Obinutuzumab – Uses, Dosage, Side Effects, Interaction Obinutuzumab is an antineoplastic CD20 antibody used to treat untreated chronic lymphocytic leukemia in combination with chlorambucil. Obinutuzumab is a humanized monoclonal antibody used as a combination treatment with chlorambucil to treat patients with untreated chronic lymphocytic leukemia. It was approved by the FDA in November 2013 and is marketed under the brand name Gazyva. There is a black box warning of fatal Hepatitis B Virus (HBV) reactivation and fatal Progressive Multifocal Leukoencephalopathy (PML). Mechanism of action In contrast to rituximab, which is a classic type I CD20 antibody, obinutuzumab binds to type II CD20 antibodies. This allows obinutuzumab to have a much higher induction of antibody-dependant cytotoxicity and a higher direct cytotoxic effect than the classic CD20 antibodies. Obinutuzumab is a monoclonal antibody that targets the CD20 antigen expressed on the surface of pre-B and mature B lymphocytes. Upon binding to CD20, obinutuzumab mediates B-cell lysis through (1) engagement of immune effector cells, (2) by directly activating intracellular death signaling pathways (direct cell death), and/or (3) activation of the complement cascade. The immune effector cell mechanisms include antibody-dependent cellular cytotoxicity (ADCC) and antibody-dependent cellular phagocytosis. As an antibody with reduced fucose content, obinutuzumab induces greater ADCC activity than rituximab in vitro using human cancer cell lines. Obinutuzumab also demonstrated an increased ability to induce direct cell death when compared to rituximab. Obinutuzumab binds to FcRIII using purified proteins with a higher affinity than rituximab. Obinutuzumab and rituximab bind with similar affinity to overlapping epitopes on CD20. In patients with CLL, GAZYVA caused CD19 B-cell depletion (defined as CD19 B cell counts < 0.07 x 109 /L). Initial CD19 B cell recovery was observed in some patients approximately 9 months after the last GAZYVA dose. At 18 months of follow-up, some patients remain B cell-depleted. Although the depletion of B cells in the peripheral blood is a measurable pharmacodynamic effect, it is not directly correlated with the depletion of B cells in solid organs or in malignant deposits. B cell depletion has not been shown to be directly correlated to clinical response. Indications Obinutuzumab is used as a combination treatment with chlorambucil to treat patients with untreated chronic lymphocytic leukemia. Refractory Follicular Lymphoma Previously untreated Chronic lymphocytic leukemia It can be used as a first-line treatment for chronic lymphocytic leukemia in combination with chemotherapy or with venetoclax, as a first-line treatment for follicular lymphoma in combination with chemotherapy, and as a treatment for relapsed or refractory follicular lymphoma in combination with bendamustine chemotherapy. Use in Cancer Obinutuzumab is approved to be used with other drugs to treat: Chronic lymphocytic leukemia (CLL). It is used with chlorambucil in patients who have not yet been treated for CLL. Follicular lymphoma. It is used: With bendamustine hydrochloride and then by itself to treat follicular lymphoma that relapsed after treatment with rituximab or did not respond to the treatment. With chemotherapy as first-line treatment in adults with stage II bulky, stage III, or stage IV follicular lymphoma. Patients who have at least a partial remission are then treated with obinutuzumab by themselves. Obinutuzumab is also being studied in the treatment of other types of cancer. Contraindications It is contraindicated in patients with known hypersensitivity reactions (e.g., anaphylaxis) to obinutuzumab or to any of the excipients, or serum sickness with prior obinutuzumab use. a bad infection anemia decreased blood platelets low levels of a type of white blood cell called neutrophils pregnancy reactivation of hepatitis B infection progressive multifocal leukoencephalopathy, a type of brain infection Dosage STRENGTHS: 1000 mg/40 mL (25 mg/mL) single-dose vial. Prepare the solution for infusion, using an aseptic technique, as follows: Inspect visually for any particulate matter and discoloration prior to administration. Dilute into a 0.9% sodium chloride PVC or non-PVC polyolefin infusion bag. Do not use other diluents such as dextrose (5%). Chronic Lymphocytic Leukemia Preparation of solution for infusion on day 1 (100 mg) and day 2 (900 mg) of Cycle 1: Withdraw 40 mL of GAZYVA solution from the vial. Dilute 4 mL (100 mg) of GAZYVA into a 100 mL 0.9% sodium chloride infusion bag for immediate administration. Dilute the remaining 36 mL (900 mg) into a 250 mL 0.9% sodium chloride infusion bag at the same time for use on day 2 and store at 2°C to 8°C (36°F to 46°F) for up to 24 hours. After allowing the diluted bag to come to room temperature, use it immediately. Clearly label each infusion bag. Preparation of solution for infusion on days 8 and 15 of Cycle 1 and day 1 of Cycles 2–6: Withdraw 40 mL of GAZYVA solution from the vial. Dilute 40 mL (1000 mg) into a 250 mL 0.9% sodium chloride infusion bag. Follicular Lymphoma Chronic Lymphocytic Leukemia THERAPY CONSISTS OF SIX 28-DAY TREATMENT CYCLES IN COMBINATION WITH CHLORAMBUCIL: Cycle 1, Day 1: 100 mg IV at 25 mg/hr over 4 hours; do not increase the infusion rate Cycle 1, Day 2: 900 mg IV at 50 mg/hr if no infusion reaction occurred during the previous infusion and the rate can be escalated in increments of 50 mg/hr every 30 minutes to a maximum rate of 400 mg/hr; if an infusion reaction occurred during the previous infusion, administer at 25 mg/hr and the rate can be escalated in increments of up to 50 mg/hr every 30 minutes to a maximum rate of 400 mg/hr Cycle 1, Days 8 and 15 AND Cycles 2 through 6, Day 1: 1000 mg IV at 100 mg/hr if no infusion reaction occurred during the previous infusion and the final rate was 100 mg/hr or faster and the rate can be escalated in increments of 100 mg/hr every 30 minutes to a maximum rate of 400 mg/hr; if an infusion reaction occurred during the previous infusion, administer at 50 mg/hr and the rate can be escalated in increments of 50 mg/hr every 30 minutes to a maximum rate of 400 mg/hr NOTE: If a dose is missed, administer it as soon as possible and adjust dosing schedule to maintain the time interval between doses. If appropriate, patients who do not complete the Cycle 1 Day 1 dose may proceed to the Cycle 1 Day 2 dose. PREMEDICATION TO PREVENT INFUSION-RELATED REACTIONS (IRR): CLL Cycle 1, Day 1 and 2 AND FL Cycle 1, Day 1: All patients should receive dexamethasone 20 mg or methylprednisolone 80 mg at least 1 hour prior to the obinutuzumab infusion AND acetaminophen 650 to 1000 mg and an antihistamine (e.g., diphenhydramine 50 mg) at least 30 minutes before the obinutuzumab infusion. All Subsequent Infusions: All patients should receive acetaminophen 650 to 1000 mg at least 30 minutes prior to the obinutuzumab infusion. If patients experienced Grade 1 or 2 IRR with the previous infusion: Administer acetaminophen 650 to 1000 mg and an antihistamine (e.g., diphenhydramine 50 mg) at least 30 minutes prior to the obinutuzumab infusion. If patients experienced Grade 3 IRR with the previous infusion OR have a lymphocyte count greater than 25 X 10(9)/L prior to the next treatment: Administer an IV glucocorticoid (dexamethasone 20 mg or methylprednisolone 80 mg) at least 1 hour prior to the obinutuzumab infusion AND acetaminophen 650 to 1000 mg and an antihistamine (e.g., diphenhydramine 50 mg) at least 30 minutes prior to the obinutuzumab infusion. The administration should be by a healthcare professional with medical support to manage severe infusion reactions. Premedicate before each infusion to reduce infusion-related reactions. Administer only as an IV infusion through a dedicated line; do not administer as an IV push or bolus. Patients at high risk of tumor lysis syndrome (e.g., high tumor burden, high circulating absolute lymphocyte counts [greater than 25 x 10(9)/L] or renal impairment) should be premedicated with antihyperuricemics (e.g., allopurinol, rasburicase) and be adequately hydrated prior to each infusion. Hypotension may occur during the IV infusion. The clinician may consider withholding antihypertensive treatments for 12 hours prior to and throughout each infusion and for the first hour after administration. Monitor blood counts at regular intervals. Patients with Grade 3 to 4 neutropenia lasting more than one week should receive antimicrobial prophylaxis until the resolution of neutropenia to Grade 1 or 2. Antiviral and antifungal prophylaxis should be considered. Consider therapy interruption if patients experience an infection, Grade 3 or 4 cytopenia, or Grade 2 or higher nonhematologic toxicity. The treatment of patients with previously untreated chronic lymphocytic leukemia (CLL) in combination with chlorambucil Follicular Lymphoma THERAPY REGIMENS FOR FOLLICULAR LYMPHOMA (FL): For patients with follicular lymphoma who did not respond or who progressed during or up to 6 months after treatment with rituximab or a rituximab-containing regimen, administer obinutuzumab in combination with bendamustine in six 28-day cycles. Patients who achieve stable disease, complete response, or partial response to the initial 6 cycles should continue obinutuzumab 1000 mg as monotherapy for up to 2 years. For patients with previously untreated FL, administer obinutuzumab with one of the following chemotherapy regimens: Six 28-day cycles in combination with bendamustine. Six 21-day cycles in combination with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP), followed by 2 additional 21-day cycles of obinutuzumab alone. Eight 21-day cycles in combination with cyclophosphamide, vincristine, and prednisone/prednisolone/methylprednisolone (CVP). Patients with previously untreated FL who achieve a complete response or partial response to the initial 6 or 8 cycles should continue obinutuzumab 1000 mg as monotherapy for up to 2 years. DOSE TO BE ADMINISTERED DURING 6 TO 8 TREATMENT CYCLES, FOLLOWED BY OBINUTUZUMAB AS MONOTHERAPY FOR PATIENTS WITH FL: Cycle 1, Day 1: 1000 mg IV at 50 mg/hr; the rate of infusion can be escalated in 50 mg/hr increments every 30 minutes to a maximum of 400 mg/hr Cycle 1, Day 8, and Day 15 AND Cycles 2 through 6 on Day 1 OR 2 through 8 on Day 1 AND as monotherapy every 2 months for up to 2 years: 1000 mg IV at 100 mg/hr if no infusion reaction or a Grade 1 reaction occurred during the previous infusion and the final rate was 100 mg/hr or faster and the rate can be escalated in increments of 100 mg/hr every 30 minutes to a maximum rate of 400 mg/hr; if an infusion reaction of Grade 2 or higher occurred during the previous infusion, administered at 50 mg/hr and the rate can be escalated in increments of 50 mg/hr every 30 minutes to a maximum rate of 400 mg/hr If a planned dose is missed, administer it as soon as possible. During obinutuzumab and chemotherapy treatment, adjust the dosing schedule accordingly to maintain the time interval between chemotherapy cycles. During monotherapy, maintain the original dosing schedule for subsequent doses. Monotherapy should be initiated approximately 2 months after the last dose of obinutuzumab administered during the induction phase. PREMEDICATION TO PREVENT INFUSION-RELATED REACTIONS (IRR): CLL Cycle 1, Day 1 and 2 AND FL Cycle 1, Day 1: All patients should receive dexamethasone 20 mg or methylprednisolone 80 mg at least 1 hour prior to the obinutuzumab infusion AND acetaminophen 650 to 1000 mg and an antihistamine (e.g., diphenhydramine 50 mg) at least 30 minutes before the obinutuzumab infusion. All Subsequent Infusions: All patients should receive acetaminophen 650 to 1000 mg at least 30 minutes prior to the obinutuzumab infusion. If patients experienced Grade 1 or 2 IRR with the previous infusion: Administer acetaminophen 650 to 1000 mg and an antihistamine (e.g., diphenhydramine 50 mg) at least 30 minutes prior to the obinutuzumab infusion. If patients experienced Grade 3 IRR with the previous infusion OR have a lymphocyte count