consider discontinuing efgartigimod and using alternative therapies.fingolimodMonitor Closely (1)rituximab increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .hepatitis A vaccine inactivatedMonitor Closely (1)rituximab, hepatitis A vaccine inactivated. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.hepatitis a/b vaccineMonitor Closely (1)rituximab, hepatitis a/b vaccine. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.hepatitis b vaccineMonitor Closely (1)rituximab, hepatitis b vaccine. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.HIV vaccineMonitor Closely (1)rituximab, HIV vaccine. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.human papillomavirus vaccine, nonavalentMonitor Closely (1)rituximab, human papillomavirus vaccine, nonavalent. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.human papillomavirus vaccine, quadrivalentMonitor Closely (1)rituximab, human papillomavirus vaccine, quadrivalent. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.idecabtagene vicleucelSerious - Use Alternative (2)rituximab, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. idecabtagene vicleucel, rituximab. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.influenza A (H5N1) vaccineMonitor Closely (1)rituximab, influenza A (H5N1) vaccine. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.influenza virus vaccine (H5N1), adjuvantedMonitor Closely (1)rituximab, influenza virus vaccine (H5N1), adjuvanted. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.influenza virus vaccine quadrivalentMonitor Closely (1)rituximab, influenza virus vaccine quadrivalent. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.influenza virus vaccine quadrivalent, adjuvantedMonitor Closely (1)rituximab, influenza virus vaccine quadrivalent, adjuvanted. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.influenza virus vaccine quadrivalent, cell-culturedMonitor Closely (1)rituximab, influenza virus vaccine quadrivalent, cell-cultured. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.influenza virus vaccine quadrivalent, intranasalSerious - Use Alternative (1)rituximab, influenza virus vaccine quadrivalent, intranasal. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.influenza virus vaccine trivalentMonitor Closely (1)rituximab, influenza virus vaccine trivalent. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.influenza virus vaccine trivalent, adjuvantedMonitor Closely (1)rituximab, influenza virus vaccine trivalent, adjuvanted. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.ioversolMonitor Closely (1)ioversol and rituximab both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.Japanese encephalitis virus vaccineMonitor Closely (1)rituximab, Japanese encephalitis virus vaccine. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.lisocabtagene maraleucelSerious - Use Alternative (2)rituximab, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. lisocabtagene maraleucel, rituximab. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.measles (rubeola) vaccineSerious - Use Alternative (1)rituximab, measles (rubeola) vaccine. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.measles mumps and rubella vaccine, liveSerious - Use Alternative (1)rituximab, measles mumps and rubella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.measles, mumps, rubella and varicella vaccine, liveSerious - Use Alternative (1)rituximab, measles, mumps, rubella and varicella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.mechlorethamineMonitor Closely (1)mechlorethamine, rituximab. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with mechlorethamine may increase the risk of immunosuppression and myelosuppression.ofatumumab SCMonitor Closely (1)ofatumumab SC, rituximab. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.paliferminSerious - Use Alternative (1)palifermin increases toxicity of rituximab by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hr before, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.poliovirus vaccine inactivatedMonitor Closely (1)rituximab decreases effects of poliovirus vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response may be suboptimal. Patients on chemotherapy with anti-B cell antibodies should wait =6 months after therapy before being vaccinated with inactivated vaccines.ponesimodMonitor Closely (1)ponesimod and rituximab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.rabies vaccineMonitor Closely (1)rituximab, rabies vaccine. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.rabies vaccine chick embryo cell derivedMonitor Closely (1)rituximab, rabies vaccine chick embryo cell derived. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.ropeginterferon alfa 2bSerious - Use Alternative (1)ropeginterferon alfa 2b, rituximab. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.rotavirus oral vaccine, liveSerious - Use Alternative (1)rituximab, rotavirus oral vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.rozanolixizumabMonitor Closely (1)rozanolixizumab will decrease the level or effect of rituximab 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 vaccineSerious - Use Alternative (1)rituximab, rubella vaccine. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.siponimodMonitor Closely (1)siponimod and rituximab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.sipuleucel-TMonitor Closely (1)rituximab decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.smallpox (vaccinia) vaccine, liveSerious - Use Alternative (1)rituximab, smallpox (vaccinia) vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.tisagenlecleucelSerious - Use Alternative (2)rituximab, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. tisagenlecleucel, rituximab. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.trastuzumabMonitor Closely (1)trastuzumab, rituximab. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy.trastuzumab deruxtecanMonitor Closely (1)trastuzumab deruxtecan, rituximab. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy.ublituximabSerious - Use Alternative (1)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. varicella virus vaccine liveSerious - Use Alternative (1)rituximab, varicella virus vaccine live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.yellow fever vaccineSerious - Use Alternative (1)rituximab, yellow fever vaccine. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.zoster vaccine liveSerious - Use Alternative (1)rituximab, zoster vaccine live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.zoster vaccine recombinantMonitor Closely (1)rituximab, zoster vaccine recombinant. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab. >10% NHL Angioedema (11%) Asthenia (26%), chills (33%), dizziness (10%), fever (53%), headache (19%) Pruritus (14%), rash (15%) Abdominal pain (14%), diarrhea (10%), nausea (23%), vomiting (10%) Leukopenia (14%), lymphopenia (48%), neutropenia (14%), thrombocytopenia (12%) Back pain (10%), myalgia (10%) Cough (13%), rhinitis (12%) Infection (31%), night sweats (15%) GPA and MPA Nausea (18%) Diarrhea (17%) Headache (17%) Muscle spasms (17%) Anemia (16%) Peripheral edema (16%) Insomnia (14%) Arthralgia (13%) Cough (13%) Fatigue (13%) Increased ALT (13%) Hypertension (12%) Epistaxis (11%) PV Infusion reactions (58%) Depression (18%) Herpes simplex (13%) Alopecia (13%) 1-10% NHL Edema Flushing Hypertension Anxiety Anemia Elevated LDH Hyperglycemia Bronchospasm, dyspnea, sinusitis, throat irritation, urticaria RA (Rituximab+Methotrexate vs Methotrexate Alone) Hypertension Anxiety, asthenia, chills, migraine, paresthesia, pyrexia Pruritus, urticaria Dyspepsia, nausea, upper abd pain Hypercholesterolemia Arthralgia Rhinitis, throat irritation, URI GPA and MPA Dyspnea (10%) Leukopenia (10%) Rash (10%) PV Fatigue (8%) Upper abdominal pain (5%) Conjunctivitis (5%) Dizziness, headache (5%) Herpes zoster (5%) Irritability (5%) Muscular pain (5%) Pyrexia (5%) Tachycardia (5%) Pruritus, skin disorder, skin papilloma, urticaria (5%) Frequency Not Defined Tumor lysis syndrome Lymphoid malignancies Hypogammaglobulinemia Postmarketing Reports Hematologic: Prolonged pancytopenia, marrow hypoplasia, Grade 3-4 prolonged or late-onset neutropenia, hyperviscosity syndrome in Waldenstrom macroglobulinemia, prolonged hypogammaglobulinemia Cardiac: Fatal cardiac failure Immune/autoimmune events: Uveitis, optic neuritis, systemic vasculitis, pleuritis, lupus-like syndrome, serum sickness, polyarticular arthritis, and vasculitis with rash Infection: Viral infections, including progressive multifocal leukoencephalopathy (PML), increase in fatal infections in HIV-associated lymphoma, and a reported increased incidence