ublituximab (Rx)

Brand and Other Names:Briumvi, ublituximab-xiiy

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 25 mg/mL (150mg/6mL single-dose vial)

Multiple Sclerosis

Indicated for treatment of relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease

First infusion: 150 mg IV

Second infusion: 450 mg IV 2 weeks after first infusion

Subsequent infusions: 450 mg IV 24 weeks after first infusion and then q24Weeks thereafter

Dosage Modifications

Infusion-related reactions

  • Refer to recommended infusion rates listed in Administration
  • Note: Change in rate will increase total duration of infusion, but not the total dose
  • Mild-to-moderate
    • Reduce infusion rate to half the rate at onset of reaction and maintain reduced rate for at least 30 minutes
    • If reduced rate tolerated, increase rate
  • Severe
    • Immediately interrupt infusion and administer appropriate supportive treatment, as necessary
    • Restart infusion only after all symptoms have resolved
    • When restarting, begin at half of infusion rate at time of onset of reaction; if tolerated, increase rate
  • Life-threatening
    • Immediately stop infusion and permanently discontinue

Renal impairment

  • Mild: No dosage adjustment necessary
  • Moderate-to-severe: Pharmacokinetics are unknown

Hepatic impairment

  • Mild: No dosage adjustment necessary
  • Moderate-to-severe: Pharmacokinetics are unknown

Dosing Considerations

Verify pregnancy status in females of reproductive potential before each infusion

Before every infusion, assess if there is an active infection; if active infection is confirmed, delay infusion until infection resolves

Hepatitis B virus (HBV)

  • Screen for HBV and quantitative serum immunoglobulin before initiating
  • Confirmed active HBV (patients with positive hepatitis B surface antigen [HBsAg] and anti-HBV tests): Contraindicated
  • Patients who are negative for HBsAg and positive for hepatitis B core antibody (HBcAb+) or who are carriers of HBV (HBsAg+): Consult liver disease experts before starting and during treatment

Serum immunoglobulins

  • Before initiating, perform testing for quantitative serum immunoglobulins
  • For low serum immunoglobulins, consult immunology experts before initiating

Vaccinations

  • Vaccination with live-attenuated or live vaccines is not recommended during treatment and after discontinuation until B-cell repletion
  • Administer all immunizations according to immunization guidelines
    • Live or live-attenuated vaccines: At least 4 weeks before initiating, whenever possible
    • Non-live vaccines: At least 2 weeks before initiating

Monitoring for infusion-related reactions

  • First 2 infusions: Closely monitor during and for at least 1 hr after completing infusions
  • Subsequent infusions: Monitor at discretion of healthcare provider unless infusion reaction and/or hypersensitivity have been observed

Safety and efficacy not established

Next:

Interactions

Interaction Checker

and ublituximab

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (1)

            • talimogene laherparepvec

              ublituximab and talimogene laherparepvec both increase immunosuppressive effects; risk of infection. Contraindicated. Talimogene laherparepvec is a live, attenuated herpes simplex virus and may cause life-threatening disseminated herpetic infection in patients who are immunocompromised

            Serious - Use Alternative (15)

            • axicabtagene ciloleucel

              ublituximab, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            • brexucabtagene autoleucel

              ublituximab, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            • ciltacabtagene autoleucel

              ublituximab, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            • deucravacitinib

              ublituximab and deucravacitinib both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            • epcoritamab

              ublituximab and epcoritamab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis.

            • glofitamab

              ublituximab and glofitamab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis.

            • ibritumomab tiuxetan

              ublituximab and ibritumomab tiuxetan both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis.

            • idecabtagene vicleucel

              ublituximab, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            • lisocabtagene maraleucel

              ublituximab, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            • mosunetuzumab

              ublituximab and mosunetuzumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis.

            • obinutuzumab

              ublituximab and obinutuzumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis.

            • ofatumumab

              ublituximab and ofatumumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis.

            • ofatumumab SC

              ublituximab, ofatumumab SC. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Duplicate therapy. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis. .

            • rituximab

              ublituximab and rituximab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Each drug is an anti-CD20 monoclonal antibody indicated for multiple sclerosis.

