Key takeaways

  • Truxima is a biosimilar version of the brand-name drug Rituxan. Biosimilars tend to be less expensive than their brand-name versions.
  • Doctors prescribe Truxima to treat conditions such as rheumatoid arthritis or non-Hodgkin’s lymphoma in adults.
  • Truxima is administered via intravenous infusion by a healthcare professional at a hospital or another healthcare facility.

Truxima is prescribed to treat the following conditions in adults:

To learn more about Truxima’s uses, see “Is Truxima used for rheumatoid arthritis?” and “Is Truxima used for other conditions?”

Truxima basics

The active ingredient in Truxima is rituximab-abbs. (The active ingredient is what makes a drug work.) It belongs to a group of drugs called monoclonal antibodies, and it’s a kind of immunotherapy.

Truxima is a biologic drug. A biologic is made from living cells, while other drugs are made from chemicals. Drugs made from chemicals can have generic versions, which contain an exact copy of the active ingredient in the brand-name medication. (An active ingredient is what makes a drug work.) Biologics, on the other hand, cannot be copied exactly.

Instead of a generic version, a biologic has a biosimilar version. Biosimilars are “similar” to the parent drug and are considered just as effective and safe. Like generic drugs, biosimilars are often less expensive than brand-name drugs. Truxima is a biosimilar version of the brand-name drug Rituxan (rituximab).

Truxima comes as a liquid solution given as an intravenous (IV) infusion (an injection into a vein given over time). A healthcare professional will give you Truxima infusions at a hospital or another healthcare facility.

Truxima is a biosimilar version of Rituxan (rituximab), a brand-name biologic drug. (See “Truxima basics” for more information about biosimilar and biologic drugs.)

While Truxima and Rituxan are very similar, one key difference is that Rituxan may be used to treat certain conditions in some children. Truxima is only used in adults.

To learn more about Truxima’s uses, see “Is Truxima used for rheumatoid arthritis?” and “Is Truxima used for other conditions?” To find out whether Truxima is as effective as Rituxan for rheumatoid arthritis, see the “Ask the pharmacist” section at the end of this article.

For more information about which medication is right for your condition, talk with your doctor.

Like most drugs, Truxima may cause mild to serious side effects. While the following lists include some of the more common ones, they do not include all the possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Truxima. They can also suggest ways to help relieve any side effects.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while receiving Truxima and want to tell the FDA about it, visit MedWatch or call 800-332-1088.

Mild side effects

Here is a list of some of the mild side effects Truxima can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the drug’s prescribing information.

Truxima’s side effects may vary, depending on the condition you’re using the drug to treat.

Mild side effects that have been reported include:

  • tiredness
  • body aches
  • muscle spasms
  • joint pain
  • fever
  • chills
  • weakness
  • headache
  • anemia (low red blood cell count)
  • edema (fluid buildup and swelling in your lower legs or hands)
  • digestive side effects, such as diarrhea or nausea
  • mild infection

Mild side effects of many drugs go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Truxima are possible, but they are not common. If you have serious side effects from this drug, call your doctor right away. But if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects of Truxima that have been reported include:

Allergic reaction

Some people may have an allergic reaction to Truxima. It is not clear whether this side effect occurred in studies of the drug, but it can still happen.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat, which can cause trouble breathing

Call your doctor right away if you have an allergic reaction to Truxima. But if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Find answers to some common questions about Truxima here.

Is Truxima used to treat multiple sclerosis (MS)?

Truxima is not approved to treat MS, but the drug can be used off-label for this purpose. Off-label use is when a drug is used to treat a condition other than those it’s approved for by the Food and Drug Administration.

A review of studies has shown that rituximab may be a safe and effective treatment for relapsing-remitting MS and progressive types of MS, such as primary progressive MS.

Truxima belongs to a group of drugs called monoclonal antibodies. Other drugs in this group are FDA-approved for treating MS, such as:

If you’d like guidance about the best treatment option for your MS, talk with your doctor.

