Rituxan (rituximab)
Antineoplastic Monoclonal Antibodies Intravenous Vial (Ml)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Rituximab, rituximab-abbs, rituximab-arrx, and rituximab-pvvr are chimeric human-murine anti-human antigen CD20 monoclonal antibodies and antineoplastic agents.
Rituximab and hyaluronidase human is a fixed combination of rituximab (a chimeric human-murine anti-human antigen CD20 monoclonal antibody) and recombinant human hyaluronidase (an endoglycosidase).
Rituximab-abbs (Truxima(R)), rituximab-arrx (Riabni(R)), and rituximab-pvvr (Ruxience(R)) are biosimilar to rituximab (Rituxan(R)). FDA defines a biosimilar as a biological product that is highly similar to an FDA-licensed reference biological with the exception of minor differences in clinically inactive components and for which there are no clinically meaningful differences in safety, purity, or potency. The claim of biosimilarity is based on a totality-of-evidence approach, which includes consideration of data from analytical, animal, and clinical studies (e.g., human pharmacokinetic and pharmacodynamic studies, clinical immunogenicity assessment, additional comparative clinical studies).
Therefore, biosimilarity may be established even when there are formulation or minor structural differences as long as these differences are not clinically meaningful. Biosimilars are approved through an abbreviated licensure pathway that establishes biosimilarity between the proposed biological and the reference biological but does not independently establish safety and effectiveness of the proposed biological. In order to be considered an interchangeable biosimilar, a biological product must meet additional requirements beyond demonstrating biosimilarity to its reference product; these requirements include demonstrating that the biological product can be expected to produce the same clinical results as the reference product in any given patient and, for a biological product that is administered more than once to an individual, the risk in terms of safety or diminished efficacy of alternating or switching between use of the biological product and the reference product is no greater than the risk of using the reference product without such alteration or switch.
Biosimilar products that are interchangeable can be substituted for the reference product without the intervention of the healthcare provider who prescribed the reference product. None of the currently available rituximab biosimilars have interchangeable data at this time.
Rituximab, a chimeric human-murine anti-human antigen CD20 monoclonal antibody, is an antineoplastic agent. Rituximab binds specifically to antigen CD20 located on pre-B and mature B lymphocytes. CD20 antigen is involved in the regulation of cell cycle initiation and differentiation and also may function as a calcium ion channel.
Following binding of the Fab domain of rituximab to the CD20 antigen on B lymphocytes, the Fc domain triggers a host immune response causing lysis of normal and malignant B cells; the exact mechanism of cell lysis has not been fully elucidated but is thought to involve complement-dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC). Inhibition of cellular proliferation and induction of apoptosis by rituximab have been demonstrated in some non-Hodgkin lymphoma (NHL) cell lines. Rituximab also has been shown to increase the in vitro sensitivity of certain chemoresistant human lymphoma cell lines to some cytotoxic agents, including doxorubicin.
B cells may contribute to the pathogenesis of rheumatoid arthritis and associated chronic synovitis by involvement in the production of rheumatoid factor and other autoantibodies, presentation of antigen, activation of T cells, and/or production of inflammatory cytokines.
Hyaluronidase, a component of rituximab/hyaluronidase, is a recombinant human endoglycosidase used to increase the dispersion and absorption of co-administered drugs when administered subcutaneously. Hyaluronidase temporarily depolymerizes hyaluronan, a polysaccharide found in the extracellular matrix of subcutaneous tissue; this leads to increased permeability of subcutaneous tissues. Hyaluronidase acts transiently and locally; the effects are reversible, and the permeability of the subcutaneous tissue is restored within 24-48 hours.
Hyaluronidase was shown to increase the absorption rate of a rituximab product in animal studies.
Rapid and sustained depletion of circulating and tissue-based B cells occurs as a result of the lysis of B cells induced by rituximab. Depletion of circulating B cells lasted for up to 6-9 months in 83% of patients receiving IV rituximab for NHL in a clinical study. Following completion of IV rituximab therapy, recovery of B cells begins at approximately 6 months, and levels of B cells generally return to normal within 12 months, although in some patients it may take longer.
Repletion of B-cells following rituximab/hyaluronidase treatment in patients with follicular lymphoma occurs on a similar timeline, with B-cell repletion beginning after 6 months of stopping treatment; however, in some patients, this may take longer. In patients with chronic lymphocytic leukemia (CLL) receiving rituximab/hyaluronidase, 28% were B-cell-depleted prior to the cycle 2 dose; by cycle 6, 96% of patients were B-cell-depleted. Patients remained B-cell-depleted until the month 9 follow-up visit, where signs of repletion were seen.
