Drugs Home > Precautions and Warnings With Ibritumomab

People who receive ibritumomab need to be aware that this drug could increase the risk for potentially life-threatening infusion reactions or infections. Also, this medicine should not be used by people who have certain allergies or those who are taking certain medications. Other warnings and precautions with ibritumomab apply to women who are pregnant or breastfeeding.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to receiving ibritumomab (Zevalin®) 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
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Ibritumomab Precautions and Warnings

Some warnings and precautions to be aware of prior to receiving this medication include the following:
  • Ibritumomab 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 ibritumomab 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 ibritumomab. Therefore, your healthcare provider will need to monitor you for up to three months after completing your 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
    • Paleness
    • 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 ibritumomab.
  • 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.
  • Ibritumomab 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 ibritumomab treatment. Vaccines may be less effective in people using ibritumomab. You could also become infected with the bacteria or viruses used to make "live" vaccines (see Drug Interactions With Ibritumomab).
  • 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).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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