greater than 25 X 10(9)/L prior to the next treatment: Administer an IV glucocorticoid (dexamethasone 20 mg or methylprednisolone 80 mg) for at least 1 hour prior to the obinutuzumab infusion AND acetaminophen 650 to 1000 mg and an antihistamine (e.g., diphenhydramine 50 mg) at least 30 minutes prior to the obinutuzumab infusion. The administration should be by a healthcare professional with medical support to manage severe infusion reactions. Premedicate before each infusion to reduce infusion-related reactions. Administer only as an IV infusion through a dedicated line; do not administer as an IV push or bolus. Patients at high risk of tumor lysis syndrome (e.g., high tumor burden, high circulating absolute lymphocyte counts [greater than 25 x 10(9)/L] or renal impairment) should be premedicated with antihyperuricemics (e.g., allopurinol, rasburicase) and be adequately hydrated prior to each infusion. Hypotension may occur during the IV infusion. The clinician may consider withholding antihypertensive treatments for 12 hours prior to and throughout each infusion and for the first hour after administration. Monitor blood counts at regular intervals. Patients with Grade 3 to 4 neutropenia lasting more than one week should receive antimicrobial prophylaxis until the resolution of neutropenia to Grade 1 or 2. Antiviral and antifungal prophylaxis should be considered. Consider therapy interruption if patients experience an infection, Grade 3 or 4 cytopenia, or Grade 2 or higher nonhematologic toxicity. In combination with bendamustine followed by obinutuzumab as monotherapy for the treatment of patients with follicular lymphoma (FL) who relapsed after, or are refractory to, a rituximab-containing regimen In combination with chemotherapy followed by obinutuzumab monotherapy in patients achieving at least a partial remission, is indicated for the treatment of adult patients with previously untreated stage II bulky, III, or IV follicular lymphoma (FL) Dose Adjustments INFUSION REACTIONS IN CLL AND FL PATIENTS: GRADE 1 to 2 (mild to moderate): Reduce infusion rate or interrupt the infusion and treat symptoms. Upon resolution of symptoms, continue or resume infusion. If no further infusion reaction symptoms occur, infusion rate escalation may resume at the increments and intervals as appropriate for the treatment cycle dose. For CLL patients only: The Day 1 infusion rate may be increased back up to 25 mg/hr after 1 hour but not increased further. GRADE 3 (severe): Interrupt infusion and manage symptoms. Upon resolution of symptoms, consider restarting the infusion at no more than half the previous rate (the rate used at the time the infusion reaction occurred). If no further infusion reaction symptoms occur, infusion rate escalation may resume at the increments and intervals as appropriate for the treatment cycle dose. Permanently discontinue therapy if patients experience a Grade 3 infusion-related symptom at rechallenge. For CLL patients only: The Day 1 infusion rate may be increased back up to 25 mg/hr after 1 hour but not increased further. GRADE 4 (life-threatening): Stop infusion immediately and permanently discontinue therapy. Administration advice: If a planned dose is missed, administer the missed dose as soon as possible and adjust the dosing schedule accordingly. Administer as an IV infusion only. Do not administer as an IV push or bolus. Do not mix this drug with other drugs. Preparation of solution for infusion: Withdraw 40 mL of GAZYVA solution from the vial. Dilute 40 mL (1000 mg) into a 250 mL 0.9% sodium chloride infusion bag. Mix diluted solution by gentle inversion. Do not shake or freeze. For microbiological stability, the diluted GAZYVA infusion solution should be used immediately. Dilute under appropriate aseptic conditions. If not used immediately, the solution may be stored in a refrigerator at 2°C to 8°C (36°F to 46°F) for up to 24 hours prior to use. The product can be administered at a final concentration of 0.4 mg/mL to 4 mg/mL. Administration for CLL and FL Patients Administer as an intravenous infusion only. Do not administer as an intravenous push or bolus. Do not mix GAZYVA with other drugs. No incompatibilities between GAZYVA and polyvinylchloride (PVC) or non-PVC polyolefin bags and administration sets have been observed [see How Supplied/Storage and Handling Side Effects The Most Common Infusion-related reactions are defined as any related adverse reaction that occurred during or within 24 hours of infusion. Neutropenia includes neutropenia, agranulocytosis, febrile neutropenia, granulocytopenia and neutrophil count decreased; febrile neutropenia includes febrile neutropenia, neutropenic infection, neutropenic sepsis, and febrile bone marrow aplasia. Thrombocytopenia includes thrombocytopenia and platelet count decreased. Upper respiratory tract infection includes upper respiratory tract congestion, upper respiratory tract inflammation, sinusitis bacterial, upper respiratory tract infection bacterial, pharyngitis streptococcal, sinusitis fungal, upper respiratory fungal infection, acute sinusitis, chronic sinusitis, laryngitis, nasopharyngitis, pharyngitis, rhinitis, sinusitis, tonsillitis, upper respiratory tract infection, rhinovirus infection, viral pharyngitis, viral rhinitis, viral upper respiratory tract infection. Herpesvirus infection includes genital herpes, genital herpes zoster, herpes dermatitis, herpes ophthalmic, herpes simplex, herpes simplex pharyngitis, herpes virus infection, herpes zoster, herpes zoster disseminated, herpes zoster infection neurological, herpes zoster oticus, nasal herpes, ophthalmic herpes simplex, ophthalmic herpes zoster, oral herpes, varicella, varicella-zoster virus infection. Pneumonia includes pneumonia bacterial, pneumonia Haemophilus, pneumonia pneumococcal, pneumonia fungal, pneumocystis jirovecii infection, pneumocystis jirovecii pneumonia, atypical pneumonia, lung infection, pneumonia, pneumonia aspiration, lung infiltration. Cough includes cough, productive cough, and upper-airway cough syndrome. Diarrhea includes diarrhea, defecation urgency, frequent bowel movement, gastroenteritis, and gastroenteritis viral. Headache includes cluster headache, headache, sinus headache, tension headache, and migraine. Insomnia includes initial insomnia, insomnia, and sleep disorder. Pruritus includes pruritus and pruritus generalized. More Common muscle or joint pain constipation headache difficulty falling asleep or staying asleep decreased appetite itching fever, chills, cough, sore throat, or other signs of infection unusual bleeding or bruising unusual tiredness or weakness pain, tenderness, or redness in one leg shortness of breath, new or worsening cough, coughing up blood stomach area pain, nausea, vomiting, fever, or chills chest pain, joint pain, and fever decreased urination frequency or amount Rare lower back or side pain nausea painful or difficult urination pale skin pinpoint red spots on the skin sore throat trouble breathing ulcers, sores, or white spots in the mouth unusual bleeding or bruising unusual tiredness or weakness vomiting Joint pain, stiffness, or swelling stomach pain swelling of the feet or lower legs Bruising confusion coughing or vomiting blood persistent bleeding or oozing from puncture sites, mouth, or nose rash Blurred vision dark urine dizziness drowsiness general tiredness and weakness light-colored stools seizures upper right abdominal or stomach pain yellow eyes and skin Drug Interactions DRUG INTERACTION Abatacept The risk or severity of adverse effects can be increased when Abatacept is combined with Obinutuzumab. Abciximab The risk or severity of adverse effects can be increased when Abciximab is combined with Obinutuzumab. Acebutolol Acebutolol may increase the hypotensive activities of Obinutuzumab. Acenocoumarol The risk or severity of bleeding and hemorrhage can be increased when Acenocoumarol is combined with Obinutuzumab. Acetylsalicylic acid The risk or severity of adverse effects can be increased when Acetylsalicylic acid is combined with Obinutuzumab. Adalimumab The risk or severity of adverse effects can be increased when Adalimumab is combined with Obinutuzumab. Adenovirus type The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Obinutuzumab. Aducanumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Aducanumab. Aldesleukin The risk or severity of adverse effects can be increased when Aldesleukin is combined with Obinutuzumab. Alefacept The risk or severity of adverse effects can be increased when Alefacept is combined with Obinutuzumab. Alemtuzumab The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Obinutuzumab. Alirocumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Alirocumab. Aliskiren Aliskiren may increase the hypotensive activities of Obinutuzumab. Allogeneic The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Obinutuzumab. Allopurinol The risk or severity of adverse effects can be increased when Allopurinol is combined with Obinutuzumab. Alteplase The risk or severity of bleeding and hemorrhage can be increased when Alteplase is combined with Obinutuzumab. Altretamine The risk or severity of adverse effects can be increased when Altretamine is combined with Obinutuzumab. Ambrisentan Ambrisentan may increase the hypotensive activities of Obinutuzumab. Amifostine The risk or severity of adverse effects can be increased when Amifostine is combined with Obinutuzumab. Amiloride The risk or severity of adverse effects can be increased when Amiloride is combined with Obinutuzumab. Amiodarone The risk or severity of adverse effects can be increased when Amiodarone is combined with Obinutuzumab. Amivantamab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Amivantamab. Amlodipine Amlodipine may increase the hypotensive activities of Obinutuzumab. Amobarbital Amobarbital may increase the hypotensive activities of Obinutuzumab. Amphotericin B The risk or severity of adverse effects can be increased when Amphotericin B is combined with Obinutuzumab. Amsacrine The risk or severity of adverse effects can be increased when Amsacrine is combined with Obinutuzumab. Amyl Nitrite The risk or severity of adverse effects can be increased when Amyl Nitrite is combined with Obinutuzumab. Anagrelide The risk or severity of adverse effects can be increased when Anagrelide is combined with Obinutuzumab. Anakinra The risk or severity of adverse effects can be increased when Anakinra is combined with Obinutuzumab. Ancrod The risk or severity of bleeding and hemorrhage can be increased when Ancrod is combined with Obinutuzumab. Anifrolumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Anifrolumab. Anistreplase The risk or severity of bleeding and hemorrhage can be increased when Anistreplase is combined with Obinutuzumab. Ansuvimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ansuvimab. Anthrax immune The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Obinutuzumab. Anthrax vaccine The risk or severity of infection can be increased when Anthrax vaccine is combined with Obinutuzumab. antilymphocyte The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Antilymphocyte immunoglobulin (horse). Antithrombin Alfa The risk or severity of bleeding and hemorrhage can be increased when Antithrombin Alfa is combined with Obinutuzumab. Antithrombin III The risk or severity of bleeding and hemorrhage can be increased when Antithrombin III human is combined with Obinutuzumab. Antithymocyte The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Obinutuzumab. Apixaban The risk or severity of bleeding and hemorrhage can be increased when Apixaban is combined with Obinutuzumab. Apomorphine The risk or severity of adverse effects can be increased when Apomorphine is combined with Obinutuzumab. Apremilast The risk or severity of adverse effects can be increased when Apremilast is combined with Obinutuzumab. Ardeparin The risk or severity of bleeding and hemorrhage can be increased when Ardeparin is combined with Obinutuzumab. Argatroban The risk or severity of bleeding and hemorrhage can be increased when Argatroban is combined with