            • tisagenlecleucel

              ublituximab, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            Monitor Closely (269)

            • abacavir

              ublituximab decreases effects of abacavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • abatacept

              ublituximab and abatacept both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • abrocitinib

              ublituximab and abrocitinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • acyclovir

              ublituximab decreases effects of acyclovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • adalimumab

              ublituximab and adalimumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • adenovirus types 4 and 7 live, oral

              ublituximab decreases effects of adenovirus types 4 and 7 live, oral by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • ado-trastuzumab emtansine

              ublituximab and ado-trastuzumab emtansine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • aldesleukin

              ublituximab and aldesleukin both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • alefacept

              ublituximab and alefacept both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • alemtuzumab

              ublituximab and alemtuzumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • amantadine

              ublituximab decreases effects of amantadine by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • anakinra

              ublituximab and anakinra both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • anifrolumab

              ublituximab and anifrolumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • ansuvimab

              ublituximab and ansuvimab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • anthrax vaccine adsorbed

              ublituximab decreases effects of anthrax vaccine adsorbed by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • anthrax vaccine adsorbed, adjuvanted

              ublituximab decreases effects of anthrax vaccine adsorbed, adjuvanted by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • antithymocyte globulin equine

              ublituximab and antithymocyte globulin equine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • antithymocyte globulin rabbit

              ublituximab and antithymocyte globulin rabbit both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • atazanavir

              ublituximab decreases effects of atazanavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • atoltivimab/maftivimab/odesivimab

              ublituximab and atoltivimab/maftivimab/odesivimab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • azathioprine

              ublituximab and azathioprine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • baloxavir marboxil

              ublituximab decreases effects of baloxavir marboxil by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • balstilimab

              ublituximab and balstilimab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • baricitinib

              ublituximab and baricitinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • basiliximab

              ublituximab and basiliximab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • BCG intravesical live

              ublituximab and BCG intravesical live both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • BCG vaccine live

              ublituximab decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • belatacept

              ublituximab and belatacept both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • betamethasone

              ublituximab and betamethasone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • bevacizumab

              ublituximab and bevacizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • bezlotoxumab

              ublituximab and bezlotoxumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • bictegravir

              ublituximab decreases effects of bictegravir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • blinatumomab

              ublituximab and blinatumomab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • brentuximab vedotin

              ublituximab and brentuximab vedotin both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • brincidofovir

              ublituximab decreases effects of brincidofovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • brodalumab

              ublituximab and brodalumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • burosumab

              ublituximab and burosumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • C1 esterase inhibitor recombinant

              ublituximab and C1 esterase inhibitor recombinant both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • C1 inhibitor human

              ublituximab and C1 inhibitor human both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • cabotegravir

              ublituximab decreases effects of cabotegravir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • canakinumab

              ublituximab and canakinumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • capecitabine

              ublituximab and capecitabine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • caplacizumab

              ublituximab and caplacizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • certolizumab pegol

              ublituximab and certolizumab pegol both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • cetuximab

              ublituximab and cetuximab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • cholera vaccine

              ublituximab decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • cidofovir

              ublituximab decreases effects of cidofovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • corticotropin

              ublituximab and corticotropin both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • cortisone

              ublituximab and cortisone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • COVID-19 vaccine, adjuvanted-Novavax

              ublituximab decreases effects of COVID-19 vaccine, adjuvanted-Novavax by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • COVID-19 vaccine, mRNA-Moderna

              ublituximab decreases effects of COVID-19 vaccine, mRNA-Moderna by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • COVID-19 vaccine, mRNA-Pfizer

              ublituximab decreases effects of COVID-19 vaccine, mRNA-Pfizer by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • COVID-19 vaccine, viral vector-Janssen

              ublituximab decreases effects of COVID-19 vaccine, viral vector-Janssen by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • cyclophosphamide

              ublituximab and cyclophosphamide both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • cyclosporine

              ublituximab and cyclosporine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • cyclosporine ophthalmic

              ublituximab and cyclosporine ophthalmic both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • cytarabine

              ublituximab and cytarabine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • daclizumab

              ublituximab and daclizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • dapivirine intravaginal

