90-minute infusion for previously untreated DLBCL and follicular NHL patients in Cycles 2-8

The 90-minute infusion rate means some of your patients may be able to receive RITUXAN therapy in half the average time of the standard infusion.1-3


  • *For standard infusions in Cycles 2-8, initiate at a rate of 100 mg/hr. In the absence of infusion toxicity, increase rate by 100 mg/hr increments at 30-minute intervals, to a maximum of 400 mg/hr.1

The faster infusion can be administered to patients who1-3

    • Have previously untreated DLBCL or follicular lymphoma, receiving R-CHOP or R-CVP, respectively
    • Are ≥18 years of age
    • Have an ECOG PS 0-2
    • Have a circulating lymphocyte count ≤5,000/µL at the start of Cycle 2
    • Did not experience any infusion-related serious adverse event (SAE) or Grade 3/4 infusion-related reaction (IRR) in Cycle 1
    • Do not have significant cardiovascular disease
  • Patients in Stage 3 or 4 of DLBCL and follicular lymphoma were included in the RATE (U4391g) trial2,3
  • All patients were premedicated with acetaminophen and an antihistamine prior to RITUXAN administration1-3
  • Patients had a glucocorticoid component of R-CHOP or R-CVP administered prior to RITUXAN. No other glucocorticoids were allowed1-3
  • Per the RATE (U4391g) trial, clinically significant cardiovascular disease is defined as uncontrolled hypertension, myocardial infarction, or unstable angina; New York Heart Association (NYHA) Classification Grade II or greater congestive heart failure; a ventricular arrhythmia requiring medication within 1 year prior to Day 1; or NYHA Grade II or greater peripheral vascular disease on Day 1.3

The infusion rate for 90-minute RITUXAN in appropriate patients is:

  • 20% of the total dose over the first 30 minutes (75 mg/m2)1-3
  • 80% of the total dose over the following 60 minutes (300 mg/m2)1-3
  • If the 90-minute infusion is tolerated in Cycle 2, the same rate can be used when administering the remainder of the treatment regimen (through Cycle 6 or 8)1
  • DLBCL=diffuse large B-cell lymphoma; NHL=non-Hodgkin's lymphoma; R=RITUXAN; CHOP=cyclophosphamide, doxorubicin, vincristine, and prednisone; CVP=cyclophosphamide, vincristine, and prednisone; ECOG PS=Eastern Cooperative Oncology Group performance status.
  1. RITUXAN® (Rituximab) full prescribing information, Genentech, Inc., 2013.
  2. Dakhil S, Hermann R, Chai A, Hurst D, Fine G, Richards P. Final results of a single arm phase Ill multicenter, open-label study of rituximab administered by faster infusion in patients with previously untreated diffuse large B-cell (DLBCL) or follicular non-Hodgkin’s lymphoma (FL). Presented at: 53rd American Society of Hematology (ASH) Annual Meeting and Exposition; December 10-13, 2011; San Diego, CA. Abstract #2703. Available at: https://ash.confex.com/ash/2011/webprogram/Paper37998.html.
  3. Data on file, Genentech, Inc.


RITUXAN® (Rituximab) is indicated for the treatment of patients with:

  • Relapsed or refractory, low-grade or follicular, CD20-positive, B-cell NHL as a single agent
  • Previously untreated follicular, CD20-positive, B-cell NHL in combination with first-line chemotherapy and, in patients achieving a complete or partial response to RITUXAN in combination with chemotherapy, as single-agent maintenance therapy
  • Non-progressing (including stable disease), low-grade, CD20-positive, B-cell NHL, as a single agent, after first-line CVP chemotherapy
  • Previously untreated diffuse large B-cell, CD20-positive NHL in combination with CHOP or other anthracycline-based chemotherapy regimens
  • Previously untreated and previously treated CD20-positive CLL in combination with fludarabine and cyclophosphamide (FC)

RITUXAN is not recommended for use in patients with severe, active infections.

Important Safety Information



  • Infusion Reactions: RITUXAN administration can result in serious, including fatal infusion reactions. Deaths within 24 hours of RITUXAN infusion have occurred. Approximately 80% of fatal infusion reactions occurred in association with the first infusion. Monitor patients closely. Discontinue RITUXAN infusion for severe reactions and provide medical treatment for Grade 3 or 4 infusion reactions
  • Severe Mucocutaneous Reactions: Severe, including fatal, mucocutaneous reactions can occur in patients receiving RITUXAN
  • Hepatitis B Virus (HBV) Reactivation: HBV reactivation can occur in patients treated with RITUXAN, in some cases resulting in fulminant hepatitis, hepatic failure, and death. Screen all patients for HBV infection before treatment initiation, and monitor patients during and after treatment with RITUXAN. Discontinue RITUXAN and concomitant medications in the event of HBV reactivation
  • Progressive Multifocal Leukoencephalopathy (PML), including fatal PML, can occur in patients receiving RITUXAN

Warnings and Precautions

Tumor Lysis Syndrome

  • Acute renal failure, hyperkalemia, hypocalcemia, hyperuricemia, or hyperphosphatemia from tumor lysis, some fatal, can occur within 12−24 hours after the first infusion of RITUXAN in patients with NHL. A high number of circulating malignant cells (≥25,000/mm3) or high tumor burden, confers a greater risk of TLS. Administer aggressive intravenous hydration and anti hyperuricemic therapy in patients at high risk for TLS


  • Serious, including fatal, bacterial, fungal, and new or reactivated viral infections can occur during and following the completion of RITUXAN-based therapy. Discontinue RITUXAN for serious infections and institute appropriate anti infective therapy


  • Discontinue infusions for serious or life threatening cardiac arrhythmias. Perform cardiac monitoring during and after all infusions of RITUXAN for patients who develop clinically significant arrhythmias, or who have a history of arrhythmia or angina


  • Severe, including fatal, renal toxicity can occur after RITUXAN administration in patients with NHL. Monitor closely for signs of renal failure and discontinue RITUXAN in patients with a rising serum creatinine or oliguria

Bowel Obstruction and Perforation

  • Abdominal pain, bowel obstruction and perforation, in some cases leading to death, can occur in patients receiving RITUXAN in combination with chemotherapy. Evaluate if symptoms of obstruction such as abdominal pain or repeated vomiting occur


  • The safety of immunization with live viral vaccines following RITUXAN therapy has not been studied and vaccination with live virus vaccines is not recommended

Laboratory Monitoring

  • Obtain complete blood counts (CBC) prior to each RITUXAN course

Additional Important Safety Information

  • The most common Grade 3 or 4 adverse reactions in clinical trials of NHL and CLL were infusion reactions, neutropenia, leukopenia, anemia, thrombocytopenia, and infections. Additionally, lymphopenia and lung disorder were seen in NHL trials; and febrile neutropenia, pancytopenia, hypotension, and hepatitis B were seen in CLL trials
  • The most common adverse reactions (incidence ≥25%) in clinical trials of NHL and CLL were infusion reactions. Additionally, fever, lymphopenia, chills, infection, and asthenia were seen in NHL trials; and neutropenia was seen in CLL trials
  • Pregnancy: Category C. There are no adequate and well-controlled studies of rituximab in pregnant women

For additional safety information, please see the full prescribing information, including BOXED WARNINGS and Medication Guide.

Attention Healthcare Provider: Provide Medication Guide to patient prior to RITUXAN infusion.

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch.

You may also report side effects to Genentech at (888) 835-2555.