ibritumomab

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Pronunciation: ib ri TYOO mo mab

Brand: In-111 Zevalin, Y-90 Zevalin

What is the most important information I should know about ibritumomab?

Life-threatening reactions may occur during the injection or within 24 hours afterward. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when ibritumomab is injected. Get emergency medical help if you feel itchy, light-headed or short of breath, or if you have chest tightness or pain spreading to your jaw or shoulder.

Ibritumomab can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily.

Serious and sometimes fatal infections or skin reactions may occur during treatment with ibritumomab, and up to 4 months afterward. Call your doctor right away if you have: redness, ulcers, or skin changes where the medicine was injected; or if you have swelling in your face or tongue, burning in your eyes, skin pain, or a skin rash that spreads and causes blistering and peeling.

What is ibritumomab?

Ibritumomab is a protein that targets white blood cells in the body. When ibritumomab is attached to a radioactive chemical, the radiation is delivered directly to the tumor (lymphoma).

Ibritumomab is used in combination with other medicines to treat non-Hodgkin's lymphoma.

Ibritumomab may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before receiving ibritumomab?

You should not receive this medicine if you are allergic to ibritumomab, or to radioactive chemicals or mouse proteins.

To make sure ibritumomab is safe for you, tell your doctor if you have:

  • liver disease;
  • kidney disease;
  • any type of infection;
  • lung or breathing problems;
  • bleeding or blood clotting problems;
  • low platelet counts;
  • low blood pressure;
  • a history of heart disease, heart attack, angina (chest pain), or irregular heart beats; or
  • if you take a blood thinner (warfarin, Coumadin) or other medicine to prevent blood clots.

Using ibritumomab may increase your risk of developing other types of cancer, such as leukemia. Ask your doctor about your specific risk.

Ibritumomab is made from human plasma (part of the blood) which may contain viruses and other infectious agents. Donated plasma is tested and treated to reduce the risk of it containing infectious agents, but there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of using this medication.

Do not use ibritumomab if you are pregnant. It could harm the unborn baby. Tell your doctor right away if you become pregnant during treatment. Use effective birth control while you are using this medicine and for at least 12 months after your treatment ends.

Ibritumomab can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How is ibritumomab given?

Ibritumomab is used in combination with rituximab (Rituxan) and a radioactive chemical. Ibritumomab is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when ibritumomab is injected.

You may be given medicine to prevent certain side effects while you are receiving ibritumomab. Take all of the medicines your doctor has prescribed.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with ibritumomab may cause you to bruise or bleed easily.

Ibritumomab can lower blood cells that help your body fight infections and help your blood to clot. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your ibritumomab injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving ibritumomab?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while using ibritumomab, and for at least 12 months after your treatment ends. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

What are the possible side effects of ibritumomab?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Life-threatening reactions may occur during the injection or within 24 hours afterward. Get emergency medical help if you feel itchy, light-headed or short of breath, or if you have chest tightness or pain spreading to your jaw or shoulder. These reactions can occur during the injection or within 24 hours afterward.

Call your doctor at once if you have:

  • pain, burning, redness, or skin changes where the medicine was injected;
  • fever, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, trouble breathing;
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • jaw pain or numbness, red or swollen gums, problems with your teeth, trouble eating or swallowing, hoarse voice;
  • slow wound healing, skin ulcers; or
  • severe skin reaction --fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, stomach pain, diarrhea;
  • fever, cough;
  • stuffy nose, sore throat, sinus pain; or
  • feeling weak or tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ibritumomab?

Other drugs may interact with ibritumomab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

Your doctor or pharmacist can provide more information about ibritumomab.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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