              ublituximab decreases effects of dapivirine intravaginal by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • daratumumab

              ublituximab and daratumumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • darunavir

              ublituximab decreases effects of darunavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • deflazacort

              ublituximab and deflazacort both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • delavirdine

              ublituximab decreases effects of delavirdine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • dengue vaccine

              ublituximab decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • denosumab

              ublituximab and denosumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • dexamethasone

              ublituximab and dexamethasone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • didanosine

              ublituximab decreases effects of didanosine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • dimethyl fumarate

              ublituximab and dimethyl fumarate both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • dinutuximab

              ublituximab and dinutuximab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • diphtheria & tetanus toxoids

              ublituximab decreases effects of diphtheria & tetanus toxoids by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • diphtheria & tetanus toxoids/ acellular pertussis vaccine

              ublituximab decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine

              ublituximab decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • diroximel fumarate

              ublituximab and diroximel fumarate both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • dolutegravir

              ublituximab decreases effects of dolutegravir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • doravirine

              ublituximab decreases effects of doravirine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • Ebola Zaire vaccine

              ublituximab decreases effects of Ebola Zaire vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • ecallantide

              ublituximab and ecallantide both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • eculizumab

              ublituximab and eculizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • efavirenz

              ublituximab decreases effects of efavirenz by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • efgartigimod alfa

              efgartigimod alfa will decrease the level or effect of ublituximab by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.

            • efgartigimod/hyaluronidase SC

              efgartigimod/hyaluronidase SC will decrease the level or effect of ublituximab by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.

            • elotuzumab

              ublituximab and elotuzumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • elvitegravir

              ublituximab decreases effects of elvitegravir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              ublituximab decreases effects of elvitegravir/cobicistat/emtricitabine/tenofovir DF by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • emapalumab

              ublituximab and emapalumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • emicizumab

              ublituximab and emicizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • emtricitabine

              ublituximab decreases effects of emtricitabine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • enfuvirtide

              ublituximab decreases effects of enfuvirtide by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • etanercept

              ublituximab and etanercept both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • etravirine

              ublituximab decreases effects of etravirine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • famciclovir

              ublituximab decreases effects of famciclovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • fedratinib

              ublituximab and fedratinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • filgotinib

              ublituximab and filgotinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • fingolimod

              ublituximab and fingolimod both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • floxuridine

              ublituximab and floxuridine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • fludarabine

              ublituximab and fludarabine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • fludrocortisone

              ublituximab and fludrocortisone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • fluorouracil

              ublituximab and fluorouracil both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • fosamprenavir

              ublituximab decreases effects of fosamprenavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • foscarnet

              ublituximab decreases effects of foscarnet by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • fostemsavir

              ublituximab decreases effects of fostemsavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • ganciclovir

              ublituximab decreases effects of ganciclovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • gemcitabine

              ublituximab and gemcitabine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • gemtuzumab

              ublituximab and gemtuzumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • glatiramer

              ublituximab and glatiramer both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • golimumab

              ublituximab and golimumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • guselkumab

              ublituximab and guselkumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • haemophilus influenzae type b vaccine

              ublituximab decreases effects of haemophilus influenzae type b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • hepatitis A vaccine inactivated

              ublituximab decreases effects of hepatitis A vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • hepatitis a/b vaccine

              ublituximab decreases effects of hepatitis a/b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • hepatitis b vaccine

              ublituximab decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • HIV vaccine

              ublituximab decreases effects of HIV vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • human papillomavirus vaccine, bivalent

              ublituximab decreases effects of human papillomavirus vaccine, bivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • human papillomavirus vaccine, nonavalent

              ublituximab decreases effects of human papillomavirus vaccine, nonavalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • human papillomavirus vaccine, quadrivalent

              ublituximab decreases effects of human papillomavirus vaccine, quadrivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • hydrocortisone

              ublituximab and hydrocortisone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • hydroxychloroquine sulfate

              ublituximab and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • hydroxyurea

              ublituximab and hydroxyurea both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ibalizumab

              ublituximab decreases effects of ibalizumab by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • icatibant

