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Obinutuzumab

About Obinutuzumab

Obinutuzumab is a prescription injection used to treat chronic lymphocytic leukaemia (CLL) and follicular lymphoma. It is specifically designed to target and destroy certain abnormal white blood cells in the body, helping to manage these types of blood cancers.

This medicine is injected slowly into a vein by a healthcare professional in scheduled treatment cycles. It is not taken daily, and your schedule must be followed precisely to ensure the treatment works effectively. Since it is given as an injection, food intake does not affect how it is absorbed, but staying well-hydrated by drinking plenty of water before and after your sessions can help protect your kidneys.

While receiving this medicine, you may experience temporary reactions during the injection, such as fever, chills, or low blood pressure. Other common issues include low blood cell counts, which can increase your risk of infections. You must contact your doctor immediately if you experience severe shivering, breathing difficulties, or signs of a serious infection like a high fever.

Do not take this if you have had a severe, life-threatening allergic reaction to this medicine in the past. Before starting treatment, tell your doctor if you have a history of hepatitis B, kidney problems, or active infections, as this medicine can cause infections that were previously controlled by your immune system to become active again or worsen.

This medicine can interact with other drugs that weaken your immune system or live vaccines, which can lead to severe infections. If you are pregnant or breastfeeding, speak with your healthcare provider, as this medicine can cause harm to an unborn baby or nursing infant. Elderly individuals should also consult their doctor closely, as they may be more sensitive to side effects like infections.

Uses of Obinutuzumab

Obinutuzumab is used in the treatment of Chronic Lymphocytic Leukaemia, and Follicular Lymphoma. The detailed uses of Obinutuzumab are as follows: • Chronic lymphocytic leukemia (CLL): Obinutuzumab is used in combination with chlorambucil to treat previously untreated CLL in adults. It helps reduce the number of malignant B cells and delays disease progression. • Follicular lymphoma (FL): Obinutuzumab is used with bendamustine in patients whose FL has relapsed or not responded to a rituximab-containing regimen. It is also used as a first-line treatment for stage II bulky, III, or IV FL in combination with chemotherapy, followed by Obinutuzumab alone as maintenance therapy. • Immunotherapy support: Obinutuzumab is used as a targeted immunotherapy that binds to the CD20 protein on B cells, helping the immune system recognize and destroy cancerous cells while preserving the body’s ability to regenerate healthy blood cells.

Medicinal Benefits

Obinutuzumab helps target and destroy abnormal B-cells, supporting the treatment of certain blood cancers and helping improve disease control. The key benefits of Obinutuzumab are as follows:

  • Targeted Cancer Cell Destruction: By directly seeking out and attaching to abnormal white blood cells, Obinutuzumab helps clear these cells from your bloodstream and lymph nodes.
  • Long-term Disease Control: When combined with chemotherapy, it helps delay the progression of lymphoma and leukaemia, helping you maintain remission for a longer period.
  • Customised Therapy Cycles: It is given in structured cycles, allowing your body time to recover and rebuild healthy cells between treatment sessions.

Directions for Use

  • Follow your doctor's instructions on the dosage and timing of this medication.
  • A trained healthcare professional will administer Obinutuzumab.
  • Do not self-administer.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Obinutuzumab

Common Side Effects (Usually mild):

  • Fever and chills
  • Tiredness or weakness
  • Mild diarrhoea or upset stomach
  • Joint or muscle pain
  • Cough or nasal congestion
     

Serious Side Effects (Consult your doctor right away):

  • Severe infusion reactions (shortness of breath, chest tightness, throat swelling, or severe dizziness)
  • Signs of infection (high fever, severe chills, painful urination, or a persistent cough)
  • Signs of liver damage (yellowing of the eyes or skin, dark urine, or severe right-sided stomach pain)
  • Signs of rapid cell breakdown, also known as tumour lysis syndrome—which happens when many cancer cells die quickly and release substances into the blood that can overwhelm the kidneys and heart (rapid heart rate, muscle cramping, or decreased urination)
  • Signs of Progressive Multifocal Leukoencephalopathy (PML), a rare but dangerous brain infection caused by a virus that can become active when the immune system is very weak (confusion, loss of balance, vision changes, or difficulty speaking)

Drug Warnings

  • Receive Pre-medicines: Always double-check with your nurse that you receive your pre-medicine drugs before the infusion begins.
  • Monitor Your Temperature: Monitor your body temperature at home daily, especially during the first few cycles of treatment, and report any spikes immediately.
  • Take Care When Driving: Do not plan to drive or operate machinery immediately after your infusion, as the pre-medicines or the treatment itself can make you feel very tired or dizzy.
  • Inform Healthcare Professionals: Tell your dentist and any other doctors that you are receiving Obinutuzumab before scheduling any medical or dental procedures.
  • Avoid Live Vaccines: Avoid getting any live vaccines during your treatment, and consult your doctor about when it is safe to resume vaccinations.
  • Watch the Injection Site: Watch your injection site for any swelling, redness, or pain, and notify your nurse immediately if you notice these signs during or after the infusion.

