Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Rituximab

Biologic (anti-CD20 monoclonal antibody)

Brand names: Rituxan

Oral health effects

  • Increased infection / candidiasis risk & delayed healing

    B-cell depletion raises infection risk; oral viral/fungal infections may occur.

    Clinical management: Monitor for fungal/viral infection; emphasize hygiene; consider antimicrobial prophylaxis per medical advice; plan atraumatic care and coordinate timing of invasive procedures.

  • Severe mucocutaneous reactions (paraneoplastic pemphigus, SJS/TEN, lichenoid lesions)

    Boxed warning: severe, sometimes fatal mucocutaneous reactions, including paraneoplastic pemphigus, Stevens-Johnson syndrome, lichenoid and vesiculobullous dermatitis and toxic epidermal necrolysis; onset is variable and can be as early as the first day of exposure.

    Clinical management: New painful oral erosions, blistering or lichenoid lesions in a patient receiving rituximab need urgent referral to the prescriber/oral medicine — do not treat as routine aphthae. Provide gentle, symptomatic oral care.

Sources

  1. Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.
  2. Rituximab (Rituxan) prescribing information (FDA label) Genentech, Inc. / DailyMed, 2025.