              ublituximab and icatibant both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • indinavir

              ublituximab decreases effects of indinavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • inebilizumab

              ublituximab and inebilizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • infliximab

              ublituximab and infliximab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • influenza A (H5N1) vaccine

              ublituximab decreases effects of influenza A (H5N1) vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine (H5N1), adjuvanted

              ublituximab decreases effects of influenza virus vaccine (H5N1), adjuvanted by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine quadrivalent

              ublituximab decreases effects of influenza virus vaccine quadrivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine quadrivalent, adjuvanted

              ublituximab decreases effects of influenza virus vaccine quadrivalent, adjuvanted by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine quadrivalent, cell-cultured

              ublituximab decreases effects of influenza virus vaccine quadrivalent, cell-cultured by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine quadrivalent, intranasal

              ublituximab decreases effects of influenza virus vaccine quadrivalent, intranasal by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine quadrivalent, recombinant

              ublituximab decreases effects of influenza virus vaccine quadrivalent, recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine trivalent

              ublituximab decreases effects of influenza virus vaccine trivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine trivalent, adjuvanted

              ublituximab decreases effects of influenza virus vaccine trivalent, adjuvanted by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • influenza virus vaccine trivalent, recombinant

              ublituximab decreases effects of influenza virus vaccine trivalent, recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • interferon alfa 2b

              ublituximab and interferon alfa 2b both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • interferon alfa n3

              ublituximab and interferon alfa n3 both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • interferon alfacon 1

              ublituximab and interferon alfacon 1 both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • interferon beta 1a

              ublituximab and interferon beta 1a both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • interferon beta 1b

              ublituximab and interferon beta 1b both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • interferon gamma 1b

              ublituximab and interferon gamma 1b both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ipilimumab

              ublituximab and ipilimumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • isatuximab

              ublituximab and isatuximab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • Japanese encephalitis virus vaccine

              ublituximab decreases effects of Japanese encephalitis virus vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • lamivudine

              ublituximab decreases effects of lamivudine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • leflunomide

              ublituximab and leflunomide both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • letermovir

              ublituximab decreases effects of letermovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • loncastuximab tesirine

              ublituximab and loncastuximab tesirine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • maraviroc

              ublituximab decreases effects of maraviroc by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • maribavir

              ublituximab decreases effects of maribavir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • measles (rubeola) vaccine

              ublituximab decreases effects of measles (rubeola) vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • measles mumps and rubella vaccine, live

              ublituximab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • measles, mumps, rubella and varicella vaccine, live

              ublituximab decreases effects of measles, mumps, rubella and varicella vaccine, live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine

              ublituximab decreases effects of meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • meningococcal A C Y and W-135 diphtheria conjugate vaccine

              ublituximab decreases effects of meningococcal A C Y and W-135 diphtheria conjugate vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • meningococcal A C Y and W-135 polysaccharide vaccine combined

              ublituximab decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • meningococcal C and Y/haemophilus influenza type B vaccine

              ublituximab decreases effects of meningococcal C and Y/haemophilus influenza type B vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • meningococcal group B vaccine

              ublituximab decreases effects of meningococcal group B vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • mercaptopurine

              ublituximab and mercaptopurine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • methotrexate

              ublituximab and methotrexate both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • methylprednisolone

              ublituximab and methylprednisolone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • mirvetuximab soravtansine

              ublituximab and mirvetuximab soravtansine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • modified ragweed tyrosine adsorbate

              ublituximab decreases effects of modified ragweed tyrosine adsorbate by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • mogamulizumab

              ublituximab and mogamulizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • momelotinib

              ublituximab and momelotinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • mometasone sinus implant

              ublituximab and mometasone sinus implant both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • monomethyl fumarate

              ublituximab and monomethyl fumarate both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • moxetumomab pasudotox

              ublituximab and moxetumomab pasudotox both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • muromonab CD3

              ublituximab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • mycophenolate

              ublituximab and mycophenolate both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • nadofaragene firadenovec

              ublituximab and nadofaragene firadenovec both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • narsoplimab

              ublituximab and narsoplimab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • natalizumab

              ublituximab and natalizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • naxitamab

