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Generic Name: ibritumomab (ib ri TYOO mo mab)
Brand Names: In-111 Zevalin, Y-90 Zevalin

What is In-111 Zevalin (ibritumomab)?

Ibritumomab is a protein that targets white blood cells in the body. When ibritumomab is attached to a radioactive chemical, the radiation is delivered directly to the tumor (lymphoma).

Ibritumomab is used in combination with other medicines to treat non-Hodgkin's lymphoma.

Ibritumomab may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about In-111 Zevalin (ibritumomab)?

Ibritumomab is used in combination with rituximab (Rituxan) and a radioactive chemical. Ibritumomab is given as an injection through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection.

Ibritumomab can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Avoid contact with people who have colds, the flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. It is important that you not miss any scheduled visits to your doctor.

Some people receiving ibritumomab have developed "secondary" bone marrow or blood cell cancers such as leukemia. Talk with your doctor about your individual risk while receiving this medication.

What should I discuss with my healthcare provider before receiving In-111 Zevalin (ibritumomab)?

Before receiving ibritumomab, tell your doctor if you are allergic to any drugs, or if you have:

• liver disease;
• kidney disease;

• any type of infection;

• lung or breathing problems;

• bleeding or blood clotting problems;

• low platelet counts;

• low blood pressure; or

• a history of heart disease, heart attack, angina (chest pain), or irregular heart beats.

If you have any of these conditions, you may not be able to receive ibritumomab, or you may need a dosage adjustment or special tests during treatment.

Ibritumomab is made from human plasma (part of the blood) and may contain viruses and other infectious agents that can cause disease. Although donated human plasma is screened, tested, and treated to reduce the risk of it containing anything that could cause disease, there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of using this medication.

Some people receiving ibritumomab have developed "secondary" bone marrow or blood cell cancers such as leukemia. Talk with your doctor about your individual risk while receiving this medication.

How is ibritumomab used?

Ibritumomab is used in combination with rituximab (Rituxan) and a radioactive chemical. Ibritumomab is given as an injection through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection.

Ibritumomab is usually given every 7 to 9 days. Follow your doctor's instructions.

Ibritumomab can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. It is important that you not miss any scheduled visits to your doctor.

What happens if I miss a dose?

Contact your doctor if you miss an appointment for your ibritumomab injection.

What happens if I overdose?

Symptoms of an ibritumomab overdose may include weakness, pale skin, and easy bruising or bleeding.

What should I avoid while using In-111 Zevalin (ibritumomab)?

Avoid contact with people who have colds, the flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection.

In-111 Zevalin (ibritumomab) side effects

Call your doctor at once if you have any of these serious side effects:

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

• fever with chills, body aches, and other flu symptoms;

• easy bruising or bleeding, unusual weakness; or

• white patches or sores inside your mouth or on your lips.

Less serious side effects may be more likely to occur, such as:

• nausea, vomiting, loss of appetite;

• anxiety;

• dizziness; or

• joint pain.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect In-111 Zevalin (ibritumomab)?

Before receiving ibritumomab, tell your doctor if you are using any type of blood thinner or medication use to prevent blood clots, such as:

• warfarin (Coumadin);

• alteplase (Activase);

• anistreplase (Eminase);

• clopidogrel (Plavix);

• dipyridamole (Persantine);

• streptokinase (Kabikinase, Streptase);

• sulfinpyrazone (Anturane);

• ticlopidine (Ticlid); or

• urokinase (Abbokinase).

There may be other drugs that can affect ibritumomab. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your doctor or pharmacist has information about ibritumomab written for health professionals that you may read.

What does my medication look like?

Ibritumomab is available with a prescription under the brand name Zevalin. Other brand or generic formulations may also be available. Ask your healthcare provider or pharmacist any questions you have about this medication, especially if it is new to you.

• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.