: dizziness, fainting, fast heartbeat, chest pain, trouble breathing, wheezing, itching/swelling of the throat, nausea, vomiting, diarrhea, flushing, headache, fever, or chills.
If you take drugs for high blood pressure, ask your doctor ahead of time if you should change the way you take your blood pressure medication right before and after your dose of obinutuzumab. Some people have had reactions (such as dizziness/fainting) due to taking blood pressure medication too close to the time of their obinutuzumab infusion.
See also Warning and How to Use sections.
Cough or muscle pain may occur. If either of these effects persists or worsens, tell your doctor or pharmacist promptly.
Many people using this medication have serious side effects. However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.
This medication decreases bone marrow function, an effect that may lead to a low number of blood cells such as red cells, white cells, and platelets. This effect can cause anemia, decrease your body's ability to fight an infection, or cause easy bruising/bleeding. Tell your doctor immediately if you develop any of the following symptoms: unusual tiredness, pale skin, signs of infection (such as fever, chills, persistent sore throat), easy bruising/bleeding.
Obinutuzumab sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). To lower your risk, drink plenty of fluids unless your doctor directs you otherwise. Also, your doctor may prescribe an additional medication. Tell your doctor right away if you have symptoms such as: low back/side pain (flank pain), pink/bloody urine, change in the amount of urine, painful urination, muscle spasms/weakness.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Before using obinutuzumab, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Obinutuzumab can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.
To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.
This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
During pregnancy, this medication should be used only when clearly needed. Female patients should use reliable forms of birth control during treatment and for 12 months after treatment. Discuss the risks and benefits with your doctor.
It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: other drugs that weaken the immune system/increase the risk of infection (such as natalizumab, rituximab).
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
See also Warning section.
Do not share this medication with others.
Laboratory tests (such as blood counts) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. Do not double the dose to catch up.
Not applicable. This medication is given in a hospital or clinic and will not be stored at home.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised November 2013. Copyright(c) 2013 First Databank, Inc.
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