              ublituximab and naxitamab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • nelarabine

              ublituximab and nelarabine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • nelfinavir

              ublituximab decreases effects of nelfinavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • nevirapine

              ublituximab decreases effects of nevirapine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • nivolumab

              ublituximab and nivolumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ocrelizumab

              ublituximab and ocrelizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • olaratumab

              ublituximab and olaratumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • oportuzumab monatox

              ublituximab and oportuzumab monatox both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • oseltamivir

              ublituximab decreases effects of oseltamivir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • pacritinib

              ublituximab and pacritinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • panitumumab

              ublituximab and panitumumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • peginterferon beta-1a

              ublituximab and peginterferon beta-1a both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • pembrolizumab

              ublituximab and pembrolizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • pentostatin

              ublituximab and pentostatin both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • peramivir

              ublituximab decreases effects of peramivir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • pimecrolimus

              ublituximab and pimecrolimus both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • pneumococcal vaccine 13-valent

              ublituximab decreases effects of pneumococcal vaccine 13-valent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • pneumococcal vaccine 15-valent

              ublituximab decreases effects of pneumococcal vaccine 15-valent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • pneumococcal vaccine 20-valent

              ublituximab decreases effects of pneumococcal vaccine 20-valent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • pneumococcal vaccine heptavalent

              ublituximab decreases effects of pneumococcal vaccine heptavalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • pneumococcal vaccine polyvalent

              ublituximab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • poliovirus vaccine inactivated

              ublituximab decreases effects of poliovirus vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • poliovirus vaccine live oral trivalent

              ublituximab decreases effects of poliovirus vaccine live oral trivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • pralatrexate

              ublituximab and pralatrexate both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • prednisolone

              ublituximab and prednisolone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • prednisone

              ublituximab and prednisone both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • rabies vaccine

              ublituximab decreases effects of rabies vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • rabies vaccine chick embryo cell derived

              ublituximab decreases effects of rabies vaccine chick embryo cell derived by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • raltegravir

              ublituximab decreases effects of raltegravir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • ravulizumab

              ublituximab and ravulizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • raxibacumab

              ublituximab and raxibacumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • remdesivir

              ublituximab decreases effects of remdesivir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • remestemcel-L

              ublituximab and remestemcel-L both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • respiratory syncytial virus (RSV) vaccine

              ublituximab decreases effects of respiratory syncytial virus (RSV) vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • rilonacept

              ublituximab and rilonacept both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • rilpivirine

              ublituximab decreases effects of rilpivirine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • rimantadine

              ublituximab decreases effects of rimantadine by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • risankizumab

              ublituximab and risankizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ritlecitinib

              ublituximab and ritlecitinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ritonavir

              ublituximab decreases effects of ritonavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • rituximab-hyaluronidase

              ublituximab and rituximab-hyaluronidase both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • romosozumab

              ublituximab and romosozumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ropeginterferon alfa 2b

              ublituximab and ropeginterferon alfa 2b both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • rotavirus oral vaccine, live

              ublituximab decreases effects of rotavirus oral vaccine, live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • rozanolixizumab

              rozanolixizumab will decrease the level or effect of ublituximab by receptor binding competition. Use Caution/Monitor. Coadministration of rozanolixizumab with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing rozanolixizumab and using alternative therapies.

            • rubella vaccine

              ublituximab decreases effects of rubella vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • ruxolitinib

              ublituximab and ruxolitinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ruxolitinib topical

              ublituximab and ruxolitinib topical both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • saquinavir

              ublituximab decreases effects of saquinavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • sarilumab

              ublituximab and sarilumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • SARS-CoV-2 vaccine, inactivated

              ublituximab decreases effects of SARS-CoV-2 vaccine, inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • secukinumab

              ublituximab and secukinumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • siltuximab

              ublituximab and siltuximab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • sintilimab

              ublituximab and sintilimab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • sipuleucel-T

              ublituximab decreases effects of sipuleucel-T by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressants may decrease therapeutic effect of sipuleucel-T. Consider reducing dose or discontinuing immunosuppressants before initiating sipuleucel-T.