Obinutuzumab. Aripiprazole Aripiprazole may increase the hypotensive activities of Obinutuzumab. Aripiprazole lauroxil Aripiprazole lauroxil may increase the hypotensive activities of Obinutuzumab. Arsenic trioxide The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Obinutuzumab. Articaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Articaine. Asfotase alfa The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Asfotase alfa. COVID-19 Vaccine The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Obinutuzumab. Atenolol Atenolol may increase the hypotensive activities of Obinutuzumab. Atezolizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Atezolizumab. Atoltivimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Atoltivimab. Avanafil The risk or severity of hypotension can be increased when Avanafil is combined with Obinutuzumab. Avelumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Avelumab. Azacitidine The risk or severity of adverse effects can be increased when Azacitidine is combined with Obinutuzumab. Azathioprine The risk or severity of adverse effects can be increased when Azathioprine is combined with Obinutuzumab. Azilsartan Azilsartan medoxomil may increase the hypotensive activities of Obinutuzumab. Bacillus The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Obinutuzumab. Bacillusantigen The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Obinutuzumab. Bacillus calmette The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Obinutuzumab. Bamlanivimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Bamlanivimab. Baricitinib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Baricitinib. Basiliximab The risk or severity of adverse effects can be increased when Basiliximab is combined with Obinutuzumab. BCG vaccine The risk or severity of infection can be increased when BCG vaccine is combined with Obinutuzumab. Beclomethasone The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Obinutuzumab. Belantamab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Belantamab mafodotin. Belatacept The risk or severity of adverse effects can be increased when Belatacept is combined with Obinutuzumab. Belimumab The risk or severity of adverse effects can be increased when Belimumab is combined with Obinutuzumab. Belinostat The risk or severity of adverse effects can be increased when Belinostat is combined with Obinutuzumab. Belumosudil The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Belumosudil. Bemiparin The risk or severity of bleeding and hemorrhage can be increased when Bemiparin is combined with Obinutuzumab. Benazepril Benazepril may increase the hypotensive activities of Obinutuzumab. Bendamustine The risk or severity of adverse effects can be increased when Bendamustine is combined with Obinutuzumab. Bendroflumethiazide Bendroflumethiazide may increase the hypotensive activities of Obinutuzumab. Benralizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Benralizumab. Benzocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Benzocaine. Benzthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Obinutuzumab. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Benzyl alcohol. Bepridil Bepridil may increase the hypotensive activities of Obinutuzumab. Besilesomab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Besilesomab. Betamethasone The risk or severity of adverse effects can be increased when Betamethasone is combined with Obinutuzumab. Betaxolol Betaxolol may increase the hypotensive activities of Obinutuzumab. Bethanidine Bethanidine may increase the hypotensive activities of Obinutuzumab. Betrixaban The risk or severity of bleeding and hemorrhage can be increased when Betrixaban is combined with Obinutuzumab. Bevacizumab The risk or severity of adverse effects can be increased when Bevacizumab is combined with Obinutuzumab. Bexarotene The risk or severity of adverse effects can be increased when Bexarotene is combined with Obinutuzumab. Bezlotoxumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Bezlotoxumab. Bimekizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Bimekizumab. Bisoprolol Bisoprolol may increase the hypotensive activities of Obinutuzumab. Bivalirudin The risk or severity of bleeding and hemorrhage can be increased when Bivalirudin is combined with Obinutuzumab. Bleomycin The risk or severity of adverse effects can be increased when Bleomycin is combined with Obinutuzumab. Blinatumomab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Blinatumomab. Bordetella The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Obinutuzumab. Bortezomib The risk or severity of adverse effects can be increased when Bortezomib is combined with Obinutuzumab. Bosentan Bosentan may increase the hypotensive activities of Obinutuzumab. Bosutinib The risk or severity of adverse effects can be increased when Bosutinib is combined with Obinutuzumab. Brentuximab vedotin The risk or severity of adverse effects can be increased when Brentuximab vedotin is combined with Obinutuzumab. Bretylium Bretylium may increase the hypotensive activities of Obinutuzumab. Brodalumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Brodalumab. You Might Also Read Gemifloxacin, Uses, Dosage, Side Effects, Interactions, Pregnancy Brolucizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Brolucizumab. Bromocriptine The risk or severity of adverse effects can be increased when Bromocriptine is combined with Obinutuzumab. Budesonide The risk or severity of adverse effects can be increased when Budesonide is combined with Obinutuzumab. Bumetanide The risk or severity of adverse effects can be increased when Bumetanide is combined with Obinutuzumab. Bupivacaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Bupivacaine. Burosumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Burosumab. Busulfan The risk or severity of adverse effects can be increased when Busulfan is combined with Obinutuzumab. Butabarbital Butabarbital may increase the hypotensive activities of Obinutuzumab. Butacaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Butacaine. Butalbital Butalbital may increase the hypotensive activities of Obinutuzumab. Butamben The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Butamben. Cabazitaxel The risk or severity of adverse effects can be increased when Cabazitaxel is combined with Obinutuzumab. Canagliflozin The risk or severity of adverse effects can be increased when Canagliflozin is combined with Obinutuzumab. Canakinumab The risk or severity of adverse effects can be increased when Canakinumab is combined with Obinutuzumab. Candesartan cilexetil Candesartan cilexetil may increase the hypotensive activities of Obinutuzumab. Cangrelor The risk or severity of adverse effects can be increased when Cangrelor is combined with Obinutuzumab. Capecitabine The risk or severity of adverse effects can be increased when Capecitabine is combined with Obinutuzumab. Caplacizumab The risk or severity of adverse effects can be increased when Caplacizumab is combined with Obinutuzumab. Capromab pendetide The risk or severity of adverse effects can be increased when Capromab pendetide is combined with Obinutuzumab. Capsaicin The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Capsaicin. Captopril Captopril may increase the hypotensive activities of Obinutuzumab. Carbamazepine The risk or severity of adverse effects can be increased when Carbamazepine is combined with Obinutuzumab. Carbetocin The risk or severity of adverse effects can be increased when Carbetocin is combined with Obinutuzumab. Carboplatin The risk or severity of adverse effects can be increased when Carboplatin is combined with Obinutuzumab. Carfilzomib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Obinutuzumab. Carmustine The risk or severity of adverse effects can be increased when Carmustine is combined with Obinutuzumab. Carvedilol Carvedilol may increase the hypotensive activities of Obinutuzumab. Casirivimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Casirivimab. Catumaxomab The risk or severity of adverse effects can be increased when Catumaxomab is combined with Obinutuzumab. Celiprolol Celiprolol may increase the hypotensive activities of Obinutuzumab. Cemiplimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Cemiplimab. Certolizumab pegol The risk or severity of adverse effects can be increased when Certolizumab pegol is combined with Obinutuzumab. Cetuximab The risk or severity of adverse effects can be increased when Cetuximab is combined with Obinutuzumab. Chlorambucil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Obinutuzumab. Chloramphenicol The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Obinutuzumab. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Chloroprocaine. Chlorothiazide Chlorothiazide may increase the hypotensive activities of Obinutuzumab. Chlorpromazine The risk or severity of adverse effects can be increased when Chlorpromazine is combined with Obinutuzumab. Chlorthalidone Chlorthalidone may increase the hypotensive activities of Obinutuzumab. Ciclesonide The risk or severity of adverse effects can be increased when Ciclesonide is combined with Obinutuzumab. Cilazapril Cilazapril may increase the hypotensive activities of Obinutuzumab. Cilgavimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Cilgavimab. Cilostazol The risk or severity of adverse effects can be increased when Cilostazol is combined with Obinutuzumab. Cinchocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Cinchocaine. Cisplatin The risk or severity of adverse effects can be increased when Cisplatin is combined with Obinutuzumab. Cladribine The risk or severity of adverse effects can be increased when Cladribine is combined with Obinutuzumab. Clevidipine The risk or severity of adverse effects can be increased when Clevidipine is combined with Obinutuzumab. Clobetasol The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Obinutuzumab. Clofarabine The risk or severity of adverse effects can be increased when Clofarabine is combined with Obinutuzumab. Clomipramine The risk or severity of adverse effects can be increased when Clomipramine is combined with Obinutuzumab. Clonidine Clonidine may increase the hypotensive activities of Obinutuzumab. Clopidogrel The risk or severity of adverse effects can be increased when Clopidogrel is combined with Obinutuzumab. Clostridium The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Obinutuzumab. Clozapine The risk or severity of neutropenia can be increased when Obinutuzumab is combined with Clozapine. Cocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Cocaine. Conivaptan The risk or severity of adverse effects can be increased when Conivaptan is combined with Obinutuzumab. Conjugated estrogens Conjugated estrogens may increase the thrombogenic activities of Obinutuzumab. Corticotropin The risk or severity of adverse effects can be increased when Corticotropin is combined with Obinutuzumab. Cortisone acetate The risk or severity of adverse effects can be increased when Cortisone acetate is combined with Obinutuzumab. Corynebacterium The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Obinutuzumab. Cryptenamine Cryptenamine may increase the hypotensive activities of Obinutuzumab. Cyanocobalamin The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Obinutuzumab. Cyclopenthiazide Cyclopenthiazide may increase the hypotensive activities of Obinutuzumab. Cyclophosphamide The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Obinutuzumab. Cyclosporine Obinutuzumab may increase the immunosuppressive activities of Cyclosporine. Cyclothiazide Cyclothiazide may increase the hypotensive activities of Obinutuzumab. Cytarabine The risk or severity of adverse effects can be increased when Cytarabine is combined with Obinutuzumab. Dabigatran The risk or severity of bleeding and hemorrhage can be increased when Dabigatran is combined with Obinutuzumab. Dabigatran The risk or severity of bleeding and hemorrhage can be increased when Dabigatran etexilate is combined with Obinutuzumab. Dacarbazine The risk or severity of adverse effects can be increased when Dacarbazine is combined with Obinutuzumab. Dactinomycin The risk or severity of adverse effects can be increased when Dactinomycin is combined with Obinutuzumab. Dalteparin The risk or severity of bleeding and hemorrhage can be increased when Dalteparin is combined with Obinutuzumab. Danaparoid The risk or severity of bleeding and hemorrhage can be increased when Danaparoid is combined with Obinutuzumab. Dapagliflozin The risk or severity of adverse effects can be increased when Dapagliflozin is combined with Obinutuzumab. Daratumumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Daratumumab. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Obinutuzumab. Dasatinib The risk or severity of adverse effects can be increased when Dasatinib is combined with Obinutuzumab. Dasiglucagon Dasiglucagon may increase the hypotensive activities of Obinutuzumab. Daunorubicin The risk or severity of adverse effects can be increased when Daunorubicin is combined with Obinutuzumab. Debrisoquine Debrisoquine may increase the hypotensive activities of Obinutuzumab. Decitabine The risk or severity of adverse effects can be increased when Decitabine is combined with Obinutuzumab. Defibrotide The risk or severity of adverse effects can be increased when Defibrotide is combined with Obinutuzumab. Deflazacort The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Deflazacort. Denosumab The risk or severity of adverse effects can be increased when Denosumab is combined with Obinutuzumab. Deserpidine Deserpidine may increase the hypotensive activities of Obinutuzumab. Desflurane The risk or severity of adverse effects can be increased when Desflurane is combined with Obinutuzumab. Desirudin The risk or severity of bleeding and hemorrhage can be increased when Desirudin is combined with Obinutuzumab. Desoximetasone The risk or severity of adverse effects can be increased when Desoximetasone is combined with Obinutuzumab. Deucravacitinib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Deucravacitinib. Dexamethasone The risk or severity of adverse effects can be increased when Dexamethasone is combined with Obinutuzumab. Dexmedetomidine The risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Obinutuzumab. Dexrazoxane The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Obinutuzumab. Dextran The risk or severity of bleeding and hemorrhage can be increased when Dextran is combined with Obinutuzumab. Diazoxide Diazoxide may increase the hypotensive activities of Obinutuzumab. Diclofenamide The risk or severity of adverse effects can be increased when Diclofenamide is combined with Obinutuzumab. Dicoumarol The risk or severity of bleeding and hemorrhage can be increased when Dicoumarol is combined with Obinutuzumab. Dienestrol Dienestrol may increase the thrombogenic activities of Obinutuzumab. Diethylstilbestrol Diethylstilbestrol may increase the thrombogenic activities of Obinutuzumab. Difluocortolone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Difluocortolone. Digoxin Immune) The risk or severity of adverse effects can be increased when Digoxin Immune Fab (Ovine) is combined with Obinutuzumab. Dihydralazine Dihydralazine may increase the hypotensive activities of Obinutuzumab. Diltiazem Diltiazem may increase the hypotensive activities of Obinutuzumab. Dimethyl fumarate The risk or severity of adverse effects can be increased when Dimethyl fumarate is combined with Obinutuzumab. Dinutuximab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Dinutuximab. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Diphenhydramine. Dipyridamole The risk or severity of adverse effects can be increased when Dipyridamole is combined with Obinutuzumab. Diroximel The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Diroximel fumarate. Docetaxel The risk or severity of adverse effects can be increased when Docetaxel is combined with Obinutuzumab. Dostarlimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Dostarlimab. Doxazosin Doxazosin may increase the hypotensive activities of Obinutuzumab. Doxorubicin The risk or severity of adverse effects can be increased when Doxorubicin is combined with Obinutuzumab. Drotrecogin alfa The risk or severity of bleeding and hemorrhage can be increased when Drotrecogin alfa is combined with Obinutuzumab. Dulaglutide The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Dulaglutide. Duloxetine The risk or severity of orthostatic hypotension and syncope can be increased when Obinutuzumab is combined with Duloxetine. Dupilumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Dupilumab. Durvalumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Durvalumab. Dyclonine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Dyclonine. Ebola Zaire The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Obinutuzumab. Eculizumab The risk or severity of adverse effects can be increased when Eculizumab is combined with Obinutuzumab. Edetic acid The risk or severity of bleeding and hemorrhage can be increased when Edetic acid is combined with Obinutuzumab. Edoxaban The risk or severity of bleeding and hemorrhage can be increased when Edoxaban is combined with Obinutuzumab. Efalizumab The risk or severity of adverse effects can be increased when Efalizumab is combined with Obinutuzumab. Eflapegrastim The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Eflapegrastim. Eftrenonacog alfa The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Eftrenonacog alfa. Elotuzumab The risk or severity of adverse effects can be increased when Elotuzumab is combined with Obinutuzumab. Emapalumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Emapalumab. Emicizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Emicizumab. Empagliflozin The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Empagliflozin. Enalapril Enalapril may increase the hypotensive activities of Obinutuzumab. Enalaprilat Enalaprilat may increase the hypotensive activities of Obinutuzumab. Enoxaparin The risk or severity of bleeding and hemorrhage can be increased when Enoxaparin is combined with Obinutuzumab. Epirubicin The risk or severity of adverse effects can be increased when Epirubicin is combined with Obinutuzumab. Eplerenone Eplerenone may increase the hypotensive activities of Obinutuzumab. Epoprostenol The risk or severity of adverse effects can be increased when Epoprostenol is combined with Obinutuzumab. Eprosartan Eprosartan may increase the hypotensive activities of Obinutuzumab. Eptifibatide The risk or severity of adverse effects can be increased when Eptifibatide is combined with Obinutuzumab. Eptinezumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Eptinezumab. Erenumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Erenumab. Eribulin The risk or severity of adverse effects can be increased when Eribulin is combined with Obinutuzumab. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Obinutuzumab. Esmolol Esmolol may increase the hypotensive activities of Obinutuzumab. Esterified Esterified estrogens may increase the thrombogenic activities of Obinutuzumab. Estetrol Estetrol may increase the thrombogenic activities of Obinutuzumab. Estradiol Estradiol may increase the thrombogenic activities of Obinutuzumab. Estradiol acetate Estradiol acetate may increase the thrombogenic activities of Obinutuzumab. Estradiol benzoate Estradiol benzoate may increase the thrombogenic activities of Obinutuzumab. Estradiol Estradiol cypionate may increase the thrombogenic activities of Obinutuzumab. Estradiol valerate Estradiol valerate may increase the thrombogenic activities of Obinutuzumab. Estramustine The risk or severity of adverse effects can be increased when Estramustine is combined with Obinutuzumab. Estriol Estriol may increase the thrombogenic activities of Obinutuzumab. Estrone Estrone may increase the thrombogenic activities of Obinutuzumab. Estrone sulfate Estrone sulfate may increase the thrombogenic activities of Obinutuzumab. Etacrynic acid The risk or severity of adverse effects can be increased when Etacrynic acid is combined with Obinutuzumab. Etanercept The risk or severity of adverse effects can be increased when Etanercept is combined with Obinutuzumab. Ethanol Ethanol may increase the hypotensive activities of Obinutuzumab. Ethinylestradiol Ethinylestradiol may increase the thrombogenic activities of Obinutuzumab. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Etidocaine. Etoposide The risk or severity of adverse effects can be increased when Etoposide is combined with Obinutuzumab. Everolimus The risk or severity of adverse effects can be increased when Everolimus is combined with Obinutuzumab. Evolocumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Evolocumab. Famtozinameran The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Obinutuzumab. Fanolesomab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Fanolesomab. Felodipine Felodipine may increase the hypotensive activities of Obinutuzumab. Fenoldopam Fenoldopam may increase the hypotensive activities of Obinutuzumab. Filgotinib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Filgotinib. Fingolimod Obinutuzumab may increase the immunosuppressive activities of Fingolimod. Floxuridine The risk or severity of adverse effects can be increased when Floxuridine is combined with Obinutuzumab. Flucytosine The risk or severity of adverse effects can be increased when Flucytosine is combined with Obinutuzumab. Fludarabine The risk or severity of adverse effects can be increased when Fludarabine is combined with Obinutuzumab. Fludrocortisone The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Obinutuzumab. Fluindione The risk or severity of bleeding and hemorrhage can be increased when Fluindione is combined with Obinutuzumab. Flunisolide The risk or severity of adverse effects can be increased when Flunisolide is combined with Obinutuzumab. Fluocinolone The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Obinutuzumab. Fluocinonide The risk or severity of adverse effects can be increased when Fluocinonide is combined with Obinutuzumab. Fluocortolone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Fluocortolone. Fluorometholone The risk or severity of adverse effects can be increased when Fluorometholone is combined with Obinutuzumab. Fluorouracil The risk or severity of adverse effects can be increased when Fluorouracil is combined with Obinutuzumab. Flupentixol The risk or severity of myelosuppression can be increased when Flupentixol is combined with Obinutuzumab. Fluprednisolone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Fluprednisolone. Fluticasone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Fluticasone. Fluticasone furoate The risk or severity of adverse effects can be increased when Fluticasone furoate is combined with Obinutuzumab. Fluticasone The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Obinutuzumab. Fondaparinux The risk or severity of bleeding and hemorrhage can be increased when Fondaparinux is combined with Obinutuzumab. Fosinopril Fosinopril may increase the hypotensive activities of Obinutuzumab. Fostamatinib The risk or severity of hypotension can be increased when Fostamatinib is combined with Obinutuzumab. Fremanezumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Fremanezumab. Furosemide Furosemide may increase the hypotensive activities of Obinutuzumab. Galcanezumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Galcanezumab. Gallium nitrate The risk or severity of adverse effects can be increased when Gallium nitrate is combined with Obinutuzumab. Gemcitabine The risk or severity of adverse effects can be increased when Gemcitabine is combined with Obinutuzumab. Gemtuzumab The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Obinutuzumab. Glatiramer The risk or severity of adverse effects can be increased when Glatiramer is combined with Obinutuzumab. Golimumab The risk or severity of adverse effects can be increased when Golimumab is combined with Obinutuzumab. Guanabenz Guanabenz may increase the hypotensive activities of Obinutuzumab. Guanadrel Guanadrel may increase the hypotensive activities of