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Pemphigus vulgaris
Adult: For moderate to severe cases: 1,000 mg for 2 doses separated by 2 weeks. Maintenance: 500 mg at months 12 and 18, then every 6 months thereafter, if necessary, based on clinical assessment. Doses to be given via infusion. 1st infusion may be initiated at 50 mg/hour and may be increased in 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and may be increased by 100 mg/hour increments every 30 minutes, to Max rate of 400 mg/hour. In case of relapse, may give 1,000 mg via infusion. Subsequent infusions may be administered no sooner than 16 weeks after the previous infusion. Premedicate with paracetamol and antihistamine before each infusion; administration of glucocorticoids (e.g. methylprednisolone) 30 minutes prior to each infusion is also recommended. Administer prophylaxis for Pneumocystis jirovecii pneumonia during and following treatment, as appropriate according to local clinical guidelines.
Intravenous
Rheumatoid arthritis
Adult: In combination with methotrexate for patients with moderately- to severely-active cases who have had inadequate response to, or who are intolerant to other disease-modifying anti-rheumatic drugs including 1 or more tumour necrosis factor inhibitors: 1,000 mg for 2 doses separated by 2 weeks. Subsequent courses may be given every 24 weeks or according to clinical evaluation, but no sooner than every 16 weeks. Doses to be given via infusion. 1st infusion may be initiated at 50 mg/hour and may be increased in 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and may be increased by 100 mg/hour increments every 30 minutes, to Max rate of 400 mg/hour. Premedicate with paracetamol and antihistamine before each infusion; administration of glucocorticoids (e.g. methylprednisolone) 30 minutes prior to each infusion is also recommended.
Intravenous
Granulomatosis with polyangiitis, Microscopic polyangiitis
Adult: In combination with glucocorticoids for patients with severe, active cases: Induction therapy: 375 mg/m2 once weekly for 4 doses. Maintenance therapy: 500 mg for 2 doses separated by 2 weeks, then 500 mg once every 6 months thereafter. Doses to be given via infusion. 1st infusion may be initiated at 50 mg/hour and may be increased in 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and may be increased by 100 mg/hour increments every 30 minutes, to Max rate of 400 mg/hour. Premedicate with paracetamol and antihistamine before each infusion. Administer prophylaxis for Pneumocystis jirovecii pneumonia during and following treatment, as appropriate according to local clinical guidelines.
Child: ≥2 years In combination with glucocorticoids: Induction therapy: 375 mg/m2 once weekly for 4 weeks given via infusion. Maintenance therapy: 250 mg/m2 for 2 doses separated by 2 weeks given via infusion, then 250 mg/m2 every 6 months based on clinical assessment. Premedicate with paracetamol and antihistamine before each infusion. Administer prophylaxis for Pneumocystis jirovecii pneumonia during and following treatment, as appropriate.
Child: ≥2 years In combination with glucocorticoids: Induction therapy: 375 mg/m2 once weekly for 4 weeks given via infusion. Maintenance therapy: 250 mg/m2 for 2 doses separated by 2 weeks given via infusion, then 250 mg/m2 every 6 months based on clinical assessment. Premedicate with paracetamol and antihistamine before each infusion. Administer prophylaxis for Pneumocystis jirovecii pneumonia during and following treatment, as appropriate.
Intravenous, Subcutaneous
Refractory follicular lymphoma, Relapsed follicular lymphoma
Adult: As monotherapy: 375 mg/m2 once weekly for 4 or 8 doses given via infusion. Alternatively, initiate at least 1 full dose of rituximab IV infusion followed by SC inj of 1,400 mg once weekly for 3 or 7 weeks. In combination with chemotherapy for induction therapy: 375 mg/m2 on day 1 of each cycle via infusion for up to 8 cycles. Maintenance: 375 mg/m2 once every 3 months via infusion; starting 3 months after the last dose of induction therapy. Alternatively, initiate at least 1 full dose of rituximab IV infusion on cycle 1 followed by SC inj of 1,400 mg per cycle for up to 8 cycles. Maintenance: 1,400 mg once every 3 months via SC inj; starting 3 months after the last dose of induction. In case of retreatment following relapse: 1,400 mg once weekly via SC inj for 3 weeks. Continue maintenance therapies until disease progression or for a Max of 2 years (total of 8 doses). SC inj may be given over approx 5 minutes. Infusions may be initiated at 50 mg/hour and increased by 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and increased by 100 mg/hour increments every 30 minutes. Max rate: 400 mg/hour. Premedicate with paracetamol and antihistamine before each dose; glucocorticoid may also be considered. Individual products or dosage forms are not interchangeable (refer to specific product guideline).
