What is Ruxience?
Ruxience is a type of treatment that helps the immune system find and attack harmful cells in the body. It targets a protein called CD20, which is expressed on certain types of white blood cells.
By attaching to these cells, Ruxience helps destroy them and reduce inflammation or cancer growth, depending on the condition being treated.
Before starting Ruxience, discuss your full medical history with your doctor. Let them know if you have had serious reactions to Ruxience or similar treatments, heart problems, lung or kidney issues, or a weakened immune system.
Also mention if you have any current infections or have had major ones in the past, such as hepatitis B or C, herpes, chickenpox, shingles, or West Nile virus.
Inform your doctor if you have recently received a vaccine or plan to get one, as some vaccines may not be safe during treatment.
If you are pregnant, planning to become pregnant, or breastfeeding, speak with your doctor. You may need a pregnancy test before starting Ruxience. Use birth control during treatment and for 12 months after your last dose.
Do not breastfeed while using Ruxience and for six months afterward, as it may pass into breast milk and harm your baby.
Indications and Benefits of Ruxience
Ruxience is an FDA-approved medication to treat several health conditions in adults:
- Non-Hodgkin’s Lymphoma (NHL): a type of cancer that starts in the lymphatic system, which is part of the immune system. Ruxience can be used alone or together with other chemotherapy drugs to treat certain types of NHL, including follicular lymphoma and diffuse large B-cell lymphoma.
- Chronic Lymphocytic Leukemia (CLL): a cancer of the blood and bone marrow. Ruxience is given with chemotherapy drugs like fludarabine and cyclophosphamide to help control this condition.
- Rheumatoid Arthritis (RA): a long-lasting condition that causes swelling and pain in the joints. If other treatments, such as TNF blockers, have not worked, doctors may prescribe Ruxience in combination with methotrexate to help relieve symptoms.
- Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA): these are rare autoimmune diseases that cause inflammation in blood vessels and organs. Ruxience is used with steroids like glucocorticoids to help control these conditions.
- Pemphigus Vulgaris (PV): a rare skin condition that causes painful blisters. Ruxience helps manage moderate to severe PV in adults.
Ruxience is not approved for use in children.
How It Works
Ruxience contains a type of targeted treatment called a monoclonal antibody. It is designed to find and attach to a protein called CD20, which is found on the surface of certain white blood cells known as B cells.
These B cells help in the development of diseases like Non-Hodgkin Lymphoma, Chronic Lymphocytic Leukemia, and Rheumatoid Arthritis.
Once Ruxience binds to CD20, it facilitates the destruction of these B cells through a natural process in the immune system, including complement-dependent cytotoxicity and antibody-dependent cell-mediated cytotoxicity.
In autoimmune conditions like rheumatoid arthritis, B cells may contribute to inflammation by producing harmful proteins and activating other immune cells.
By targeting and removing these B cells, Ruxience helps lower inflammation and control disease symptoms more effectively.
Dosage
The exact dosage of Ruxience depends on the condition being treated, body size, and how a person responds to treatment. Doctors carefully plan each ruxience dosing schedule to make sure it is both safe and effective.
Before starting treatment, patients often receive other medications to lower the risk of infusion reactions. Blood tests are done before and during treatment to check safety.
What Dosage Strengths Does Ruxience Come In?
Ruxience is available in two vial strengths. A healthcare provider will prepare and adjust the ruxience dose based on the treatment plan:
- 100 mg in 10 mL (10 mg/mL) single-dose vial
- 500 mg in 50 mL (10 mg/mL) single-dose vial
Ruxience is always diluted in a fluid bag before use and should never be administered as an intravenous injection.
