Obinutuzumab (Gazyva®)

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About This Drug

Obinutuzumab is a drug used to treat cancer. It is given in the vein (IV).

Possible Side Effects 

  • A decrease in the number of white blood cells and platelets. This may raise your risk of infection and raise your risk of bleeding.
  • Fever
  • Tiredness and weakness
  • Headache
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.
  • Trouble sleeping (insomnia)
  • Sinus inflammation
  • Cough
  • Upper respiratory infection
  • Pneumonia
  • Itching
  • Decreased appetite (decreased hunger)
  • Loose bowel movements (diarrhea)
  • Constipation (unable to move bowels)
  • Joint, bone and muscle pain
  • Herpes virus infection
  • Urinary tract infection
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug. Sometimes you may be given medication to stop or lessen these side effects. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen after your infusion. If this happens, call 911 for emergency care.

Note:  Each of the side effects above was reported in 10% or greater of patients treated with obinotuzumab.  Not all possible side effects are included above.

Warnings and Precautions

  • Severe infusion reactions and allergic reactions which can rarely be life-threatening
  • Severe decrease in the numbers of white blood cells and platelets which can be life-threatening
  • Severe infections, including viral, bacterial and fungal, which can very rarely be life-threatening
  • Reactivation of the hepatitis B virus if you have been exposed in the past, which may very rarely cause liver failure and be life-threatening
  • Changes in your central nervous system can happen which can rarely be life-threatening. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, have hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • Tumor lysis syndrome: This drug may act on the cancer cells very quickly. This may affect how your kidneys work and rarely be life-threatening.
  • A baby exposed to obinutuzumab in pregnancy may have decreased white blood cells

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information

  • Talk to your doctor before receiving any vaccinations during and while you are recovering from your treatment. Some vaccinations with live or weakened vaccines are not recommended.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease the risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Keeping your pain under control is important to your wellbeing. Please tell your doctor or nurse if you are experiencing pain.
  • If you are having trouble sleeping, talk to your nurse or doctor on tips to help you sleep better.
  • To help with decreased appetite, eat small, frequent meals. 
  • Eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • Consider using sauces and spices to increase taste. Daily exercise, with your doctor’s approval, may increase your appetite.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation and/or diarrhea.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Infusion reactions may occur after your infusion. If this happens, call 911 for emergency care. 
  • Moisturize your skin several times a day.
  • Avoid sun exposure and apply sunscreen routinely when outdoors.
  • To help with hair loss, wash with a mild shampoo and avoid washing your hair every day.
  • Avoid rubbing your scalp, pat your hair or scalp dry.
  • Avoid coloring your hair.
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.

Food and Drug Interactions

  • There are no known interactions of obinutuzumab with food and other medications
  • Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions. 

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.4 F (38 C) or higher
  • Chills
  • Tiredness that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Chest pain
  • Easy bleeding or bruising
  • Headache that does not go away
  • Trouble falling or staying asleep
  • Itching that is bothersome
  • Confusion and/or agitation
  • Seizures
  • Hallucinations
  • Trouble understanding or speaking
  • Blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Wheezing or trouble breathing
  • Coughing up yellow, green, or bloody mucus
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Loose bowel movements (diarrhea), 4 times in one day or loose bowel movements with lack of strength or a feeling of being dizzy
  • No bowel movement in 3 days or when you feel uncomfortable
  • Pain or burning when you pass urine
  • Difficulty urinating
  • Feeling like you have to pass urine often, but not much comes out when you do
  • Tender or heavy feeling in your lower abdomen
  • Cloudy urine and/or urine that smells bad
  • Pain on one side of your back under your ribs. This is where your kidneys are.
  • Pain that does not go away, or is not relieved by prescribed medicines
  • Signs of tumor lysis: Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. If this happens, call 911 for emergency care.
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: It is not known if this drug may harm an unborn child. For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while receiving this drug. Let your doctor know right away if you think you may be pregnant. 
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby. 
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. 

Revised June 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.