Obinutuzumab Treatment: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Obinutuzumab is a prescription medication used to treat specific types of blood cancers, including chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL). It works by targeting cancer cells, enabling your immune system to destroy them. Obinutuzumab is administered as an infusion into a vein, often in combination with other cancer treatments. Always consult your healthcare provider before starting or adjusting your treatment plan.

Names of Medication

US Brand Name: Gazyva (Obinutuzumab)

Medications typically have two names: a brand name and a generic name. The generic name refers to the active ingredient, while the brand name is the version marketed to the public. In this case, the generic name is listed in parentheses.

Pharmacologic Category

Monoclonal Antibody

Anti-CD20 Antibody

Obinutuzumab Dosing

Obinutuzumab is used to treat various blood cancers, and the dosing schedule depends on the specific condition being treated. Always follow your doctor’s instructions carefully, and never adjust your dose without consulting your healthcare provider. If you have any questions about your treatment, you can schedule a telemedicine appointment with one of our providers.

Chronic Lymphocytic Leukemia (CLL)

Obinutuzumab is administered in combination with other medications. The typical dosing schedule is 100 mg on Day 1, 900 mg on Day 2, and 1000 mg on Days 8 and 15 of the first cycle. For cycles 2 through 6, 1000 mg is given on Day 1 of each cycle.

Follicular Lymphoma (FL)

For patients who have not previously received treatment, Obinutuzumab is given alongside chemotherapy. The standard dose is 1000 mg on Days 1, 8, and 15 of the first cycle, followed by 1000 mg on Day 1 of each subsequent cycle (up to 6-8 cycles).

Non-Hodgkin Lymphoma (NHL)

Obinutuzumab is administered with chemotherapy. The dosing schedule is similar to that for follicular lymphoma, with 1000 mg on Days 1, 8, and 15 of the first cycle, followed by 1000 mg on Day 1 of each subsequent cycle.

Marginal Zone Lymphoma (MZL)

Obinutuzumab is given at a dose of 1000 mg on Days 1, 8, and 15 of the first cycle, followed by 1000 mg on Day 1 of each subsequent cycle (up to 6 cycles).

Small Lymphocytic Lymphoma (SLL)

Obinutuzumab is typically administered with chemotherapy. The dosing schedule is similar to that for CLL, with 100 mg on Day 1, 900 mg on Day 2, and 1000 mg on Days 8 and 15 of the first cycle. For cycles 2 through 6, 1000 mg is given on Day 1 of each cycle.

B-cell Lymphoma

Obinutuzumab is administered with chemotherapy. The typical dose is 1000 mg on Days 1, 8, and 15 of the first cycle, followed by 1000 mg on Day 1 of each subsequent cycle.

Hairy Cell Leukemia

Obinutuzumab is not commonly used for this condition, but your doctor may recommend it as part of your treatment plan. Always follow your doctor’s specific instructions.

Lymphoplasmacytic Lymphoma

Obinutuzumab is administered with chemotherapy, with a dose of 1000 mg on Days 1, 8, and 15 of the first cycle, followed by 1000 mg on Day 1 of each subsequent cycle.

Waldenström Macroglobulinemia

Obinutuzumab is given in combination with chemotherapy. The typical dose is 1000 mg on Days 1, 8, and 15 of the first cycle, followed by 1000 mg on Day 1 of each subsequent cycle.

Dosage Forms and Strengths

Solution for intravenous infusion: 1000 mg/40 mL (25 mg/mL)

Administration Instructions for Obinutuzumab

Obinutuzumab is administered as an intravenous (IV) infusion, meaning it is delivered directly into a vein. Infusions are typically performed in a healthcare setting, such as a hospital or clinic, under the supervision of a healthcare professional. The first infusion is usually given slowly to monitor for any reactions. If the first infusion is well-tolerated, subsequent infusions may be administered more quickly. Always follow your healthcare provider’s instructions carefully.

Obinutuzumab Side Effects and Adverse Reactions

Like all medications, Obinutuzumab can cause side effects. Some are common, while others are rare but more serious. It’s important to discuss any side effects with your doctor. If you have concerns, you can also schedule a telemedicine appointment with one of our providers.

Common Side Effects

Infusion-related reactions: These may include fever, chills, nausea, and low blood pressure. These reactions are most common during the first infusion.

Low white blood cell count (neutropenia): This can increase your risk of infection.

Fatigue: Feeling unusually tired or weak is a common side effect.

Less Common Side Effects

Infections: Obinutuzumab can weaken your immune system, making you more susceptible to infections.

Low platelet count (thrombocytopenia): This can increase your risk of bleeding or bruising.

Serious Side Effects

Severe allergic reactions: Symptoms may include difficulty breathing, swelling of the face or throat, and severe rash. Seek medical attention immediately if you experience these symptoms.

Progressive multifocal leukoencephalopathy (PML): A rare but serious brain infection that can be life-threatening. Symptoms may include confusion, difficulty speaking, and vision problems.

Contraindications for Obinutuzumab Treatment

A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. Before starting Obinutuzumab, it’s important to know if you have any conditions that would make this medication unsafe for you.

Contraindications for Obinutuzumab

Allergic reaction to Obinutuzumab or any of its ingredients: If you have had a severe allergic reaction (such as hives, difficulty breathing, or swelling of the face) to Obinutuzumab or any of its components, you should not take this medication. It could cause a life-threatening reaction called anaphylaxis.

Active infection: Obinutuzumab can weaken your immune system, making it harder for your body to fight infections. If you have an active infection, taking Obinutuzumab could worsen it or make it more difficult to treat.

