Rituximab

[ks1966]

Hello 👋

I took my Rituximab infusion yesterday. I was wondering if there are things that I should avoid doing. such as dental care. Some do and don’t would be appreciated.

Thank you

[Lolabridge]

Hello! I do hope it works quickly and well for you as it did for me.You need to carry a card to state you are on Rituximab and your nurse can provide one. Do warn your dentist and any other medical professionals you are on it, especially your GP. This is because you are more at risk of infections so need prompt treatment if you get one.

I have listed it with all my other meds on my phone so emergency services can see it.

[ks1966 in reply to Lolabridge]

Thank you very much. I’ll do that

[weathervane in reply to ks1966]

Were you advised to shield again for a certain time ? Im due to have another infusion on 10th of june and i was wondering if the advice would be different. The only advice i can give you is to be careful with hand washing, avoid friends if they have a bad cold where possible and contact your gp if you get a bad sore throat or a-chest infection and inform the gp or on call service that you receive rituximab . I hope it works well for you , best wishes.

[ks1966 in reply to weathervane]

Thank you. I wasn’t told much unfortunately

[Neonkittie17 in reply to weathervane]

I was advised to shield again by my biologics nurse when I had my Rtx infusion end of April. x

[Moomin8 in reply to Neonkittie17]

OMG! Shield until when?

[Lolabridge in reply to Moomin8]

No, shielding is no longer officially required. But continue to be very careful and follow the advice weathervane suggests.

[Neonkittie17 in reply to Moomin8]

Don’t panic 💗 ... Re shielding and Rtx the rheumy/nurse have always said to all their Rtx patients pre pandemic to keep to stay in as much/avoid crowds ... for for first month. Then cautious for another month.

My case is a bit different as I have regular side effects of bronchitis from the med, but my nurse said to me I had to be super cautious whilst the case numbers were high and I live in an area where they top the case leagues most of the time. It’s been bad in my area. As Rtx depletes your B cells for long periods (months) of time, before they repopulate/return, the rheumy has always said to me from starting it in 2014 that you have to be very careful not to be around people with infections and don’t stay places where people are coughing and sneezing with colds etc in normal time pre-pandemic. Makes sense. I’d not have done that before I was on Rtx.

(Some in-laws asked us to attend a dinner and sat someone opposite me knowing we had said we couldn’t be there if anyone had infections ... and the host assured me they would not allow anyone to be there with infections. It was 90 miles from home so couldn’t get up and go easily. They did let someone attend who had a chest infection 😑. I ended up with pneumonia as a result and have never really got back on track from that.)

I was also warned quite strongly when on anti TNFs about not to clean the cat litter tray if not wearing disposable gloves. My cat used it a lot as he had colitis.

Just ask your rheumy/nurse. It mentioned cheeses and pate and raw egg to avoid and infections in my Rtx pack/folder/dvd when I started the med. I am sure you’ll be fine but at the moment we have to still be careful. Those on the higher spec meds a bit more so. x

[weathervane in reply to Neonkittie17]

Thanks for that info Neonkittie , i was wondering if that would be the case .

[Neonkittie17 in reply to weathervane]

💗

[Moomin8 in reply to weathervane]

Working I'm a school, it's difficult to avoid sneezes 🤕🤧 and coughs. But thank you for your advice. 😊

[weathervane in reply to Moomin8]

I i think im getting a cold or sore throat I was advised to take 75mg of zinc for a couple of days, I think it helps . Unfortunately you might have to do that all the time as a teacher 🙄.

[Neonkittie17 in reply to weathervane]

I take zinc too and have since I started biologics. x

[bpeal1 in reply to Lolabridge]

Again very different advice. I wasn’t told to shield after both my lots last year (May and December), but maybe that’s because I wasn’t shielding anyway. My rheumatologist told me I didn’t need to shield just to be careful, I’m mid forties, no other health issues and don’t take steroids.

[AgedCrone]

Just get on with your life & expect to start feeling better.....don’t even think about side effects.As with most drugs keep up your fluid intake ... up I’m sure you will find

Rtx really is the easiest most convenient Biologic & when it starts working you will be really grateful it has been prescribed for you.