            • sirolimus

              ublituximab and sirolimus both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • sirolimus intravitreal

              ublituximab and sirolimus intravitreal both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • sirukumab

              ublituximab and sirukumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • smallpox (vaccinia) and monkeypox vaccine, live, nonreplicating

              ublituximab decreases effects of smallpox (vaccinia) vaccine, attenuated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • smallpox (vaccinia) vaccine, attenuated

              ublituximab decreases effects of smallpox (vaccinia) vaccine, attenuated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • smallpox (vaccinia) vaccine, live

              ublituximab decreases effects of smallpox (vaccinia) vaccine, live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • stavudine

              ublituximab decreases effects of stavudine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • sutimlimab

              ublituximab and sutimlimab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tacrolimus

              ublituximab and tacrolimus both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tacrolimus ointment

              ublituximab and tacrolimus ointment both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tafasitamab

              ublituximab and tafasitamab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tecovirimat

              ublituximab decreases effects of tecovirimat by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • tenofovir DF

              ublituximab decreases effects of tenofovir DF by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • teplizumab

              ublituximab and teplizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • teprotumumab

              ublituximab and teprotumumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tetanus & reduced diphtheria toxoids/ acellular pertussis vaccine

              ublituximab decreases effects of tetanus & reduced diphtheria toxoids/ acellular pertussis vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • tetanus toxoid adsorbed or fluid

              ublituximab decreases effects of tetanus toxoid adsorbed or fluid by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • thioguanine

              ublituximab and thioguanine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tick-borne encephalitis vaccine

              ublituximab decreases effects of tick-borne encephalitis vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • tipranavir

              ublituximab decreases effects of tipranavir by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • tocilizumab

              ublituximab and tocilizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tofacitinib

              ublituximab and tofacitinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • tositumomab

              ublituximab and tositumomab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • trastuzumab

              ublituximab and trastuzumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • trastuzumab deruxtecan

              ublituximab and trastuzumab deruxtecan both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • trastuzumab duocarmazine

              ublituximab and trastuzumab duocarmazine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • travelers diarrhea and cholera vaccine inactivated

              ublituximab decreases effects of travelers diarrhea and cholera vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • triamcinolone acetonide extended-release injectable suspension

              ublituximab and triamcinolone acetonide extended-release injectable suspension both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • triamcinolone acetonide injectable suspension

              ublituximab and triamcinolone acetonide injectable suspension both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • typhoid polysaccharide vaccine

              ublituximab decreases effects of typhoid polysaccharide vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • typhoid vaccine live

              ublituximab decreases effects of typhoid vaccine live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • upadacitinib

              ublituximab and upadacitinib both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • ustekinumab

              ublituximab and ustekinumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • valacyclovir

              ublituximab decreases effects of valacyclovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • valganciclovir

              ublituximab decreases effects of valganciclovir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • varicella virus vaccine live

              ublituximab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • vedolizumab

              ublituximab and vedolizumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • voclosporin

              ublituximab and voclosporin both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

            • yellow fever vaccine

              ublituximab decreases effects of yellow fever vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • zanamivir

              ublituximab decreases effects of zanamivir by immunosuppressive effects; risk of infection. Use Caution/Monitor.

            • zidovudine

              ublituximab decreases effects of zidovudine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely.

            • zoster vaccine live

              ublituximab decreases effects of zoster vaccine live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • zoster vaccine recombinant

              ublituximab decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            Minor (0)

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              Adverse Effects

              >10%

              Infusion reactions (48%)

              Upper respiratory tract infections (45%)

              IgM below the LLN at 96 weeks (20.9%)

              1-10%

              Lower respiratory tract infections (9%)

              Herpes-virus-associated infections (6%)

              IgG below the LLN at 96 weeks (6.5%)

              Pain in extremity (6%)

              Insomnia (6%)

              Fatigue (5%)

              IgA below the LLN at 96 weeks (2.4%)

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              Warnings

              Contraindications

              Active hepatitis B virus infection

              History of life-threatening infusion reaction to ublituximab

              Cautions

              Based on animal studies, fetal harm may occur when administered to pregnant females