Does Truxima cause hair loss?

Alopecia (hair loss) was not reported as a side effect in Truxima’s studies. But it’s a possible side effect of a very similar drug, Rituxan (rituximab).

Hair loss was reported in a study that looked at Rituxan for treating pemphigus vulgaris. (Truxima was recently approved by the FDA to treat this condition.)

If you’re having hair loss during treatment with Truxima, talk with your doctor. They may be able to determine why this is happening and suggest ways to manage it.

How long does a Truxima infusion take?

A Truxima infusion takes at least 90 minutes. The drug is given as an intravenous (IV) infusion (an injection into a vein given over time). A healthcare professional will give you the infusions at a hospital or another healthcare facility.

You should allow several hours for your appointment. Before the infusion, you’ll likely receive drugs to help prevent or minimize infusion-related reactions. And you’ll need to stay for a while after the infusion so that a healthcare professional can treat any infusion side effects that might occur.

Costs of prescription drugs can vary, depending on many factors, such as what your insurance plan covers.

Truxima is a biosimilar version of Rituxan (rituximab), a brand-name biologic drug. A biologic is made from living cells, while other drugs are made from chemicals. Drugs made from chemicals can have generic versions, which are exact copies of the active drug in the brand-name medication. Biologics, on the other hand, cannot be copied exactly.

Instead of a generic, a biologic drug has a biosimilar. Biosimilars are “similar” to the parent drug and are considered just as effective and safe. Like generic-name drugs, biosimilars are often less expensive than their brand-name versions.

Talk with your doctor if you have questions about the cost of treatment alternatives, such as Rituxan.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the manufacturer’s patient assistance website for information about different support options.

You may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits, but the discounted price may be lower than what you would pay through insurance.

Truxima is used to treat rheumatoid arthritis (RA) in adults. RA is an autoimmune condition in which your immune system mistakenly attacks your joints and other healthy tissues. This causes inflammation (swelling and damage) throughout your body.

Truxima is used to reduce the symptoms of moderate to severe active RA. For this use, it’s prescribed with another drug called methotrexate (Trexall, Rasuvo, others).

Specifically, Truxima is used in adults who have already tried at least one other kind of medication, called a tumor necrosis factor (TNF) antagonist, but it did not work well enough for their RA.

Examples of TNF antagonists include:

Truxima is thought to treat RA by targeting a certain protein that’s on some B cells (a type of white blood cell). Truxima attaches to this protein, and in doing so signals your immune system to destroy the B cells. This may reduce inflammation, ease related symptoms, and slow the progression of RA.

Truxima is also used to treat the following conditions in adults:

Truxima treats these conditions in specific situations. The sections that follow outline these situations. Your doctor can give you additional details.

Truxima is thought to work by attaching to certain proteins in your body. In doing so, it signals your immune system to destroy B cells (a type of white blood cell). This can help reduce the number of cancerous cells in your body and may also reduce inflammation (swelling and damage). To learn more about how the drug works for your condition, talk with your doctor.

Truxima for non-Hodgkin’s lymphoma (NHL)

NHL is a cancer of the lymphatic system, which is part of your immune system. Truxima is used in adults with a certain kind of NHL. To learn more about the drug’s use for this condition, talk with your doctor.

For this use, Truxima is either prescribed alone or with chemotherapy drugs. Your doctor will tell you more about the kind of NHL you may have and how Truxima can help treat it. They’ll also tell you whether you’ll receive any other drugs to treat your cancer.

Truxima for chronic lymphocytic leukemia (CLL)

Truxima is used to treat CLL in adults. This is a kind of blood cancer that begins in the bone marrow, where your body makes blood cells.

Truxima is used in adults with a certain kind of CLL. For this use, Truxima is prescribed together with two chemotherapy drugs: cyclophosphamide (Cytoxan) and fludarabine. Truxima is used in adults who have had past treatments for their CLL and those who have not had such treatments.