Dosage Chart
| Condition | Recommended Ruxience Dose | Dosing Schedule | Important Notes |
| Non-Hodgkin’s Lymphoma (NHL) – Relapsed | 375 mg/m² once weekly | 4 to 8 doses | Monitor blood counts before each dose |
| NHL – Retreatment | 375 mg/m² once weekly | 4 doses | Used for recurring disease |
| NHL – First Treatment with Chemo | 375 mg/m² on Day 1 of chemo cycle | Up to 8 cycles, then maintenance every 8 weeks for 12 doses | Maintenance starts 8 weeks after chemo if response is achieved |
| NHL – Stable after CVP | 375 mg/m² once weekly | 4 doses at 6-month intervals (up to 16 doses) | For patients with stable disease after initial chemo |
| Diffuse Large B-Cell NHL (DLBCL) | 375 mg/m² on Day 1 of chemo cycle | Up to 8 cycles | Used with anthracycline-based chemotherapy |
| Chronic Lymphocytic Leukemia (CLL) | 375 mg/m² Day before Cycle 1, then 500 mg/m² for Cycles 2–6 | Every 28 days | Given with FC chemotherapy (fludarabine and cyclophosphamide) |
| Rheumatoid Arthritis (RA) | 1,000 mg x 2 doses, 2 weeks apart | Repeat every 24 weeks (not sooner than 16 weeks) | Given methotrexate, premedication with methylprednisolone is advised |
| GPA / MPA – Induction | 375 mg/m² once weekly | 4 weeks | Used with glucocorticoids |
| GPA / MPA – Follow-up | 500 mg x 2 doses, 2 weeks apart, then 500 mg every 6 months | Ongoing based on evaluation | Timing may vary based on previous induction treatment |
| Pemphigus Vulgaris (PV) – Initial | 1,000 mg x 2 doses, 2 weeks apart | One-time initial treatment | Given with tapering steroids |
| PV – Maintenance | 500 mg | Month 12, then every 6 months | Based on the doctor’s evaluation |
| PV – Relapse | 1,000 mg | At the time of relapse | Can repeat if symptoms return; wait at least 16 weeks between doses |
Usage Guide
Ruxience is given through a slow infusion into a vein, usually in the arm. This is known as intravenous infusion.
The Ruxience route of administration is always supervised by a trained healthcare professional.
You will not take Ruxience by mouth or on your own. Before each dose, your doctor may administer other treatments to help reduce the risk of side effects, such as fever or chills.
Your health will be closely monitored throughout treatment, including regular blood tests and health assessments before each visit.
How to Administer Ruxience?
- Ruxience is only given at a healthcare facility where trained staff can monitor you. It cannot be used at home.
- Before the infusion begins, your healthcare provider may administer other treatments, such as antihistamines or acetaminophen. These help reduce reactions like fever, chills, or rash.
- A nurse or doctor will place a needle in a vein, usually in your arm, or use a central catheter if you already have one. The Ruxience route of administration is always by slow drip into the vein.
- Your first infusion may take several hours to complete. The staff will slowly increase the rate if you feel well. Later doses may go faster if there were no problems the first time.
- Before each visit, your doctor or nurse will ask about your general health. Always report any new symptoms, such as fever, rash, or feeling tired.
- Your doctor will monitor your blood counts during and after treatment. This helps check for side effects and keeps your treatment safe.
Side Effects
Ruxience may cause both common and serious side effects. Some may happen during the infusion, while others may appear later.
Knowing the possible side effects of Ruxience, including infusion-related side effects and long-term side effects, can help you stay informed and prepared during your treatment.
These side effects are more likely to happen and are usually mild to moderate:
- Reactions during the infusion, such as fever, chills, or rash
- Infections (can include fever, sore throat, or cold symptoms)
- Feeling tired
- Nausea
- Body aches
- Muscle spasms
- Diarrhea
- Joint pain during or soon after infusion
- Swelling in the body
- Low white or red blood cell counts
- More frequent colds or upper respiratory infections
These side effects are less common but can be serious or life-threatening. Seek medical help right away if any of these occur:
- Tumor Lysis Syndrome (TLS)
- Nausea, vomiting, diarrhea, or feeling very tired
- TLS can lead to kidney failure or abnormal heart rhythms
- Serious infections
- Fever, flu-like symptoms, cold sores, or painful urination
- Low antibody levels for a long time after treatment
- Heart problems
- Chest pain or irregular heartbeats
- Risk of heart attack in people with heart disease
- Kidney problems
- Changes in blood tests may show signs of kidney damage
- Stomach or bowel problems
- Severe belly pain or ongoing vomiting
- Bowel tears or blockages may occur, especially with chemotherapy
Missed Dose
If you miss a dose of Ruxience or forget your scheduled appointment, contact your doctor as soon as possible.
