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Rituximab for subcutaneous delivery: Clinical management principles from a nursing perspective
Author(s) -
Carlson Julia,
Cox Keith,
Bedwell Kylie,
Ku Mathew
Publication year - 2015
Publication title -
international journal of nursing practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.62
H-Index - 55
eISSN - 1440-172X
pISSN - 1322-7114
DOI - 10.1111/ijn.12413
Subject(s) - medicine , rituximab , adverse effect , neutropenia , premedication , nausea , intensive care medicine , nursing , pharmacology , lymphoma , anesthesia , chemotherapy
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.