Truxima for granulomatosis with polyangiitis (GPA)

GPA is an autoimmune disorder in which your immune system attacks your own blood vessels by mistake. This causes inflammation in your blood vessels.

For treating GPA, Truxima is prescribed with glucocorticoids (commonly called steroids), such as prednisone.

Truxima for microscopic polyangiitis (MPA)

MPA is a kind of necrotizing vasculitis, a condition in which you have inflammation in your blood vessels. It’s a rare autoimmune disorder that can damage your smallest blood vessels, called capillaries. The lungs and kidneys are commonly affected because these organs contain networks of capillaries.

For treating MPA, Truxima is prescribed with glucocorticoids (commonly called steroids), such as prednisone.

Truxima for pemphigus vulgaris

Pemphigus vulgaris is a condition that affects your mucous membranes. These membranes line your mouth and throat, nose, eyes, and other areas of your body. Symptoms include painful blisters that ooze, form crusts, or peel.

For treating pemphigus vulgaris, Truxima may be prescribed on its own.

Other uses

Truxima may also be used off-label to treat other conditions. (Off-label use is when a drug is used to treat a condition other than those it’s approved for.) Talk with your doctor for more information.

Here you’ll find dosages for Truxima recommended by the manufacturer, but your doctor will determine the dosage you receive.

Form

Truxima comes in vials of liquid solution. The drug will be prepared and given to you by a healthcare professional as an intravenous (IV) infusion. (This is an injection into a vein given over time.) You’ll receive these infusions at a hospital or another healthcare facility.

Prior to receiving Truxima

Your doctor will likely order tests for hepatitis B and complete blood count before you receive your first dose of Truxima. This is to help determine whether the drug is safe for you to receive.

Your doctor will order additional blood work prior to each dose of Truxima that you receive.

They will also likely have you take acetaminophen (Tylenol) and an antihistamine before each Truxima IV infusion.

Recommended dosages

The dosing schedule for Truxima varies, depending on the condition you’re using it to treat. You may receive your infusion as often as once weekly. Or you may have several weeks or months between infusions.

For some conditions, you may take other drugs along with Truxima. Your doctor will give you dosage instructions for any other drugs you may take during treatment.

The following are dosages recommended by the manufacturer of Truxima for adults. Your doctor will explain how often you’ll receive this drug to treat your condition.

Dosage for rheumatoid arthritis

For rheumatoid arthritis (RA), you’ll first receive 1,000 mg of Truxima followed by another 1,000 mg 2 weeks later. This RA dosage is referred to as a full course.

Based on your RA symptoms, your doctor will give you a full course of Truxima every 16 to 24 weeks.

Dosage for non-Hodgkin’s lymphoma

For non-Hodgkin’s lymphoma, you’ll receive a dosage of Truxima that is based on your body surface area in square meters (m2). The recommended dose is 375 mg/m2.

Your dosage will depend on the type of non-Hodgkin’s lymphoma you have and whether you are receiving Truxima alone or with chemotherapy.

For example, if you have non-Hodgkin’s lymphoma that has the following characteristics, your doctor will likely recommend that you receive Truxima once weekly for 4 to 8 weeks.

  • relapsed (returned after treatment) or refractory (does not respond to treatment)
  • low-grade or follicular
  • CD20-positive (the cancer cells have a protein called CD20 on the surface)
  • originates in the B-cells (cells that are part of the immune system)

For details about Truxima dosages for the other types of non-Hodgkin’s lymphoma this drug is prescribed to treat, see this Truxima dosage article. Your doctor can also give you more details on Truxima dosages for this condition.

Dosage for chronic lymphocytic leukemia

For chronic lymphocytic leukemia, you’ll receive a dosage of Truxima that is based on your body surface area in m2.

You’ll receive a 375 mg/m2 dose of Truxima prior to starting chemotherapy. Then you’ll receive 500 mg/m2 on day 1 of chemotherapy cycles 2 to 6 (every 28 days). With chemotherapy cycles, you receive chemotherapy drugs followed by a period of rest.