Hepatitis B infection: If you have a history of hepatitis B, Obinutuzumab can cause the virus to reactivate, leading to serious liver problems. Your healthcare provider will likely test you for hepatitis B before starting treatment.

If you think you may have any of these conditions, please consult with one of our healthcare providers through telemedicine before starting Obinutuzumab.

Drug to Drug Interactions with Obinutuzumab

Obinutuzumab can interact with other medications, potentially leading to harmful effects or reducing the effectiveness of your treatment. It’s essential to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs, supplements, and herbal products.

Medications that Interact with Obinutuzumab

Immunosuppressants (e.g., Methotrexate, Cyclosporine): These medications suppress the immune system and may increase the risk of infections when used alongside Obinutuzumab.

Live vaccines (e.g., MMR, Varicella): Live vaccines should not be administered during treatment with Obinutuzumab, as your immune system may not be strong enough to handle the live virus, potentially leading to infection.

Blood thinners (e.g., Warfarin, Heparin): Obinutuzumab may increase the risk of bleeding, especially when taken with blood-thinning medications.

Always review your medication list with your healthcare provider before starting Obinutuzumab. You can also schedule a telemedicine appointment with us to ensure your treatment plan is safe and effective.

Obinutuzumab in Pregnancy

Is it Safe to Take Obinutuzumab During Pregnancy?

Obinutuzumab is generally not recommended during pregnancy unless absolutely necessary, as it can harm an unborn baby, particularly if taken during the second and third trimesters. If you are pregnant or planning to become pregnant, it’s important to discuss the potential risks and benefits of Obinutuzumab with your healthcare provider. You may need to use effective birth control while on this medication and for at least six months after your last dose.

Obinutuzumab While Breastfeeding

Is it Safe to Take Obinutuzumab While Breastfeeding?

It is currently unknown whether Obinutuzumab passes into breast milk. Due to the potential for serious side effects in a nursing infant, breastfeeding is not recommended during treatment and for at least six months after the last dose. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to discuss alternative options.

Estimated Cost of Obinutuzumab

The cost of Obinutuzumab can vary depending on your location and pharmacy. Without insurance, the estimated cost for a 30-day supply using a GoodRx coupon ranges from approximately $5,000 to $10,000. Prices may fluctuate, so it’s a good idea to check with your pharmacy or use a discount service like GoodRx for the most up-to-date pricing.

Possible Alternatives to Obinutuzumab

If Obinutuzumab is not suitable for you, or if you are exploring other treatment options, there are alternatives available. Always consult your healthcare provider before making any changes to your treatment plan. You can schedule a telemedicine appointment with one of our providers to discuss these alternatives in more detail.

Chronic Lymphocytic Leukemia (CLL)

Alternative medications: Ibrutinib (Imbruvica), Venetoclax (Venclexta), Rituximab (Rituxan)

Lifestyle changes: Maintaining a healthy diet, engaging in regular exercise, and practicing good hygiene to prevent infections

Follicular Lymphoma

Alternative medications: Rituximab (Rituxan), Bendamustine (Treanda), Lenalidomide (Revlimid)

Lifestyle changes: Managing stress, staying physically active, and following a balanced diet

Non-Hodgkin Lymphoma

Alternative medications: Rituximab (Rituxan), CHOP chemotherapy (Cyclophosphamide, Doxorubicin, Vincristine, Prednisone)

Lifestyle changes: Staying active, eating a nutritious diet, and managing stress effectively

Marginal Zone Lymphoma

Alternative medications: Rituximab (Rituxan), Chlorambucil (Leukeran), Bendamustine (Treanda)

Lifestyle changes: Regular physical activity and a healthy diet

Small Lymphocytic Lymphoma

Alternative medications: Ibrutinib (Imbruvica), Rituximab (Rituxan), Venetoclax (Venclexta)

Lifestyle changes: Preventing infections and maintaining a healthy lifestyle

B-cell Lymphoma

Alternative medications: Rituximab (Rituxan), CHOP chemotherapy, CAR T-cell therapy

Lifestyle changes: Following a balanced diet, staying physically active, and managing stress

Hairy Cell Leukemia

Alternative medications: Cladribine (Leustatin), Pentostatin (Nipent), Rituximab (Rituxan)

Lifestyle changes: Staying active and maintaining a healthy diet

Lymphoplasmacytic Lymphoma

Alternative medications: Rituximab (Rituxan), Ibrutinib (Imbruvica), Bendamustine (Treanda)

Lifestyle changes: Regular exercise and a balanced diet

Waldenström Macroglobulinemia

Alternative medications: Ibrutinib (Imbruvica), Rituximab (Rituxan), Bendamustine (Treanda)

Lifestyle changes: Maintaining a healthy lifestyle and managing stress effectively

Recent Updates on Obinutuzumab Research

Recent studies on Obinutuzumab are focused on improving its effectiveness and minimizing side effects. One area of research is exploring the combination of Obinutuzumab with other targeted therapies, such as Ibrutinib or Venetoclax, to enhance outcomes for patients with chronic lymphocytic leukemia (CLL) and other B-cell lymphomas. Early results suggest that these combinations may improve survival rates and slow disease progression.

Researchers are also investigating the use of Obinutuzumab in earlier stages of lymphoma to determine whether starting treatment sooner leads to better long-term outcomes. Clinical trials are ongoing, and new data is expected in the coming years.

If you are interested in learning more about these studies or considering participation in a clinical trial, discuss this with your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to explore your options further.

James Kingsley

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