Hyaluronidase and rituximab is a combination medicine used to treat follicular lymphoma, diffuse large B-cell lymphoma, or chronic lymphocytic leukemia.

Hyaluronidase and rituximab is sometimes used together with other cancer medicines.

This combination medicine is usually given only after you have received at least 1 injection of rituximab alone.

Hyaluronidase and rituximab may also be used for purposes not listed in this medication guide.

Do not use if you are pregnant. Avoid getting pregnant for at least 12 months after you stop using hyaluronidase and rituximab.

Rituximab may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have problems with speech, thought, vision, or muscle movement.

If you've ever had hepatitis B, using rituximab can cause this virus to become active or get worse.

Severe skin problems can also occur during treatment with rituximab. Call your doctor if you have painful skin or mouth sores, or a severe skin rash with blistering, peeling, or pus.

Some side effects may occur during the injection or within 24 hours afterward. Tell your caregiver right away if you feel itchy, dizzy, weak, light-headed, short of breath, chilled, feverish, or if you have chest pain, wheezing, a sudden cough, or pounding heartbeats or fluttering in your chest.

Hyaluronidase and rituximab is injected under the skin of your stomach area. hyaluronidase and rituximab must be injected slowly over 5 to 7 minutes. A healthcare provider will give you this injection.

You will be watched closely for at least 15 minutes after receiving hyaluronidase and rituximab, to make sure you do not have an allergic reaction.

Before each injection, you may be given other medicine to prevent certain side effects. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

If you have chronic lymphocytic leukemia, you may also need to take medicine to prevent infections. You may need to keep taking this medicine for up to 12 months after your last dose of hyaluronidase and rituximab.

Hyaluronidase and rituximab can lower blood cells that help your body fight infections. Your blood will need to be tested often.

If you've ever had hepatitis B, using rituximab can cause this virus to become active or get worse. You may need frequent liver function tests while using this medicine and for several months after you stop.

Tell your doctor if you have ever had:

• kidney disease;

• lung disease;

• a severe reaction to hyaluronidase or rituximab;

• a weak immune system (caused by disease or by using certain medicines);

• a severe infection such as herpes, shingles, cytomegalovirus, chickenpox, parvovirus, West Nile virus, or hepatitis B or C;

• heart disease, angina (chest pain), or heart rhythm disorder; or

• if you recently received any vaccine, or you are are scheduled to receive a vaccine.

Rituximab may harm an unborn baby. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 12 months after your last dose. Tell your doctor if you become pregnant.

Do not breastfeed while using this medicine, and for at least 6 months after your last dose.

Call your doctor for instructions if you miss a dose of hyaluronidase and rituximab.

Since hyaluronidase and rituximab is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Do not receive a "live" vaccine while using hyaluronidase and rituximab. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Some side effects may occur during the injection (or within 24 hours afterward). Tell your caregiver right away if you feel itchy, dizzy, weak, light-headed, short of breath, chilled, feverish, or if you have chest pain, wheezing, a sudden cough, or pounding heartbeats or fluttering in your chest.

Rituximab may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have problems with speech, thought, vision, or muscle movement.

Serious and sometimes fatal infections may occur during treatment with hyaluronidase and rituximab. Call your doctor right away if you have signs of infection such as:

• fever, sore throat, cold or flu symptoms;

• sores or white patches in your mouth or throat;

• pain or burning when you urinate;

• earaches, headaches; or

• painful skin sores with redness, warmth, or swelling.

Call your doctor at once if you have any of these other side effects, even if they occur several months after your last dose of hyaluronidase and rituximab:

• severe stomach pain, severe vomiting;

• right-sided upper stomach pain, loss of appetite, yellowing of your skin or eyes, and not feeling well;

• little or no urination;

• skin or mouth sores, or a severe skin rash with blistering, peeling, or pus;

• chest pain, irregular heartbeats;

• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet;

• low white blood cell counts--fever, mouth sores, skin sores, sore throat, cough, trouble breathing; or

• signs of tumor cell breakdown--tiredness, weakness, muscle cramps, nausea, vomiting, diarrhea, fast or slow heart rate, tingling in your hands and feet or around your mouth.

Common side effects of hyaluronidase and rituximab may include:

• low blood cell counts;

• nausea, vomiting, constipation;

• hair loss;

• feeling tired;

• cough; or

• redness where the injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may affect hyaluronidase and rituximab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.