              Decreased immunoglobulin levels

              • Decreased immunoglobulin levels observed; monitor levels of quantitative serum immunoglobulins during treatment, especially in patients with opportunistic or recurrent infections, and after discontinuation until B-cell repletion
              • Consider discontinuing therapy if
                • Patients with low immunoglobulins develop serious opportunistic or recurrent infections
                • Prolonged hypogammaglobulinemia occurs requiring treatment with IV immunoglobulins

              Infections

              • Serious bacterial and viral infections reported
              • An increased risk of infections, including serious and fatal bacterial, fungal, and new or reactivated viral infections, observed during and after completion of other anti-CD20 B-cell–depleting treatments
              • Delay administration in patients with an active infection until infection is resolved
              • When initiating after an immunosuppressive therapy or initiating an immunosuppressive therapy, consider potential for increased immunosuppressive effects
              • Not studied in combination with other MS therapies
              • Progressive multifocal leukoencephalopathy (PML)
                • PML is an opportunistic viral infection of the brain caused by the JC virus (JCV) that typically only occurs in patients who are immunocompromised
                • JCV infection resulting in PML has been observed in patients treated with other anti-CD20 antibodies and other MS therapies
                • Symptoms associated with PML are diverse, progress over days to weeks, and include progressive weakness on one side of body or clumsiness of limbs, disturbance of vision, and changes in thinking, memory, and orientation leading to confusion and personality changes
                • At first sign or symptom suggestive of PML, withhold therapy and perform an appropriate diagnostic evaluation
                • If PML is suspected, monitor with MRI for signs that may be consistent with PML and further investigate
                • If confirmed, discontinue treatment
              • HBV reactivation
                • HBV reactivation may occur
                • Fulminant hepatitis, hepatic failure, and death caused by HBV reactivation reported in patients treated with anti-CD20 antibodies
                • Screen for HBV in all patients before initiating
                • Do not initiate with active HBV confirmed by positive results for HBsAg and anti-HB tests
                • For patients who are negative for HBsAg and HBcAb+ or who are HBsAg+, consult a liver disease expert before starting and during treatment

              Infusion-related reactions

              • Infusion-related reactions (eg, pyrexia, chills, headache, influenza-like illness, tachycardia, nausea, throat irritation, erythema, anaphylactic reactions) reported
              • Administer premedications (eg, methylprednisolone or an equivalent corticosteroid, and an antihistamine) to reduce frequency and severity of infusion reactions; consider adding of an antipyretic (eg, acetaminophen)
              • Manage infusion reactions based on severity

              Drug interaction overview

              • Vaccinations
                • Administer all immunizations according to immunization guidelines at least 4 weeks before initiating for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines
                • Ublituximab may interfere with non-live vaccine efficacy
                • Safety of immunization with live or live-attenuated vaccines during or following treatment not studied
                • Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion
              • Vaccination of Infants born to mothers treated during pregnancy
                • Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells
                • Depletion of B cells in these infants may increase the risks from live or live-attenuated vaccines
                • Inactivated or non-live vaccines may be administered as indicated, before recovering from B-cell depletion; consider assessing vaccine immune responses, such as through consultation with a qualified specialist, to determine whether a protective immune response has mounted
              • Immunosuppressive or immune-modulating therapies
                • Ublituximab may potentiate risk of additive immune system effects when coadministered with immunosuppressive or immune-modulating therapies
                • Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies when switching from therapies with immune effects to ublituximab
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              Pregnancy & Lactation

              Pregnancy

              There are no data on developmental risk associated with use in pregnant females

              Data are insufficient to identify drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes

              However, monoclonal antibodies can be actively transported across the placenta and may cause immunosuppression to in-utero exposed infant

              Verify pregnancy status in females of reproductive potential

              Fetal/neonatal adverse reactions

              Transport of endogenous IgG antibodies across placenta increases as pregnancy progresses and peaks during third trimester

              No data are available on B-cell levels in human neonates following maternal exposure to ublituximab

              However, transient peripheral B-cell depletion and lymphocytopenia reported in infants born to mothers exposed to other anti-CD20 antibodies during pregnancy

