Proactively managing key risks such as infection, liver injury, and vaccine administration during the use of rituximab is a core aspect of ensuring medication safety. Here are three specific precautions:

1、 Proactive prevention and control of infection risk

Daily prevention: wash hands frequently, avoid going to crowded and poorly ventilated places; When there are signs of infection such as fever, cough, or sore throat, promptly measure body temperature and record the onset time of symptoms.

Medical communication: Any infection (including mild symptoms) must be reported to the doctor, who will determine whether to suspend medication; Avoid close contact with patients with active tuberculosis, shingles, or chickenpox during treatment.

Latent infection screening: For those who have completed tuberculosis screening before medication, if night sweats or weight loss occur during treatment, relevant indicators need to be rechecked.

2、 Monitoring and Management of Hepatotoxicity

Regular testing: check liver function (ALT/AST/bilirubin) every 2-4 weeks before medication and 3 months before treatment; Follow up check ups should be conducted at least every 3 months.

Warning symptoms: If there is obvious fatigue, darkened urine color (brown), yellowing of the skin or sclera, and pain in the upper right abdomen, the medication should be stopped immediately and liver function should be checked urgently.

Avoid cumulative damage: Use acetaminophen with caution during treatment if it exceeds 2g/day, abstain from alcohol, and do not self medicate with Chinese herbs or health products (such as Polygonum multiflorum and Tripterygium wilfordii).

3、 Strict regulations on vaccine management

Contraindications for live vaccines: During the medication period and at least 4 weeks after discontinuation, it is prohibited to receive attenuated live vaccines for mumps, chickenpox, herpes zoster, and nasal spray influenza vaccines.

Inactivated vaccine can be vaccinated: Inactivated influenza vaccine, COVID-19 vaccine and pneumococcal vaccine can be vaccinated after the doctor's evaluation, but the immune response may be weakened, so it is recommended to complete the basic immunization in advance.

Vaccination timing: The planned vaccine recipient should consult with their doctor and try to wait at least 7 days before the next dose. After vaccination, observe for 30 minutes before leaving the hospital.