Cancer Home > Zevalin Warnings and Precautions
Tell your healthcare provider if you get infections easily, plan to receive a vaccination, or have ever had a severe reaction to rituximab before starting treatment with Zevalin. Other precautions for safely using this medicine include warnings of potential allergic reactions and drug interactions. Zevalin can also cause other complications, such as infusion reactions and low blood cell counts.
What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to receiving Zevalin® (ibritumomab) if you have:
- An infection or get infections easily
- Plans to receive a vaccination
- A history of a severe reaction to rituximab (Rituxan®)
- Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Specific Precautions and Warnings With ZevalinSome warnings and precautions to be aware of prior to receiving this medication include the following:
- Zevalin is given with rituximab. Infusion reactions, which can be mild to life-threatening, are common with rituximab treatment. You will be given certain medications before your dose, called "premedication," to help reduce your risk for these problems. Contact your healthcare provider immediately if you experience symptoms of an infusion reaction, such as:
- Most people who receive Zevalin can experience a significant reduction in one or more blood cell types, which could lead to potentially serious side effects. A reduction in blood cells can occur up to three months after you receive Zevalin. Therefore, your healthcare provider will need to monitor you for up to three months after completing treatment. A reduction in blood cell types can cause problems, such as:
- Anemia, due to low red blood cells
- Serious infections, due to low white blood cells
- Dangerous bleeding, due to low platelets.
- Contact your healthcare provider right away if you develop any symptoms of low blood cell counts, such as:
- Signs of an infection
- Unusual bleeding or bruising
- Weakness or fatigue
- Small reddish or purplish spots on the skin.
- This medicine may cause serious and potentially life-threatening skin or mucous membrane reactions. These reactions can occur up to four months after your dose. Contact your healthcare provider right away if you experience sores, peeling, or blistering of the skin, mouth, or any other body areas.
- There have been reports of people developing diseases of the blood cells (known medically as myelodysplastic syndrome) and leukemia after receiving Zevalin.
- Your healthcare provider will need to obtain lab tests to check your blood cell counts once a week after you receive this medicine until your blood cell counts are normal.
- Zevalin contains albumin, a protein that comes from donor human blood. There is a very small chance that viruses could be transferred through the blood. However, there are no reported cases of this occurring.
- Talk to your healthcare provider before getting any type of vaccination or immunization during Zevalin treatment. Vaccines may be less effective in people using this drug. You could also become infected with the bacteria or viruses used to make "live" vaccines (see Zevalin Drug Interactions).
- Zevalin may react with several other medications (see Zevalin Drug Interactions).
- This product is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see Zevalin and Pregnancy).
- This medication is expected to pass through human milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Zevalin and Breastfeeding).