Obinutuzumab (Generic Name)
Other Names: Gazyva®
About This Drug
Obinutuzumab is a drug used to treat chronic lymphocytic leukemia and follicular lymphoma. The drug is given in the vein (IV).
Possible Side Effects (More Common)
- Bone marrow suppression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
- Abnormal bleeding – coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, blood in your urine, abnormally heavy menstrual flow, nosebleeds, or any unusual bleeding
- Infusion-related reactions
- Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
- Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 24 hours. Medicines are available to stop or lessen these side effects.
- Constipation (not able to move bowels)
- Decreased appetite (decreased hunger)
- Hepatitis B – if you have ever had hepatitis B, the virus may come back during treatment with this drug. Your doctor will test to see if you have ever had hepatitis B prior to your treatment.
- Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel: extreme tiredness, agitation, confusion, or have: hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
- Tumor lysis: This drug may act on the cancer cells very quickly. This may affect how your kidneys work. Your doctor will monitor your kidney function.
- Electrolyte changes. Your blood will be checked for electrolyte changes as needed.
- Changes in kidney function. Your doctor will check your kidney function as needed.
- Changes in liver function. Your doctor will check your liver function as needed.
- Changes in heart function. Your doctor will check your heart as needed.
Possible Side Effects (Less Common)
- Fever, chills
- Loose bowel movements (diarrhea) that may last for a few days
Infusion Reactions are the most common side effect linked to use of this drug and can be quite severe. Medicines will be given before you get the drug to lower the severity of this side effect. The infusion reactions are the worse with the first dose of the drug and become less severe with more doses of the drug.
While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these symptoms of an allergic reaction:
- Trouble catching your breath
- Feeling like your tongue or throat are swelling
- Feeling your heart beat quickly or in a not normal way (palpitations)
- Feeling dizzy or lightheaded
- Flushing, itching, rash, and/or hives
Treating Side Effects
- Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
- If you have a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn’t stop after 10 to 15 minutes
- Ask your doctor or nurse about medicine to stop or lessen headache, loose bowel movements (diarrhea), constipation, nausea, throwing up (vomiting), or pain.
- If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories
- After treatment with this drug, vaccination with live viruses should be delayed until the immune system recovers.
- Symptoms of abnormal bleeding may be: coughing up blood, throwing up blood (may look like coffee grounds), red or black, tarry bowel movements, blood in urine, abnormally heavy menstrual flow, nosebleeds, or any unusual bleeding.
- Symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
- Urinary tract infection. Symptoms may include:
- Pain or burning when you pass urine
- Feeling like you have to pass urine often, but not much comes out when you do
- Tender or heavy feeling in your lower abdomen
- Cloudy urine and/or urine that smells bad
- Pain on one side of your back under your ribs. This is where your kidneys are
- Fever, chills, nausea and/or throwing up
Food and Drug Interactions
There are no known interactions of obinutuzumab with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.
When to Call the Doctor
Call your doctor or nurse right away if you have any of these symptoms:
- Fever of 100.5°F (38.0°C) or above
- Easy bleeding or bruising
- Trouble breathing
- Nausea that stops you from eating or drinking
- Throwing up (vomiting) more than 3 times in one day
- Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911
- Blurred vision or other changes in eyesight
- Feeling dizzy or lightheaded
- Changes in your speech or vision
- Feeling confused
- Weakness of your arms and legs or poor coordination (feeling clumsy)
- Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
- Decreased urination
- Blood in urine or bowel movements
- Symptoms of a urinary tract infection (see important information)
Call your doctor or nurse as soon as possible if any of these symptoms happen:
- Fatigue and/or that interferes with your daily activities
- Abdominal pain
- Nausea that is not relieved by prescribed medicines
- Loose bowel movements (diarrhea) 4 times or loose bowel movements with lack of strength or a feeling of being dizzy
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Pregnancy warning: This drug is known to cross the placenta. This drug may have harmful effects on an unborn baby. Effective methods of birth control should be used during treatment with this drug and for 12 months after the last treatment. If exposure occurs to an unborn baby, the baby’s immune system may be affected, which could last for months after birth. Until the immune system recovers, live vaccines should not be administered to the baby. Be sure to talk with your doctor if you are pregnant or planning to become pregnant while getting this drug.
- Breast feeding warning: It is not known if obinutuzumab is passed into human breast milk. In animal studies, this drug was detected in in breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.
Revised January 2017