Dosage for granulomatosis with polyangiitis

For granulomatosis with polyangiitis, you’ll start with a dosage that will help destroy inflammatory cells. This is called induction treatment. After induction treatment, you’ll receive a lower dosage to help manage your condition. This is called maintenance treatment.

For induction, the recommended dosage is 375 mg/m2 once weekly for 4 weeks. For maintenance, the dosage is 500 mg followed by another 500 mg 2 weeks later. Then you’ll receive 500 mg every 6 months.

Dosage for microscopic polyangiitis

The dosage of Truxima for microscopic polyangiitis is the same as it is for granulomatosis with polyangiitis. For more information, see the section that precedes this one.

Dosage for pemphigus vulgaris

For pemphigus vulgaris, you’ll receive 1,000 mg of Truxima. This will be followed by another 1,000 mg of Truxima 2 weeks later.

If your symptoms are managed, you’ll receive 500 mg of Truxima after 12 months. You’ll continue receiving 500 mg of the drug every 6 months.

If your symptoms return, you’ll receive 1,000 mg of Truxima.

Note that the manufacturer recommends waiting at least 16 weeks between doses of Truxima.

Questions about Truxima’s dosage

Here are some common questions about Truxima’s dosage.

  • What if I miss a dose of Truxima? Call your doctor’s office right away if you miss an infusion appointment. They’ll work with you to reschedule your Truxima infusion as soon as possible.
  • Will I need to use Truxima long term? It depends on the condition you’re using Truxima to treat. If you and your doctor decide that it’s working well for you and does not cause severe side effects, you’ll likely use it long term for certain health conditions. But for other conditions, there’s a recommended number of Truxima infusions. Talk with your doctor to learn more about how long you’ll likely use Truxima.
  • How long does Truxima take to work? Truxima starts working as soon as you receive your first dose. But it may take a few weeks before it begins to relieve your symptoms. In some cases, you may have blood tests to check how well Truxima is working.

Your doctor will explain how Truxima will be given to you, how much you’ll be given, and how often.

Receiving Truxima

Truxima comes in vials of liquid solution. The drug will be prepared and given to you by a healthcare professional as an intravenous (IV) infusion. (This is an injection into a vein given over time.) You’ll receive these infusions at a hospital or another healthcare facility.

It takes at least 90 minutes to receive a Truxima infusion. (For more details about this, see “What are some frequently asked questions about Truxima?”)

Using Truxima with other drugs

Depending on the condition Truxima is being used to treat, your doctor may prescribe other drugs for you to take with it. Your doctor can tell you more about whether Truxima is used with other medications for your condition.

Questions for your doctor

You may have questions about Truxima and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Truxima affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if it will help you feel more comfortable.
  • If you do not understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So do not be afraid to ask questions or offer feedback on your treatment.

This section talks about some important things to discuss with your doctor when you’re considering Truxima treatment. They include any other medical conditions and any ongoing treatments you may have.

Interactions

Using a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Interactions with drugs or supplements

Truxima can interact with the chemotherapy drug cisplatin. Using these drugs together could increase the risk of kidney problems, such as kidney failure.

No other drug interactions with Truxima are known. Still, before starting the treatment, be sure to tell your doctor about all the medications you take, including prescription and over-the-counter kinds. Also describe any vitamins, herbs, or supplements you take. Your doctor or pharmacist can tell you about any interactions these items may cause.

Boxed warnings

Truxima has several boxed warnings, listed here. These are serious warnings from the Food and Drug Administration (FDA) about drug effects that may be dangerous. For more information, refer to “Boxed warnings” near the beginning of this article.

Other warnings

Truxima may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting treatment. Factors to consider include those listed here:

  • infections or immune system problems
  • heart problems
  • kidney problems
  • recent vaccination with a live vaccine (a vaccine with a weakened form of a virus or bacterium)
  • allergic reaction to Truxima, Rituxan (rituximab), or any of their ingredients
  • pregnancy
  • breastfeeding
  • alcohol consumption

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.