Austin Health

Title
Rituximab for subcutaneous delivery: Clinical management principles from a nursing perspective
Publication Date
2015-12
Author(s)
Carlson, Julia
Cox, Keith
Bedwell, Kylie
Ku, Mathew
Subject
Monoclonal antibody
Non-Hodgkin's lymphoma
Nursing
Rituximab
Subcutaneous
Type of document
Conference
DOI
10.1111/ijn.12413
Abstract
Nurses play an integral role in administering treatments to patients with non-Hodgkin's lymphomas. Intravenous (IV) rituximab was approved by the Australian Therapeutic Goods Administration in 1998, and a novel subcutaneous (SC) formulation was approved in 2014. Fixed-dose SC rituximab is highly concentrated; co-formulation with a fully human recombinant vorhyaluronidase alfa enzyme helps overcome the physiological barriers of the SC space, facilitating drug dispersion. Despite a different pharmacokinetic profile to the IV preparation, SC rituximab demonstrates a comparable efficacy/safety profile. Most frequently occurring rituximab-related adverse events include neutropenia, nausea and constipation, and administration-related reactions are more frequent with the SC preparation. Compared with IV, SC delivery reduces treatment times and nurse workload, and patients report greater comfort and convenience. This article sets out nursing considerations for optimal administration of SC rituximab, including premedication, drug handling/preparation, injection technique, after-care and management of adverse events, particularly administration-related reactions.
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