In patients with rheumatoid arthritis, nearly complete depletion of peripheral B lymphocytes (CD19 counts below the lower limit of quantification (20/mcL)) occurred within 2 weeks following the first dose of IV rituximab. In most patients, depletion of circulating B cells lasted for at least 6 months. A small number of patients (approximately 4%) experienced prolonged peripheral B-cell depletion (more than 3 years) after a single course of treatment.
Rituximab therapy also was associated with the reduction of certain biologic markers of inflammation, including interleukin-6, C-reactive protein, serum amyloid protein, S100 A8/S100 A9 heterodimer complex, anti-citrullinated peptide, and rheumatoid factor. In a clinical study of IV rituximab in patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), peripheral blood CD19 B-cells remained depleted in most patients (84%) through month 6; by month 12, 81% of patients demonstrated signs of B-cell return, and by month 18, 87% of patients had recovered from B-cell depletion. In another clinical study of patients with GPA/MPA treated with IV rituximab, 70% of patients had undetectable CD19 peripheral B-cells at month 24.
Rituximab/hyaluronidase is administered subcutaneously; in pharmacokinetic studies of rituximab/hyaluronidase, the absolute bioavailability of rituximab following rituximab/hyaluronidase administration was 64.6 and 63.4% in patients with follicular lymphoma and CLL, respectively.
In a study of 203 patients with non-Hodgkin lymphoma (NHL) receiving rituximab 375 mg/m2 by IV infusion once weekly for 4 weeks, rituximab was detected in the serum of patients 3-6 months after completion of treatment. The pharmacokinetic disposition of rituximab when administered in conjunction with 6 cycles of combination chemotherapy with CHOP (i.e., cyclophosphamide, doxorubicin, vincristine, and prednisone) is similar to that observed with rituximab alone.
In a study of 35 pediatric patients >=3 years of age with diffuse large B-cell lymphoma, Burkitt lymphoma, Burkitt-like lymphoma, or mature B-cell acute leukemia, the maximum serum rituximab concentration was highest after the fourth infusion (cycle 2 of induction therapy). Pharmacokinetic parameters were similar in these patients and adult patients with NHL. No pharmacokinetic data are available for pediatric patients <3 years of age.
Based on a population pharmacokinetic analysis of data in 298 patients with NHL receiving IV rituximab once weekly or once every 3 weeks, the estimated median terminal elimination half-life was 22 days (range: 6.1-52 days). In 21 patients with CLL receiving IV rituximab 375 mg/m2 approximately every 28 days, the estimated median terminal half-life was 32 days (range: 14-62 days). Based on a population pharmacokinetic analysis of data in 2005 patients with rheumatoid arthritis, the mean terminal elimination half-life of IV rituximab was 18 days (range: 5.17-77.5 days).
Based on a population pharmacokinetic analysis of data from 97 adult patients with GPA/MPA and 25 pediatric patients with GPA/MPA, the median terminal elimination half-life of IV rituximab was 25 days (range: 11-52 days) in adult patients and 22 days (range: 11-42 days) in pediatric patients. In a population pharmacokinetic study of 67 adults with pemphigus vulgaris, the median terminal elimination half-life of IV rituximab was 21.1 days (range: 9.3-36.2 days) after the first cycle of treatment and 26.2 days (range: 16.4-42.8 days) after the second cycle of treatment. The median terminal elimination half-life of rituximab in pediatric patients with diffuse large B-cell lymphoma, Burkitt lymphoma, Burkitt-like lymphoma, or mature B-cell acute leukemia was 25.7 days (range: 18-31 days) in patients >=3 to <12 years of age and 26.3 days (range: 16.9-31.9 days) in patients >=12 to <18 years of age.
The mean terminal elimination half-life of rituximab following administration of subcutaneous rituximab/hyaluronidase was 34.1 days in patients with follicular lymphoma and 32 days in patients with CLL.
Patients with NHL and a higher CD19-positive cell count or larger measurable tumor lesions at pretreatment had a higher rate of rituximab clearance. Age and gender had no effect on the pharmacokinetics of rituximab in patients with NHL. Age, weight, and gender had no effect on the pharmacokinetics of rituximab in patients with rheumatoid arthritis.
Several rituximab biosimilars are available. Biosimilarity of these products has been demonstrated for the indications described in Table 1. Biosimilarity to originator rituximab is additionally supported by comparative clinical studies in patients with non-Hodgkin lymphoma (rituximab-abbs, rituximab-arrx, rituximab-pvvr) and rheumatoid arthritis (rituximab-abbs, rituximab-arrx, rituximab-pvvr).