Obinutuzumab. Guanethidine Guanethidine may increase the hypotensive activities of Obinutuzumab. Guanfacine Guanfacine may increase the hypotensive activities of Obinutuzumab. Guanoxan Guanoxan may increase the hypotensive activities of Obinutuzumab. Guselkumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Guselkumab. You Might Also Read Aluminum Chloride - Uses, Dosage, Side Effects Hydralazine Hydralazine may increase the hypotensive activities of Obinutuzumab. Hydrochlorothia Hydrochlorothiazide may increase the hypotensive activities of Obinutuzumab. Hydrocortisone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Hydrocortisone acetate. Hydrocortisone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Hydrocortisone butyrate. Hydrocortisone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Hydrocortisone succinate. Hydroflumethiaz Hydroflumethiazide may increase the hypotensive activities of Obinutuzumab. Hydroxychloroq The risk or severity of adverse effects can be increased when Hydroxychloroquine is combined with Obinutuzumab. Hydroxyurea The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Obinutuzumab. Ibalizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ibalizumab. Ibritumomab The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Obinutuzumab. Ibrutinib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ibrutinib. Icosapent ethyl The risk or severity of adverse effects can be increased when Icosapent ethyl is combined with Obinutuzumab. Idarubicin The risk or severity of adverse effects can be increased when Idarubicin is combined with Obinutuzumab. Idarucizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Idarucizumab. Idelalisib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Idelalisib. Ifosfamide The risk or severity of adverse effects can be increased when Ifosfamide is combined with Obinutuzumab. Iloprost The risk or severity of adverse effects can be increased when Iloprost is combined with Obinutuzumab. Imatinib The risk or severity of adverse effects can be increased when Imatinib is combined with Obinutuzumab. Imdevimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Imdevimab. Imipramine The risk or severity of adverse effects can be increased when Imipramine is combined with Obinutuzumab. Imlifidase The therapeutic efficacy of Obinutuzumab can be decreased when used in combination with Imlifidase. Indapamide Indapamide may increase the hypotensive activities of Obinutuzumab. Indomethacin The risk or severity of adverse effects can be increased when Indomethacin is combined with Obinutuzumab. Indoramin Indoramin may increase the hypotensive activities of Obinutuzumab. Inebilizumab The risk or severity of infection can be increased when Obinutuzumab is combined with Inebilizumab. Infliximab The risk or severity of adverse effects can be increased when Infliximab is combined with Obinutuzumab. Irbesartan Irbesartan may increase the hypotensive activities of Obinutuzumab. Irinotecan The risk or severity of adverse effects can be increased when Irinotecan is combined with Obinutuzumab. Isatuximab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Isatuximab. Isocarboxazid Isocarboxazid may increase the orthostatic hypotensive activities of Obinutuzumab. Isoflurane The risk or severity of adverse effects can be increased when Isoflurane is combined with Obinutuzumab. Isosorbide The risk or severity of adverse effects can be increased when Isosorbide dinitrate is combined with Obinutuzumab. Isosorbide The risk or severity of adverse effects can be increased when Isosorbide mononitrate is combined with Obinutuzumab. Isoxsuprine The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Isoxsuprine. Isradipine Isradipine may increase the hypotensive activities of Obinutuzumab. Ixabepilone The risk or severity of adverse effects can be increased when Ixabepilone is combined with Obinutuzumab. Ixekizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ixekizumab. COVID-19 Vaccine The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Obinutuzumab. Japa encephalitis The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Obinutuzumab. Labetalol Labetalol may increase the hypotensive activities of Obinutuzumab. Lacidipine Lacidipine may increase the hypotensive activities of Obinutuzumab. Lanadelumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Lanadelumab. Leflunomide The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Leflunomide. Lenalidomide The risk or severity of adverse effects can be increased when Lenalidomide is combined with Obinutuzumab. Lepirudin The risk or severity of bleeding and hemorrhage can be increased when Lepirudin is combined with Obinutuzumab. Lercanidipine Lercanidipine may increase the hypotensive activities of Obinutuzumab. Levamlodipine Levamlodipine may increase the hypotensive activities of Obinutuzumab. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Levobupivacaine. Levodopa The risk or severity of hypotension and orthostatic hypotension can be increased when Obinutuzumab is combined with Levodopa. Levosimendan The risk or severity of adverse effects can be increased when Levosimendan is combined with Obinutuzumab. Lidocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Lidocaine. Linezolid The risk or severity of adverse effects can be increased when Linezolid is combined with Obinutuzumab. Lipegfilgrastim Obinutuzumab may increase the myelosuppressive activities of Lipegfilgrastim. Lisinopril Lisinopril may increase the hypotensive activities of Obinutuzumab. Lofexidine Lofexidine may increase the hypotensive activities of Obinutuzumab. Lomustine The risk or severity of adverse effects can be increased when Lomustine is combined with Obinutuzumab. Loncastuximab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Loncastuximab tesirine. Lopinavir The serum concentration of Obinutuzumab can be increased when it is combined with Lopinavir. Losartan Losartan may increase the hypotensive activities of Obinutuzumab. Macitentan Macitentan may increase the hypotensive activities of Obinutuzumab. Maftivimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Maftivimab. Magnesium The serum concentration of Magnesium can be decreased when it is combined with Obinutuzumab. Manidipine Manidipine may increase the hypotensive activities of Obinutuzumab. Mannitol The risk or severity of adverse effects can be increased when Mannitol is combined with Obinutuzumab. Margetuximab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Margetuximab. Measles virus The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Obinutuzumab. Mecamylamine Mecamylamine may increase the hypotensive activities of Obinutuzumab. Mechlorethamine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Obinutuzumab. Meloxicam The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Meloxicam. Melphalan The risk or severity of adverse effects can be increased when Melphalan is combined with Obinutuzumab. Meningococcal The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Obinutuzumab. Mepivacaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Mepivacaine. Mepolizumab The risk or severity of adverse effects can be increased when Mepolizumab is combined with Obinutuzumab. Meprednisone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Meprednisone. Mercaptopurine The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Obinutuzumab. Mestranol Mestranol may increase the thrombogenic activities of Obinutuzumab. Methazolamide The risk or severity of adverse effects can be increased when Methazolamide is combined with Obinutuzumab. Methimazole The risk or severity of adverse effects can be increased when Methimazole is combined with Obinutuzumab. Methohexital Methohexital may increase the hypotensive activities of Obinutuzumab. Methotrexate The risk or severity of adverse effects can be increased when Methotrexate is combined with Obinutuzumab. Methoxy The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Obinutuzumab. Methyldopa Methyldopa may increase the hypotensive activities of Obinutuzumab. Methylene blue Methylene blue may increase the orthostatic hypotensive activities of Obinutuzumab. Methylphenobarbital Methylphenobarbital may increase the hypotensive activities of Obinutuzumab. Methylprednisolone The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Obinutuzumab. Metolazone Metolazone may increase the hypotensive activities of Obinutuzumab. Metoprolol Metoprolol may increase the hypotensive activities of Obinutuzumab. Metyrosine Metyrosine may increase the hypotensive activities of Obinutuzumab. Minaprine Minaprine may increase the orthostatic hypotensive activities of Obinutuzumab. Minoxidil Minoxidil may increase the hypotensive activities of Obinutuzumab. Mirvetuximab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Mirvetuximab Soravtansine. Mitomycin The risk or severity of adverse effects can be increased when Mitomycin is combined with Obinutuzumab. Mitoxantrone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Obinutuzumab. Moclobemide Moclobemide may increase the orthostatic hypotensive activities of Obinutuzumab. COVID-19 Vaccine The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Obinutuzumab. Modified vaccinia The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Obinutuzumab. Moexipril Moexipril may increase the hypotensive activities of Obinutuzumab. Mogamulizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Mogamulizumab. Mometasone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Mometasone furoate. Monomethyl The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Monomethyl fumarate. Morphine The risk or severity of adverse effects can be increased when Morphine is combined with Obinutuzumab. Mosunetuzumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Mosunetuzumab. Moxonidine Moxonidine may increase the hypotensive activities of Obinutuzumab. Mumps virus The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Obinutuzumab. Muromonab The risk or severity of adverse effects can be increased when Muromonab is combined with Obinutuzumab. Muzolimine Muzolimine may increase the hypotensive activities of Obinutuzumab. Mycophenolate The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Obinutuzumab. Mycophenolic acid The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Obinutuzumab. Nabilone The risk or severity of adverse effects can be increased when Nabilone is combined with Obinutuzumab. Nadolol Nadolol may increase the hypotensive activities of Obinutuzumab. Nadroparin The risk or severity of bleeding and hemorrhage can be increased when Nadroparin is combined with Obinutuzumab. Natalizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Natalizumab. Nebivolol Nebivolol may increase the hypotensive activities of Obinutuzumab. Necitumumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Necitumumab. Nelarabine The risk or severity of adverse effects can be increased when Nelarabine is combined with Obinutuzumab. Nesiritide The risk or severity of adverse effects can be increased when Nesiritide is combined with Obinutuzumab. Nialamide Nialamide may increase the orthostatic hypotensive activities of Obinutuzumab. Nicardipine Nicardipine may increase the hypotensive activities of Obinutuzumab. Nicorandil Nicorandil may increase the hypotensive activities of Obinutuzumab. Nifedipine The risk or severity of adverse effects can be increased when Nifedipine is combined with Obinutuzumab. Nilotinib The risk or severity of adverse effects can be increased when Nilotinib is combined with Obinutuzumab. Nilvadipine Nilvadipine may increase the hypotensive activities of Obinutuzumab. Nimesulide The risk or severity of adverse effects can be increased when Nimesulide is combined with Obinutuzumab. Nimodipine Nimodipine may increase the hypotensive activities of Obinutuzumab. Nisoldipine Nisoldipine may increase the hypotensive activities of Obinutuzumab. Nitrendipine Nitrendipine may increase the hypotensive activities of Obinutuzumab. Nitric Oxide The risk or severity of adverse effects can be increased when Nitric Oxide is combined with Obinutuzumab. Nitroglycerin Nitroglycerin may increase the hypotensive activities of Obinutuzumab. Nitroprusside Nitroprusside may increase the hypotensive activities of Obinutuzumab. Nitrous acid The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Nitrous acid. Nivolumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Nivolumab. Nuvaxovid The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Obinutuzumab. Obiltoxaximab The risk or severity of adverse effects can be increased when Obiltoxaximab is combined with Obinutuzumab. Ocrelizumab Ocrelizumab may increase the immunosuppressive activities of Obinutuzumab. Odesivimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Odesivimab. Ofatumumab The risk or severity of adverse effects can be increased when Ofatumumab is combined with Obinutuzumab. Olanzapine The risk or severity of adverse effects can be increased when Olanzapine is combined with Obinutuzumab. Olaparib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Olaparib. Olaratumab The risk or severity of adverse effects can be increased when Olaratumab is combined with Obinutuzumab. Olmesartan Olmesartan may increase the hypotensive activities of Obinutuzumab. Omalizumab The risk or severity of adverse effects can be increased when Omalizumab is combined with Obinutuzumab. Opicapone The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Opicapone. Oxaliplatin The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Obinutuzumab. Oxetacaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Oxetacaine. Oxprenolol Oxprenolol may increase the hypotensive activities of Obinutuzumab. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Oxybuprocaine. Ozanimod The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ozanimod. Paclitaxel The risk or severity of adverse effects can be increased when Paclitaxel is combined with Obinutuzumab. Palbociclib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Palbociclib. Palifermin The therapeutic efficacy of Palifermin can be decreased when used in combination with Obinutuzumab. Palivizumab The risk or severity of adverse effects can be increased when Palivizumab is combined with Obinutuzumab. Panitumumab The risk or severity of adverse effects can be increased when Panitumumab is combined with Obinutuzumab. Panobinostat The risk or severity of adverse effects can be increased when Panobinostat is combined with Obinutuzumab. Papaverine The risk or severity of adverse effects can be increased when Papaverine is combined with Obinutuzumab. Pargyline Pargyline may increase the hypotensive activities of Obinutuzumab. Parnaparin The risk or severity of bleeding and hemorrhage can be increased when Parnaparin is combined with Obinutuzumab. Pazopanib The risk or severity of adverse effects can be increased when Pazopanib is combined with Obinutuzumab. Pegaspargase The risk or severity of adverse effects can be increased when Pegaspargase is combined with Obinutuzumab. Pegcetacoplan The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Pegcetacoplan. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Obinutuzumab. Peginterferon alfa The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Obinutuzumab. Peginterferon alfa The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Obinutuzumab. Peginterferon bet The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Peginterferon beta-1a. Pembrolizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Pembrolizumab. Pemetrexed The risk or severity of adverse effects can be increased when Pemetrexed is combined with Obinutuzumab. Penbutolol Penbutolol may increase the hypotensive activities of Obinutuzumab. Penicillamine The risk or severity of adverse effects can be increased when Penicillamine is combined with Obinutuzumab. Pentobarbital Pentobarbital may increase the hypotensive activities of Obinutuzumab. Pentolinium Pentolinium may increase the hypotensive activities of Obinutuzumab. Pentosan polysulfate The risk or severity of bleeding and hemorrhage can be increased when Pentosan polysulfate is combined with Obinutuzumab. Pentostatin The risk or severity of adverse effects can be increased when Pentostatin is combined with Obinutuzumab. Pentoxifylline The risk or severity of adverse effects can be increased when Pentoxifylline is combined with Obinutuzumab. Perindopril Perindopril may increase the hypotensive activities of Obinutuzumab. Pertussis vaccine The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Obinutuzumab. Pertuzumab The risk or severity of adverse effects can be increased when Pertuzumab is combined with Obinutuzumab. Phenelzine Phenelzine may increase the orthostatic hypotensive activities of Obinutuzumab. Phenindione The risk or severity of bleeding and hemorrhage can be increased when Phenindione is combined with Obinutuzumab. Phenobarbital Phenobarbital may increase the hypotensive activities of Obinutuzumab. Phenol The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Phenol. Phenoxybenzamine Phenoxybenzamine may increase the hypotensive activities of Obinutuzumab. Phenprocoumon The risk or severity of bleeding and hemorrhage can be increased when Phenprocoumon is combined with Obinutuzumab. Phentolamine Phentolamine may increase the hypotensive activities of Obinutuzumab. Phenylalanine The risk or severity of adverse effects can be increased when Phenylalanine is combined with Obinutuzumab. Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Obinutuzumab. Pinacidil Pinacidil may increase the hypotensive activities of Obinutuzumab. Pindolol Pindolol may increase the hypotensive activities of Obinutuzumab. Pirfenidone The risk or severity of adverse effects can be increased when Pirfenidone is combined with Obinutuzumab. Polatuzumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Polatuzumab vedotin. Polyestradiol Polyestradiol phosphate may increase the thrombogenic activities of Obinutuzumab. Polythiazide Polythiazide may increase the hypotensive activities of Obinutuzumab. Pomalidomide The risk or severity of adverse effects can be increased when Pomalidomide is combined with Obinutuzumab. Ponatinib The risk or severity of adverse effects can be increased when Ponatinib is combined with Obinutuzumab. Ponesimod The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ponesimod. Practolol Practolol may increase the hypotensive activities of Obinutuzumab. Pralatrexate The risk or severity of adverse effects can be increased when Pralatrexate is combined with Obinutuzumab. Pramipexole The risk or severity of adverse effects can be increased when Pramipexole is combined with Obinutuzumab. Pramocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Pramocaine. Prasugrel The risk or severity of adverse effects can be increased when Prasugrel is combined with Obinutuzumab. Prazosin Prazosin may increase the hypotensive activities of Obinutuzumab. Prednisolone The risk or severity of adverse effects can be increased when Prednisolone is combined with Obinutuzumab. Prednisone The risk or severity of adverse effects can be increased when Prednisone is combined with Obinutuzumab. Prilocaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Prilocaine. Primidone Primidone may increase the hypotensive activities of Obinutuzumab. Procaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Procaine. Procarbazine The risk or severity of adverse effects can be increased when Procarbazine is combined with Obinutuzumab. Proparacaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Proparacaine. Propofol The risk or severity of adverse effects can be increased when Propofol is combined with Obinutuzumab. Propoxycaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Propoxycaine. Propranolol Propranolol may increase the hypotensive activities of Obinutuzumab. Propylthiouracil The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Obinutuzumab. Protein C The risk or severity of bleeding and hemorrhage can be increased when Protein C is combined with Obinutuzumab. Protein S The risk or severity of bleeding and hemorrhage can be increased when Protein S human is combined with Obinutuzumab. Quetiapine The risk or severity of adverse effects can be increased when Quetiapine is combined with Obinutuzumab. Quinapril Quinapril may increase the hypotensive activities of Obinutuzumab. Quinestrol Quinestrol may increase the thrombogenic activities of Obinutuzumab. Rabies immune The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Obinutuzumab. Rabies antigen, A The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Obinutuzumab. Rabies antigen, B The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Obinutuzumab. Raltitrexed The risk or severity of adverse effects can be increased when Raltitrexed is combined with Obinutuzumab. Ramipril Ramipril may increase the hypotensive activities of Obinutuzumab. Ramucirumab The risk or severity of adverse effects can be increased when Ramucirumab is combined with Obinutuzumab. Ranibizumab The risk or severity of adverse effects can be increased when Ranibizumab is combined with Obinutuzumab. Rasagiline Rasagiline may increase the orthostatic hypotensive activities of Obinutuzumab. Ravulizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ravulizumab. Raxibacumab The risk or severity of adverse effects can be increased when Raxibacumab is combined with Obinutuzumab. Remifentanil The risk or severity of adverse effects can be increased when Remifentanil is combined with Obinutuzumab. Rescinnamine Rescinnamine may increase the hypotensive activities of Obinutuzumab. Reserpine Reserpine may increase the hypotensive activities of Obinutuzumab. Reslizumab The risk or severity of adverse effects can be increased when Reslizumab is combined with Obinutuzumab. Reteplase The risk or severity of bleeding and hemorrhage can be increased when Reteplase is combined with Obinutuzumab. Reviparin The risk or severity of bleeding and hemorrhage can be increased when Reviparin is combined with Obinutuzumab. Rilmenidine Rilmenidine may increase the hypotensive activities of Obinutuzumab. Rilonacept The risk or severity of adverse effects can be increased when Rilonacept is combined with Obinutuzumab. Riociguat Riociguat may increase the hypotensive activities of Obinutuzumab. Risankizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Risankizumab. Risperidone Obinutuzumab may increase the hypotensive activities of Risperidone. Rituximab The risk or severity of adverse effects can be increased when Rituximab is combined with Obinutuzumab. Rivaroxaban The risk or severity of bleeding and hemorrhage can be increased when Rivaroxaban is combined with Obinutuzumab. Roflumilast Roflumilast may increase the immunosuppressive activities of Obinutuzumab. Romosozumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Romosozumab. Ropeginterferon The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ropeginterferon alfa-2b. Ropinirole The risk or severity of adverse effects can be increased when Ropinirole is combined with Obinutuzumab. Ropivacaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Ropivacaine. Rotavirus vaccine The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Obinutuzumab. Rotigotine The risk or severity of adverse effects can be increased when Rotigotine is combined with Obinutuzumab. Rubella virus The risk or severity of infection can be increased when Rubella virus vaccine is combined with Obinutuzumab. Ruxolitinib The risk or severity of adverse effects can be increased when Ruxolitinib is combined with Obinutuzumab. Sacituzumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Sacituzumab govitecan. Sacubitril The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Sacubitril. Safinamide Safinamide may increase the orthostatic hypotensive activities of Obinutuzumab. Sarilumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Sarilumab. Satralizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Satralizumab. Secobarbital Secobarbital may increase the hypotensive activities of Obinutuzumab. Secukinumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Secukinumab. Selegiline Selegiline may increase the orthostatic hypotensive activities of