              Avoid administering live vaccines to neonates and infants exposed to ublituximab in utero until B-cell recovery occurs

              Contraception

              • Females of reproductive potential: Use effective contraception during treatment and for 6 months after final dose

              Animal data

              • Weekly IV administration to pregnant monkeys during pregnancy resulted in embryofetal loss
              • Administration during second trimester resulted in external, skeletal, and visceral abnormalities in infants

              Lactation

              There are no data on drug presence in human milk, effects on breastfed infants, or effects on milk production

              Human IgG is excreted in human milk; potential for drug absorption leading to B-cell depletion in infants is unknown

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Precise mechanism of action for multiple sclerosis is unknown

              May involve binding to CD20, a cell surface antigen presented on pre-B and mature B lymphocytes

              After binding to B lymphocytes, ublituximab results in cell lysis through mechanisms including antibody-dependent cellular cytolysis and complement-dependent cytolysis

              Absorption

              Peak plasma concentration: 139 mcg/mL

              AUC (steady-state): 3,000 mcg·day/mL

              Distribution

              Vd: 3.18 L

              Metabolism

              Protein expected to degrade into small peptides and amino acids by ubiquitous proteolytic enzymes

              Elimination

              Half-life: 22 days

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              Administration

              IV Compatibilities

              0.9% NaCl

              No incompatibilities with polyvinyl chloride (PVC) or polyolefin (PO) bags and IV administration sets observed

              IV Preparation

              Visually inspect vials before administering; solution should be clear to opalescent, colorless to slightly yellow; discard if discolored or if solution contains discrete foreign particulate matter

              150 mg dose

              • Withdraw 6 mL from 250-mL 0.9% NaCl infusion bag and discard
              • Withdraw 6 mL of drug from vial and add into prepared 0.9% NaCl infusion bag
              • Gently invert to mix diluted solution by gentle inversion; do not shake

              450 mg dose

              • Withdraw 18 mL from 250-mL 0.9% NaCl infusion bag and discard
              • Withdraw 18 mL of drug from vials and add into prepared 0.9% NaCl infusion bag
              • Gently invert to mix diluted solution by gentle inversion; do not shake

              Premedication

              Premedicate before each infusion to reduce frequency and severity of infusion reactions

              Methylprednisolone 100 mg IV (or an equivalent oral dosage or equivalent corticosteroid) ~30 min before each infusion

              Antihistamine (eg, diphenhydramine) PO or IV ~30-60 min before each infusion

              Consider also adding an antipyretic (eg, acetaminophen)

              IV Administration

              Administer under close supervision of experienced healthcare professional with access to appropriate medical support to manage severe reactions (eg, serious infusion reactions)

              Before starting infusion, allow it to equilibrate to room temperature before administration (~2 hr)

              Administer diluted infusion solution through a dedicated line

              Recommended infusion rate and duration

              • Infusion duration may take longer if infusion is interrupted or slowed
              • First Infusion (150-mg dose)
                • Start at 10 mL/hr for first 30 min, THEN
                • Increase to 20 mL/hr for next 30 min, THEN
                • Increase to 35 mL/hr for next hr, THEN
                • Increase to 100 mL/hr for remaining 2 hr
                • Duration of infusion: 4 hr
              • Second infusion and subsequent infusions (450-mg dose)
                • Start at 100 mL/hr for first 30 min, THEN
                • Increase to 400 mL/hr for remaining 30 min
                • Duration of infusion: 1 hr

              Monitoring for infusion-related reactions

              • First 2 infusions: Observe for at least 1 hr after completing infusion
              • Subsequent infusions: Monitor at discretion of healthcare provider unless an infusion reaction and/or hypersensitivity observed with any infusion

              Storage

              Unopened vials

              • Refrigerate at 2-8ºC (36-46ºF) in outer carton to protect from light
              • Do not freeze
              • Do not shake

              Diluted infusion

              • Use immediately
              • If not used immediately, refrigerate at 2-8ºC (36-46ºF) for up to 24 hr; do not freeze
              • May be stored for an additional 8 hr at room temperature up to 25ºC (77ºF), which includes equilibration time and infusion time
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              Images

              No images available for this drug.
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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.