Any other clinical treatment you need....run by your rheumy nurse..but I have never been told to avoid the dentist.

Good luck...but give it at least 8/12 weeks to kick in.

[ks1966 in reply to AgedCrone]

Thank you 🙏

[Neonkittie17 in reply to AgedCrone]

Hi AC, I have always been told by my rheumys to have any planned dental treatment right in the middle of the time between last and next Rtx and my rheumy sent my dentist a letter saying this. As you can’t plan any pesky fillings departing or other emergencies, my dentist always says he’d just be happier if I went whatever the timescale and he’d give me antibiotics. I’ve done that and all’s been well. Obviously it’s not a great idea I was told again recently by my rheumy nurse to go to the dentist until a month after Rtx as you are most vulnerable then, but if you were in agony with a tooth infection etc .. you’d go. You’d get more difficulties if you didn’t.

[AgedCrone in reply to Neonkittie17]

Luckily I have only needed dental check ups with no treatment since I have been on Rtx...but if I had raging toothache I would go to the dentist whatever drug I was on!I seem to remember I was given a Do & Don’t do list at my first infusion...but as right now my whole house is in removal boxes..if I get toothache.....there is no chance of finding it! 😩

[Neonkittie17 in reply to AgedCrone]

Yes I’ve been there and had to go with raging pain and had antibiotics prescribed from the dentist and he used extra dental ones packing the tooth in prep for the permanent filling once the tooth calmed down. You can’t function with toothache on that level. All the do’s and dont’s are in a Rtx welcome pack they gave me with a dvd.

[AgedCrone in reply to Neonkittie17]

Ouch.... I can remember those days ! That appears to be one benefit of old-age your teeth settle down!A n RTX DVD....there’s posh for you.... I think I just got a scribbled on sheet of A4!

[Neonkittie17 in reply to AgedCrone]

It was 2014 so not a recent thing they do! It used to be typed sheets for dmards then it did get upmarket for the biologics! Glad your teeth have settled. 🙏🏻

[AgedCrone in reply to Neonkittie17]

Still got them all too!

[Neonkittie17 in reply to AgedCrone]

Brilliant!

[Haired in reply to Neonkittie17]

Hi Neonkittie17, Thank you for information re Dental Treatment. I have just had my 3rd infusion last Thursday and am due to see Dentist on Monday because piece of tooth has broken.

Will contact Dentist to discuss.

What condition are you being treated for ?

Many thanks

[Neonkittie17 in reply to Haired]

Had to look back see what I’d said. Yes you cannot help an emergency so make the dentist aware you’ve just had your Rtx. I hope it’s a straight forward one off visit. 🙏🏻

If they need to do some major in depth work over a couple of visits for people on Rtx they may suggest antibiotics then that’s when I have taken them for when a tooth was open for a long time during a root canal but it wasn’t just after Rtx (for RA.) You have to have your teeth fixed but what I’ve always been told is to plan major dental work right inbetween the infusions. Good luck. 🙏🏻

[Haired in reply to Neonkittie17]

Hi, thanks so much that’s very helpful .

[Neonkittie17 in reply to Haired]

You’re welcome.

[Moomin8]

Morning 🙂How did it go? I've got my first on Monday. How did you feel the day after? I will have to go to work the day after - and the rest of the week, of course 🙂.

[bpeal1 in reply to Moomin8]

I’ve had several lots, I always find I feel a bit hung over the next day. I have found I feel much better if I drink lots of water. I now drink a couple of pints of water in the evening before going to bed and take a large glass of water to bed with me as I often wake up feeling thirsty.

[Moomin8]

Thanks for the top tip 👍 💧🥛

[Lolabridge in reply to Moomin8]

And you can always take paracetamol if you feel a bit off the next day. And ask the children to be really nice to you!!

[Moomin8 in reply to Lolabridge]

🤣

[Lolabridge in reply to Moomin8]

🤞🏻

[Neonkittie17]

As others have said .. look forward to it working and you feeling much better and moving nicely. The feeling of well-being when RA isn’t making me have inflammation pain is really very nice indeed. Here’s to that for you! x