Hi Lea,

Good luck with your infusion tomorrow.

I've getting Rituxan infusions since April, 2008. I've never had any problems in some 50 infusions. There's a relatively new protocol for administering Rituxan, that speeds things up, but I'm sure they'll be conservative, since this is your first infusion.

You can expect a couple of pre-meds to stave off possible reaction: I get 100 mg solumedrol and 25 mg benadryl, both in IV, plus tylenol. I used to get 50 mg benadryl, but I nnever needed that much, and the lesser dose lets me be more alert.

Your vitals (bp, hr, o2 sat, maybe temp) will be monitored every 30 minutes. If all is good, then they'll increase the flow rate. If not, they'll either stop the infusion or wait another 30 minutes before increasing the flow. Max flow rate is 400 ml/hr, and some places quit monitoring after you reach that.

The old protocol was 1000 mg Rituxan mixed in a 1000 ml solution. The initial flow rate was 50 ml/hr, and the intial increment was also 50 mg, until you reached 400 ml/hr, and then 100 l/hr 'til it was gone. The 2nd infusion in a set was a little more generous, with start flow and increments at 100 ml/hr. You can calculate how long it takes if there's no delay from monitoring vitals.

You may always get that, but the newer protocol that I have is 1000 mg Rituxan dissolved in 500 ml solution, so that alone cuts time in half. The initial and incremental rates are always 100 ml/hr. Ask which protocol they're using.

Drink plenty of water the day before, to plump your veins to make it easier to insert the IV needle. Maybe you already have a port, in which case, never mind. I had my infusions in an out-patient chemo room until the last couple of years. They provided lunch and all the snacks you wanted, and they billed insurance 4 times as much as my doctor's office does. If you're not sure, bring snacks and entertainment.

Best wishes,
bc

Thank you very much @buddhacat. I appreciate your feedback!

How did the Rituxan go?

I was on Rituxan for 3 years. It took three months to work, so don't get anxious if it doesn't work quickly. I was in seminary when I was on Rituxan. I took my papers to write, flash cards for Greek and Hebrew, and my computer. I told A lady in another forum on DS I was bored, so she organized a cruise for everyone in that forum. We had great fun on that imaginary journey!

It worked about 98% for me, for 4 months, except my wrists. But in Canada there is no protocol for 4 month infusions, IOW. Insurance wouldn't pain for the shorter interval. So I had to do the 6 month, which wasn't 6 months till you got your next infusion, but 6 months till you could get an appointment to be re-evaluated, wait for the doctor's signature, send it to insurance, wait for snail mail to deliver the approval, then phone for the infusion appointment, which was usually 2 weeks more. One summer, my doctor went in holiday right when he was supposed to sign it. With one thing and another, I was 8 months between infusions. So 4 months ok, and 4 months with flares everywhere. That is why I quit. Bad Alberta protocols. Even BC us much better than that!

It also bothered my lungs. I've never been able to breathe properly since the day I started. One more thing was the 100 mg is Solumedrol started shutting down my adrenal gland. I had adrenal insufficiency for 4 months, I was so tired, I used to describe it as feeling like all the blood at drained out of my body. The last set of infusions, my rheumatologist told me to take 20 mg of oral prednisone before I went to my infusion, and it didn't happen.

I hope it works for you. It's great to be on a drug that is 6 months between infusions.. No dragging meds and needles around on vacations and trips.

Marlene brings up a good point about Rituxan taking a while to work. t took 8 weeks after my first pair of infusions to notice any benefit, but I compare that to 4 months to see any goodness from methotrexate. After those first 8 weeks, I had 3 excellent months, before a gradual taper back to square one. After the 2nd set of infusions, it took 7 weeks to feel the benefit, and I never looked back. From December 17, 2008, I've had almost complete pain relief from Rituxan. A few years ago, I began to notice sharp pains in my fingers after 5 months, so I went from a 6 month to 5 month schedule.

How did your infusion work out?

Where do drug infusion such as rituximab take place? Do you have to travel?

Some Rheumatologists have an infusion lounge and do it in their office. I had to go to a Hematologist who monitored my bloodwork and gave the IV at his infusion center. They typically have vinyl recliners and free wifi to pass the time.

Oh I see thank you for the reply.

Good luck!