Drug Interactions

  • Immunosuppressive Drugs: Medicines that lower your body's immune response can increase your risk of developing severe infections when used with Obinutuzumab.
  • Blood Pressure medicines: Because Obinutuzumab can cause temporary low blood pressure during the injection, your doctor may advise you to temporarily stop taking your blood pressure medicines for 12 hours before and during your infusion.
  • Live Vaccines: Receiving live vaccines during treatment can cause serious infections, as your immune system is less able to fight off the weakened virus.

Drug-Drug Interactions Checker List:

Safety Advice

  • Safety Warning

    Alcohol

    consult your doctor

    It is unknown whether Obinutuzumab interacts with alcohol. Consult your doctor.

  • Safety Warning

    Pregnancy

    unsafe

    Obinutuzumab is not recommended for use in pregnancy as it may cause fatal B-lymphocyte depletion in your foetus. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Obinutuzumab.

  • Safety Warning

    Breast Feeding

    caution

    If you are breastfeeding, inform your doctor before receiving Obinutuzumab. Your doctor may prescribe this medicine if the benefits outweigh the risks.

  • Safety Warning

    Driving

    caution

    Obinutuzumab will be administered in the hospital setting. Hence, driving is not recommended.

  • Safety Warning

    Liver

    caution

    If you have a pre-existing or a history of liver disease, inform your doctor before receiving Obinutuzumab. Obinutuzumab may cause increased bilirubin levels and liver failure. Hence, inform your doctor if you observe any symptoms such as fatigue, yellow discolouration of eyes, and dark coloured urine. A dose adjustment of this medicine or a suitable alternative may be advised based on your condition.

  • Safety Warning

    Kidney

    caution

    It is not known whether Obinutuzumab can be taken if you have kidney impairment. However, inform your doctor if you have a pre-existing or a history of kidney disease before receiving Obinutuzumab.

  • Safety Warning

    Children

    unsafe

    Obinutuzumab is not recommended for use in children as the safety and efficacy are not established.

Habit Forming

No

Diet & Lifestyle Advise

  • Stay Well-Hydrated: Drink plenty of fluids, especially water, on the days leading up to and following your infusion. This helps your kidneys flush out waste products from destroyed cancer cells.
  • Practice Strict Hygiene: Wash your hands frequently with soap and water, and avoid touching your face to prevent infections.
  • Avoid Raw or Undercooked Foods: Your immune system may be weakened during treatment. Eat only well-cooked meats, pasteurised dairy, and wash fruits and vegetables thoroughly.
  • Steer Clear of Crowds: Avoid close contact with people who are sick, have a cold, or have recently received live vaccines.

Special Advise

  • A blood test should be performed, such as a liver function test or renal function test, to check for liver/kidney function.
  • Weekly blood tests should be done during the treatment to check for CBC (Complete blood count).

Patients Concern

Disease/Condition Glossary

Chronic Lymphocytic Leukaemia: It is a type of cancer that occurs in the bone marrow and blood. It increases the number of lymphocytes (a type of white blood cell). The symptoms include fever, enlarged liver, bone or joint pain, shortness of breath, weakness, and bleeding from gums or bruises.

Follicular lymphoma: It is a type of non-Hodgkins lymphoma with slow-growing (chronic) cancer with abnormal growth of B lymphocytes, a type of white blood cells that help fight infection. This results in the buildup of too many B lymphocytes in the blood, lymph nodes, bone marrow, and spleen.

FAQs

Obinutuzumab is used to treat Chronic Lymphocytic Leukaemia, and Follicular Lymphoma.

Obinutuzumab contains Obinutuzumab, which works by inhibiting the B-cell lymphocytes that are responsible for the multiplication of cancer cells.

Obinutuzumab is given as a slow injection into a vein (intravenous infusion) by a healthcare professional in a clinic or hospital. It cannot be taken at home. Talk to your doctor for more details about your specific treatment schedule.

You should avoid receiving live vaccines during your treatment and for several months afterwards, as your immune system will be weakened. Non-live vaccines may be safe, but they may not work as well. Talk to your doctor or pharmacist before getting any vaccine.

You are given medicines like antihistamines, steroids, and fever-reducers before the infusion to reduce the risk of severe infusion-related reactions. Talk to your doctor if you have concerns about these pre-medicines.

The exact length of your treatment cycle and the number of cycles you need will be decided by your doctor based on your specific condition and how well you tolerate the medicine. Talk to your doctor to understand your complete treatment plan.

While Obinutuzumab itself does not commonly cause significant hair loss, it is often given in combination with chemotherapy medicines that do. Talk to your doctor or pharmacist to understand what to expect from your specific treatment combination.

Since this medicine lowers your white blood cells, a fever can be a sign of a serious infection. Check your temperature and contact your doctor or seek emergency medical help immediately if you develop a fever. Talk to your doctor for further guidance.

Alcohol can cause dehydration and put extra stress on your liver. Since this medicine can also affect your liver and kidneys, it is best to avoid or strictly limit alcohol. Talk to your doctor or pharmacist for personalised advice.

No, this medicine can harm an unborn baby. Women who can become pregnant must use effective birth control during treatment and for several months after their last dose. Talk to your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

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