Intravenous, Subcutaneous
CD20-positive diffuse large B cell non-Hodgkin's lymphoma
Adult: In combination with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) chemotherapy or other anthracycline-based regimens: 375 mg/m2 via infusion on day 1 of each cycle, after the administration of glucocorticoid component of the chemotherapy if applicable, for up to 8 cycles. 1st infusion may be initiated at 50 mg/hour and may be increased in 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and may be increased by 100 mg/hour increments every 30 minutes, to Max rate of 400 mg/hour. Alternatively, initiate at least 1 full dose of rituximab IV infusion in combination with CHOP chemotherapy followed by SC inj of 1,400 mg over approx 5 minutes on day 1 of each subsequent cycle for up to 8 cycles. Premedicate with paracetamol and antihistamine before each administration. Individual products or dosage forms are not interchangeable (refer to specific product guideline).
Intravenous, Subcutaneous
Chronic lymphocytic leukaemia
Adult: In combination with chemotherapy for patients with previously untreated and relapsed or refractory cases: 375 mg/m2 via infusion on the day before chemotherapy in cycle 1, then 500 mg/m2 on day 1 of each subsequent cycle, for a total of 6 cycles. 1st infusion may be initiated at 50 mg/hour and may be increased in 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and may be increased by 100 mg/hour increments every 30 minutes, to Max rate of 400 mg/hour. Alternatively, initiate at least 1 full dose of rituximab IV infusion followed by SC inj of 1,600 mg over approx 7 minutes on day 1 of each subsequent cycle (total of 6 cycles). Premedicate with paracetamol and antihistamine before each infusion; glucocorticoid may also be considered if not part of the chemotherapy regimen. Prophylaxis treatments may also be given (refer to local treatment guidelines). Individual products or dosage forms are not interchangeable (refer to specific product guideline).
Intravenous, Subcutaneous
Advanced follicular non-Hodgkin's lymphoma
Adult: In previously untreated patients: In combination with chemotherapy for induction treatment: 375 mg/m2 via infusion on day 1 of each chemotherapy cycle, for up to 8 cycles. Maintenance: 375 mg/m2 once every 2 months via infusion; starting 2 months after the last dose of induction therapy. 1st infusion may be initiated at 50 mg/hour and increased by 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and may be increased by 100 mg/hour increments every 30 minutes, to Max rate of 400 mg/hour. Alternatively, initiate at least 1 full dose of rituximab IV infusion followed by SC inj of 1,400 mg over approx 5 minutes on day 1 of cycles 2-8 of chemotherapy. Maintenance: 1,400 mg once every 2 months via SC inj; starting 2 months after the last dose of induction. Continue maintenance therapies until disease progression or for a Max duration of 2 years (total of 12 doses). Premedicate with paracetamol and antihistamine before each administration; glucocorticoid may also be considered if not part of the chemotherapy regimen. Individual products or dosage forms are not interchangeable (refer to specific product guideline).
Intravenous, Subcutaneous
CD20-positive non-progressing low-grade non-Hodgkin's lymphoma
Adult: As monotherapy following 6-8 cycles of CVP (cyclophosphamide, vincristine, and prednisone) chemotherapy: 375 mg/m2 via infusion once weekly for 4 doses at 6-month intervals, for up to a Max of 16 doses. 1st infusion may be initiated at 50 mg/hour and may be increased in 50 mg/hour increments every 30 minutes; subsequent doses may be infused at 100 mg/hour and may be increased by 100 mg/hour increments every 30 minutes, to Max rate of 400 mg/hour. Alternatively, initiate at least 1 full dose of rituximab IV infusion followed by SC inj of 1,400 mg over approx 5 minutes once weekly for 3 weeks at 6-month intervals, up to a Max of 16 doses. Premedicate with paracetamol and antihistamine before each administration; glucocorticoid may also be considered. Individual products or dosage forms are not interchangeable (refer to specific product guideline).