Obinutuzumab. Selexipag Selexipag may increase the hypotensive activities of Obinutuzumab. Sevoflurane The risk or severity of adverse effects can be increased when Sevoflurane is combined with Obinutuzumab. Sildenafil The risk or severity of hypotension can be increased when Sildenafil is combined with Obinutuzumab. Siltuximab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Siltuximab. Siponimod The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Siponimod. Sipuleucel-T The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Obinutuzumab. Sirolimus The risk or severity of adverse effects can be increased when Sirolimus is combined with Obinutuzumab. Sitaxentan Sitaxentan may increase the hypotensive activities of Obinutuzumab. Smallpox The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Obinutuzumab. Sodium citrate The risk or severity of bleeding and hemorrhage can be increased when Sodium citrate is combined with Obinutuzumab. Sodium ferric The risk or severity of hypotension can be increased when Sodium ferric gluconate complex is combined with Obinutuzumab. Sorafenib The risk or severity of adverse effects can be increased when Sorafenib is combined with Obinutuzumab. You Might Also Read Naproxen Indications Contra Indications Sotalol The risk or severity of adverse effects can be increased when Sotalol is combined with Obinutuzumab. Sotrovimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Sotrovimab. Spesolimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Spesolimab. Spirapril Spirapril may increase the hypotensive activities of Obinutuzumab. Spironolactone The risk or severity of adverse effects can be increased when Spironolactone is combined with Obinutuzumab. Streptokinase The risk or severity of bleeding and hemorrhage can be increased when Streptokinase is combined with Obinutuzumab. Streptozocin The risk or severity of adverse effects can be increased when Streptozocin is combined with Obinutuzumab. Sufentanil The risk or severity of adverse effects can be increased when Sufentanil is combined with Obinutuzumab. Sulesomab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Sulesomab. Sulfamethoxazole The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Obinutuzumab. Sulfasalazine The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Obinutuzumab. Sulfinpyrazone The risk or severity of adverse effects can be increased when Sulfinpyrazone is combined with Obinutuzumab. Sulodexide The risk or severity of bleeding and hemorrhage can be increased when Sulodexide is combined with Obinutuzumab. Sunitinib The risk or severity of adverse effects can be increased when Sunitinib is combined with Obinutuzumab. Sutimlimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Sutimlimab. S.Estrogens, A Synthetic Conjugated Estrogens, A may increase the thrombogenic activities of Obinutuzumab. S.Estrogens, B Synthetic Conjugated Estrogens, B may increase the thrombogenic activities of Obinutuzumab. Tacrolimus Tacrolimus may increase the immunosuppressive activities of Obinutuzumab. Tadalafil Tadalafil may increase the hypotensive activities of Obinutuzumab. Tafasitamab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tafasitamab. Tamsulosin The risk or severity of adverse effects can be increased when Tamsulosin is combined with Obinutuzumab. Tedizolid The risk or severity of myelosuppression can be increased when Obinutuzumab is combined with Tedizolid phosphate. Telmisartan Telmisartan may increase the hypotensive activities of Obinutuzumab. Temozolomide The risk or severity of adverse effects can be increased when Temozolomide is combined with Obinutuzumab. Temsirolimus The risk or severity of adverse effects can be increased when Temsirolimus is combined with Obinutuzumab. Tenecteplase The risk or severity of bleeding and hemorrhage can be increased when Tenecteplase is combined with Obinutuzumab. Teniposide The risk or severity of adverse effects can be increased when Teniposide is combined with Obinutuzumab. Teplizumab The risk or severity of adverse effects can be increased when Teplizumab is combined with Obinutuzumab. Teprotumumab The risk or severity of adverse effects can be increased when Teprotumumab is combined with Obinutuzumab. Terazosin Terazosin may increase the hypotensive activities of Obinutuzumab. Teriflunomide The risk or severity of adverse effects can be increased when Teriflunomide is combined with Obinutuzumab. Tetanus The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tetanus immune globulin, human. Tetracaine The risk or severity of methemoglobinemia can be increased when Obinutuzumab is combined with Tetracaine. Tezepelumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tezepelumab. Thalidomide The risk or severity of adverse effects can be increased when Thalidomide is combined with Obinutuzumab. Thiamylal Thiamylal may increase the hypotensive activities of Obinutuzumab. Thiopental Thiopental may increase the hypotensive activities of Obinutuzumab. Thioridazine The risk or severity of adverse effects can be increased when Thioridazine is combined with Obinutuzumab. Thiotepa The risk or severity of adverse effects can be increased when Thiotepa is combined with Obinutuzumab. Tibolone Tibolone may increase the thrombogenic activities of Obinutuzumab. Ticagrelor The risk or severity of adverse effects can be increased when Ticagrelor is combined with Obinutuzumab. Tick encephalitis The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Obinutuzumab. Ticlopidine The risk or severity of adverse effects can be increased when Ticlopidine is combined with Obinutuzumab. Tildrakizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tildrakizumab. Timolol Timolol may increase the hypotensive activities of Obinutuzumab. Tinzaparin The risk or severity of bleeding and hemorrhage can be increased when Tinzaparin is combined with Obinutuzumab. Tioguanine The risk or severity of adverse effects can be increased when Tioguanine is combined with Obinutuzumab. Tirofiban The risk or severity of adverse effects can be increased when Tirofiban is combined with Obinutuzumab. Tisotumab vedotin The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tisotumab vedotin. Tixagevimab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tixagevimab. Tixocortol The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tixocortol. Tizanidine The risk or severity of adverse effects can be increased when Tizanidine is combined with Obinutuzumab. Tocilizumab The risk or severity of adverse effects can be increased when Tocilizumab is combined with Obinutuzumab. Tofacitinib Obinutuzumab may increase the immunosuppressive activities of Tofacitinib. Tolazoline Tolazoline may increase the hypotensive activities of Obinutuzumab. Tolcapone The risk or severity of adverse effects can be increased when Tolcapone is combined with Obinutuzumab. Topotecan The risk or severity of adverse effects can be increased when Topotecan is combined with Obinutuzumab. Torasemide Torasemide may increase the hypotensive activities of Obinutuzumab. Tositumomab The risk or severity of adverse effects can be increased when Tositumomab is combined with Obinutuzumab. Trabectedin The risk or severity of adverse effects can be increased when Trabectedin is combined with Obinutuzumab. Tralokinumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tralokinumab. Trandolapril Trandolapril may increase the hypotensive activities of Obinutuzumab. Tranylcypromine Tranylcypromine may increase the orthostatic hypotensive activities of Obinutuzumab. Trastuzumab Trastuzumab may increase the neutropenic activities of Obinutuzumab. Trastuzumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Trastuzumab deruxtecan. Trastuzumab The risk or severity of adverse effects can be increased when Trastuzumab emtansine is combined with Obinutuzumab. Tremelimumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Tremelimumab. Treprostinil Treprostinil may increase the hypotensive activities of Obinutuzumab. Tretinoin The risk or severity of adverse effects can be increased when Tretinoin is combined with Obinutuzumab. Triamcinolone The risk or severity of adverse effects can be increased when Triamcinolone is combined with Obinutuzumab. Triamterene The risk or severity of adverse effects can be increased when Triamterene is combined with Obinutuzumab. Trichlormethiazide Trichlormethiazide may increase the hypotensive activities of Obinutuzumab. Trifluridine The risk or severity of adverse effects can be increased when Trifluridine is combined with Obinutuzumab. Triflusal The risk or severity of adverse effects can be increased when Triflusal is combined with Obinutuzumab. Trilostane The risk or severity of adverse effects can be increased when Trilostane is combined with Obinutuzumab. Trimethaphan Trimethaphan may increase the hypotensive activities of Obinutuzumab. Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Obinutuzumab. Typhoid Vaccine The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Obinutuzumab. Typhoid Vi The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Obinutuzumab. Udenafil The risk or severity of hypotension can be increased when Udenafil is combined with Obinutuzumab. Upadacitinib The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Upadacitinib. Urokinase The risk or severity of bleeding and hemorrhage can be increased when Urokinase is combined with Obinutuzumab. Ustekinumab The risk or severity of adverse effects can be increased when Ustekinumab is combined with Obinutuzumab. Valsartan Valsartan may increase the hypotensive activities of Obinutuzumab. Vardenafil The risk or severity of hypotension can be increased when Vardenafil is combined with Obinutuzumab. Varicella zoster The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Obinutuzumab. Varicella zoster The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Obinutuzumab. Vedolizumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Vedolizumab. Verapamil The risk or severity of adverse effects can be increased when Verapamil is combined with Obinutuzumab. Vericiguat The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Vericiguat. Vibrioantigen The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Obinutuzumab. Vilanterol The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Vilanterol. Vinblastine The risk or severity of adverse effects can be increased when Vinblastine is combined with Obinutuzumab. Vincristine The risk or severity of adverse effects can be increased when Vincristine is combined with Obinutuzumab. Vindesine The risk or severity of adverse effects can be increased when Vindesine is combined with Obinutuzumab. Vinorelbine The risk or severity of adverse effects can be increased when Vinorelbine is combined with Obinutuzumab. Voclosporin The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Voclosporin. Vorapaxar The risk or severity of adverse effects can be increased when Vorapaxar is combined with Obinutuzumab. Vorinostat The risk or severity of adverse effects can be increased when Vorinostat is combined with Obinutuzumab. Warfarin The risk or severity of bleeding and hemorrhage can be increased when Warfarin is combined with Obinutuzumab. Pregnancy and Lactation AU TGA pregnancy category: C US FDA pregnancy category: Not assigned. Pregnancy GAZYVA is likely to cause fetal B-cell depletion based on findings from animal studies and the drug’s mechanism of action [see Clinical Pharmacology (12.1)]. There are no data on GAZYVA use in pregnant women to inform a drug-associated risk. Monoclonal antibodies are transferred across the placenta. In animal reproduction studies, weekly intravenous administration of obinutuzumab to pregnant cynomolgus monkeys from day 20 of pregnancy until parturition which includes the period of organogenesis at doses with exposures up to 2.4 times the exposure at the clinical dose of 1000 mg monthly produced opportunistic infections and immune complex-mediated hypersensitivity reactions. No embryo-toxic or teratogenic effects were observed in the monkeys (see Data). Consider the potential risk to the fetus when prescribing GAZYVA to a pregnant woman. Lactation There is no information regarding the presence of GAZYVA in human milk, the effects on the breastfed child, or the effects on milk production. However, low levels of obinutuzumab were present in the milk of lactating cynomolgus monkeys [see Use in Specific Populations. Human IgG is known to be present in human milk. Published data suggest that antibodies in breast milk do not enter the neonatal and child circulations in substantial amounts. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for GAZYVA and any potential adverse effects on the breastfed child from GAZYVA or from the underlying maternal condition How should this medicine be used? The obinutuzumab injection comes as a solution (liquid) to be added to fluid and slowly injected intravenously (into a vein) by a doctor or nurse in a medical office or hospital. Your doctor will select a schedule to give you an obinutuzumab injection along with other medications that is best to treat your condition. Your doctor may need to interrupt or stop your treatment if you experience certain side effects. Your doctor will give you other medications to prevent or treat certain side effects before you receive each dose of obinutuzumab injection. Tell your doctor or nurse if you experience any of the following during or within 24 hours after you receive obinutuzumab: dizziness, lightheadedness, fainting, fast heartbeat, chest pain, difficulty breathing, swelling of the throat, nausea, vomiting, fatigue, diarrhea, sudden reddening of the face, neck, or upper chest, rash, headache, chills, and fever. Be sure to tell your doctor how you are feeling during your treatment with the obinutuzumab injection. What special precautions should I follow? Before receiving an obinutuzumab injection, tell your doctor and pharmacist if you are allergic to obinutuzumab, any other medications, or any of the ingredients in the obinutuzumab injection. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any medications for high blood pressure. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had heart, lung, kidney, or liver disease. Also, tell your doctor if you have any type of infection now or if you have or have ever had an infection that would not go away or an infection that comes and goes. tell your doctor if you are pregnant or plan to become pregnant. You should use effective birth control to prevent pregnancy during your treatment with obinutuzumab injection and for 6 months after your final dose. Talk to your doctor about birth control methods that will work for you. If you become pregnant while receiving obinutuzumab injection, call your doctor. tell your doctor if you are breastfeeding. You should not breastfeed while you are receiving obinutuzumab and for 6 months after your final treatment dose. if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving obinutuzumab injection. do not have any vaccinations without talking to your doctor. WARNINGS Hepatitis B Virus Reactivation Hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death, can occur in patients treated with anti-CD20 antibodies such as GAZYVA. HBV reactivation has been reported in patients who are hepatitis B surface antigen (HBsAg) positive and also in patients who are HBsAg negative but are hepatitis B core antibody (anti-HBc) positive. Reactivation has also occurred in patients who appear to have resolved hepatitis B infection (i.e., HBsAg negative, anti-HBc positive, and hepatitis B surface antibody [anti-HBs] positive). HBV reactivation is defined as an abrupt increase in HBV replication manifesting as a rapid increase in serum HBV DNA level or detection of HBsAg in a person who was previously HBsAg negative and anti-HBc positive. Reactivation of HBV replication is often followed by hepatitis, i.e., an increase in transaminase levels and, in severe cases, an increase in bilirubin levels, liver failure, and death. Screen all patients for HBV infection by measuring HBsAg and anti-HBc before initiating treatment with GAZYVA. For patients who show evidence of hepatitis B infection (HBsAg positive [regardless of antibody status] or HBsAg negative but anti-HBc positive), consult physicians with expertise in managing hepatitis B regarding monitoring and consideration for HBV antiviral therapy. Monitor patients with evidence of current or prior HBV infection for clinical and laboratory signs of hepatitis or HBV reactivation during and for several months following treatment with GAZYVA. HBV reactivation has been reported for other CD20-directed cytolytic antibodies following the completion of therapy. In patients who develop reactivation of HBV while receiving GAZYVA, immediately discontinue GAZYVA and any concomitant chemotherapy and institute appropriate treatment. Resumption of GAZYVA in patients whose HBV reactivation resolves should be discussed with physicians with expertise in managing hepatitis B. Insufficient data exist regarding the safety of resuming GAZYVA in patients who develop HBV reactivation. Progressive Multifocal Leukoencephalopathy JC virus infection resulting in progressive multifocal leukoencephalopathy (PML), which can be fatal, was observed in patients treated wit GAZYVA. Consider the diagnosis of PML in any patient presenting with new onset or changes to preexisting neurologic manifestations. Evaluation of PML includes, but is not limited to, consultation with a neurologist, brain MRI, and lumbar puncture. Discontinue GAZYVA therapy and consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML. Infusion Reactions GAZYVA can cause severe and life-threatening infusion reactions. Sixty-five percent of patients with CLL experienced a reaction to the first 1000 mg of GAZYVA infused. Thirty-eight percent of patients with relapsed or refractory NHL and 60% of patients with previously untreated NHL experienced a reaction on Day 1 of GAZYVA infusion. Infusion reactions can also occur with subsequent infusions. Symptoms may include hypotension, tachycardia, dyspnea, and respiratory symptoms (e.g., bronchospasm, larynx and throat irritation, wheezing, laryngeal edema). The most frequently reported symptoms include nausea, fatigue, chest discomfort, dyspnea, dizziness, vomiting, diarrhea, rash, hypertension, hypotension, flushing, headache, pyrexia, and chills. Premedicate patients with acetaminophen, antihistamine, and a glucocorticoid. Institute medical management (e.g., glucocorticoids, epinephrine, bronchodilators, and/or oxygen) for infusion reactions as needed. Closely monitor patients during the entire infusion. Infusion reactions within 24 hours of receiving GAZYVA have occurred. For patients with any Grade 4 infusion reactions, including but not limited to anaphylaxis, acute life-threatening respiratory symptoms, or other life-threatening infusion reaction: Stop the GAZYVA infusion. Permanently discontinue GAZYVA therapy. For patients with Grade 1, 2, or 3 infusion reactions: Interrupt GAZYVA for Grade 3 reactions until resolution of symptoms. Interrupt or reduce the rate of the infusion for Grade 1 or 2 reactions and manage symptoms. For patients with preexisting cardiac or pulmonary conditions, monitor more frequently throughout the infusion and the post-infusion period since they may be at greater risk of experiencing more severe reactions. Hypotension may occur as part of the GAZYVA infusion reaction. Consider withholding antihypertensive treatments for 12 hours prior to, during each GAZYVA infusion, and for the first hour after administration until blood pressure is stable. For patients at increased risk of hypertensive crisis, consider the benefits versus the risks of withholding their antihypertensive medication as is suggested here. Hypersensitivity Reactions Including Serum Sickness Hypersensitivity reactions have been reported in patients treated with GAZYVA. Signs of immediate onset hypersensitivity included dyspnea, bronchospasm, hypotension, urticaria, and tachycardia. Late-onset hypersensitivity diagnosed as serum sickness has also been reported, with symptoms that include chest pain, diffuse arthralgia, and fever. Hypersensitivity reactions may be difficult to clinically distinguish from infusion-related reactions. However, hypersensitivity very rarely occurs with the first infusion and, when observed, often occurs after previous exposure. If a hypersensitivity reaction is suspected during or after an infusion, the infusion must be stopped and treatment permanently discontinued. Patients with known hypersensitivity reactions to GAZYVA, including serum sickness, must not be retreated. Tumor Lysis Syndrome Tumor lysis syndrome (TLS), including fatal cases, has been reported in patients receiving GAZYVA. Patients with high tumor burden, high circulating lymphocyte count (> 25 x 109 /L) or renal impairment are at greater risk for TLS and should receive appropriate tumor lysis prophylaxis with anti-hyperuricemia (e.g., allopurinol or rasburicase) and hydration prior to the infusion of GAZYVA . During the initial days of GAZYVA treatment, monitor the laboratory parameters of patients considered at risk for TLS. For treatment of TLS, correct electrolyte abnormalities, monitor renal function and fluid balance, and administer supportive care, including dialysis as indicated. Infections Fatal and serious bacterial, fungal, and new or reactivated viral infections can occur during and following GAZYVA therapy. When GAZYVA is administered with chemotherapy followed by GAZYVA monotherapy, Grade 3 to 5 infections have been reported in up to 8% of patients during combination therapy, up to 13% of patients during monotherapy, and up to 8% of patients after treatment. Do not administer GAZYVA to patients with an active infection. Patients with a history of recurring or chronic infections may be at increased risk of infection. In GALLIUM, more Grade 3 to 5 infections were reported in the recipients of GAZYVA and bendamustine (117/410 patients, 29%), as compared to GAZYVA plus CHOP or CVP (43/281 patients, 15%). More fatal infections were reported in patients treated with GAZYVA and bendamustine (3%), as compared to GAZYVA plus CHOP or CVP (< 1%), including during the monotherapy phase and after completion of treatment. Neutropenia Severe and life-threatening neutropenia, including febrile neutropenia, has been reported during treatment with GAZYVA. Monitor patients with Grade 3 to 4 neutropenia frequently with regular laboratory tests until resolution. Anticipate, evaluate, and treat any symptoms or signs of developing an infection. Consider the administration of granulocyte colony-stimulating factors (GCSF) in patients with Grade 3 or 4 neutropenia. Neutropenia can also be of late onset (occurring more than 28 days after completion of treatment) and/or prolonged (lasting longer than 28 days). Consider dose delays in the case of Grade 3 or 4 neutropenia. Patients with severe and long-lasting (> 1 week) neutropenia are strongly recommended to receive antimicrobial prophylaxis until the resolution of neutropenia to Grade 1 or 2. Consider antiviral and antifungal prophylaxis. Thrombocytopenia Severe and life-threatening thrombocytopenia has been reported during treatment with GAZYVA in combination with chemotherapy. Fatal hemorrhagic events have been reported in patients with NHL and CLL treated with GAZYVA in combination with chemotherapy, including during Cycle 1. Monitor all patients frequently for thrombocytopenia and hemorrhagic events, especially during the first cycle. In patients with Grade 3 or 4 thrombocytopenia, monitor platelet counts more frequently until resolution and consider subsequent dose delays of GAZYVA and chemotherapy or dose reductions of chemotherapy. Transfusion of blood products (i.e., platelet transfusion) may be necessary. Consider withholding concomitant medications, which may increase bleeding risk (platelet inhibitors, anticoagulants), especially during the first cycle. Immunization The safety and efficacy of immunization with live or attenuated viral vaccines during or following GAZYVA therapy have not been studied. 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