It is important to follow your Ruxience dosing schedule to get the full benefit of the treatment. Your doctor will help you reschedule and make sure your Ruxience dose stays on track.
Overdose
Ruxience is given by a trained healthcare professional in a clinic or hospital.
Because of this, an overdose is very unlikely. However, if you believe you received more than your recommended Ruxience dose, let your healthcare team know right away.
They will monitor you for any signs of side effects and provide support if needed.
Warnings
Before starting Ruxience, it is important to know about serious safety risks. This treatment can cause severe side effects, especially during or after the infusion.
Talk to your doctor about your full medical history, including past infections, heart problems, or if you are pregnant or breastfeeding.
What Are the Ruxience Warnings?
- Ruxience can cause severe infusion-related reactions. These may include rash, low blood pressure, swelling, breathing trouble, or chest pain. Most reactions happen during the first infusion and may need immediate medical care.
- Some people may experience severe skin reactions, such as blisters, peeling, or painful rashes. These may lead to hospitalization or be life-threatening.
- Ruxience may reactivate the hepatitis B virus in individuals who have previously been infected with it. This can lead to liver damage or death. Your doctor should test you before starting treatment.
- A brain infection called progressive multifocal leukoencephalopathy (PML) can occur. It may cause memory loss, trouble walking, or vision problems.
- Tumor lysis syndrome may occur within 24 hours of infusion. This happens when cancer cells break down quickly, which can harm your kidneys or heart.
- You may develop serious bacterial, fungal, or viral infections during or after treatment. Ruxience can lower your immune system, which makes infections more likely.
- Heart problems like irregular heartbeat or heart attack can occur during treatment. Your doctor may monitor your heart if you have a history of heart disease.
- Some people may have kidney problems, especially those with non-Hodgkin lymphoma. This may lead to kidney failure and requires close monitoring.
- Ruxience may cause stomach or bowel problems, such as severe pain, bowel obstruction, or bowel tears.
- Live vaccines should not be given during or shortly before treatment. Tell your doctor about any recent or upcoming vaccines.
- Ruxience can harm an unborn baby. Use birth control during treatment and for 12 months after the last dose.
- Do not use other biologic treatments or DMARDs unless your doctor says it is safe. Using them together may raise the risk of side effects.
- Ruxience is not recommended for patients with rheumatoid arthritis who have not tried other treatments, such as TNF blockers.
Boxed Warning and Precautions for Ruxience
| Ruxience can cause serious and sometimes fatal infusion-related reactions, including severe breathing problems, heart issues, or allergic responses. These reactions usually happen during the first dose.
Your healthcare provider will premedicate you to reduce these risks and monitor you closely during the infusion. Inform your doctor immediately if you experience lightheadedness, difficulty breathing, or chest pain during treatment. |
Contraindications
There are no known reasons that completely prevent the use of Ruxience. However, your doctor will decide if Ruxience is right for you based on your medical history and current health condition. Always talk to your doctor before starting any new treatment.
Interactions
- Fludarabine
- Cyclophosphamide
- Methotrexate
- Other treatments used for rheumatoid arthritis
- Treatments that lower immune system activity
- Treatments that may cause low blood cell counts
- Vaccines, especially live vaccines
Storage Information
Store Ruxience in a refrigerator at a temperature between 2 to 8 degrees Celsius or 36 to 46 degrees Fahrenheit.
Keep the vials in their original carton to protect them from light. Do not freeze or shake the vials. Always store Ruxience away from direct sunlight.
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Cost of Ruxience in Canada
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Frequently Asked Questions
Disclaimer
Pharma Giant provides medical information to help you better understand medications and medical conditions.This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications.
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