Generic name: rituximab
Pronunciation: (ri-TUX-i-mab)
Drug class: Antineoplastic Monoclonal Antibodies
Therapeutic class: Antineoplastics
Reference product & biosimilars
Today’s intelligence on Rituxan
Indications
The following indications are listed for Rituxan:
- Burkitt's Lymphoma
- Cd20 Positive Non-Hodgkin's Lymphoma
- Chronic Lymphocytic Leukemia
- Diffuse Large B-Cell Lymphoma
- Follicular Lymphoma
- Granulomatosis With Polyangiitis
- Microscopic Polyangiitis
- Pemphigus Vulgaris
- Progressive Chronic Lymphocytic Leukemia
- Relapse Or Refractory Non-Hodgkin's Lymphoma
- Rheumatoid Arthritis
Also known as: Arthritis Deformans, Arthrosis Deformans, B-Cell Chronic Lymphocytic Leukemia, B-Cell Cll, Burkitt's Tumor, Cd20 Positive B-Cell Non-Hodgkin's Lymphoma, Chronic B-Cell Leukemia, Chronic B-Lymphocytic Leukemia, Chronic Lymphatic Leukemia, Chronic Lymphocytic Leukemia Of B-Cell Type, Chronic Lymphocytic Leukemia, B-Cell, Follicular B-Cell Lymphoma, Follicular B-Cell Non-Hodgkin's Lymphoma, Necrotizing Respiratory Granulomatosis, Nodose Rheumatism, Pathergic Granulomatosis, Progressive Cll, Refractory Chronic Lymphocytic Leukemia, Refractory Cll, Relapse Or Refractory Nhl, Rheumatic Arthritis, Rheumatic Gout, Wegener Granulomatosis.
Dosing
Depending on the severity of the symptoms, temporary or permanent discontinuance of rituximab-containing products may be warranted when severe adverse effects occur. Dosage reductions of rituximab/hyaluronidase are not recommended; when rituximab/hyaluronidase is given in combination with chemotherapy, reduce the dosage of the chemotherapeutic drugs to manage adverse reactions.
Rituximab and its biosimilars (rituximab-abbs, rituximab-arrx, and rituximab-pvvr) are administered by IV infusion. These products should not be administered by rapid IV injection.
Rituximab/hyaluronidase is administered by subcutaneous injection only; it should not be administered by IV infusion.
Rituximab and rituximab/hyaluronidase should only be administered by healthcare professionals with the medical support necessary to manage severe infusion-related reactions.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
Formal drug interaction studies of rituximab and rituximab/hyaluronidase have not been conducted.
Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
Antibody-Based Therapies/Imlifidase
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Imlifidase is a cysteine protease that cleaves immunoglobulin G (IgG), which results in degradation of all subclasses of human and rabbit IgG. Therapies based on human or rabbit IgG may be inactivated if given concurrently with imlifidase.(1)
CLINICAL EFFECTS: Antibody therapies based on human or rabbit IgG may be inactivated and lead to decreased efficacy.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Concurrent use of imlifidase and antibody-based therapies should be closely evaluated for timing of administration to avoid decreased efficacy of the antibody-based therapy.(1) Antibody-based therapies cleaved by imlifidase include, but are not limited to, basiliximab, rituximab, alemtuzumab, adalimumab, denosumab, belatacept, etanercept, rabbit anti-human thymocyte globulin (rATG) and intravenous immunoglobulin (IVIg). The prescribing information recommends the following time intervals for administration of antibody-based therapies after administration of imlifidase: -Equine anti-thymocyte globulin: No time interval needed (may be administered concurrently) -Intravenous immunoglobulin (IVIg): 12 hours -Adalimumab, alemtuzumab, basiliximab, denosumab, etanercept, or rituximab: 4 days -Rabbit anti-human thymocyte globulin (rATG) or belatacept: 1 week In addition, IVIg may contain neutralizing antibodies against imlifidase, which may inactivate imlifidase if IVIg is given before imlifidase. Consider the half-life of IVIg (3-4 weeks) before imlifidase administration to patients treated with IVIg. Eculizumab is not cleaved by imlifidase at the recommended dose level.(1)
DISCUSSION: Imlifidase is a cysteine protease that cleaves IgG, which results in degradation of all subclasses of human and rabbit IgG. Antibody therapies based on human or rabbit IgG may be inactivated if given in connection with imlifidase.(1) IVIg may contain neutralizing antibodies against imlifidase, which may inactivate imlifidase if IVIg is given before imlifidase. In clinical studies, IVIg was not administered within 4 weeks before imlifidase infusion.(1)
Biologic Dmards/Sarilumab; Tocilizumab
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Concurrent use of sarilumab(1) or tocilizumab(2) with other biologic DMARDs may result in additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of sarilumab(1) or tocilizumab(2) with other biologic DMARDs may increase the risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The concurrent use of sarilumab(1) or tocilizumab(2) with other biologic DMARDs should be avoided.
DISCUSSION: Concurrent use of sarilumab(1) or tocilizumab(2) and other biologic DMARDs may increase the risk of infection.
Immunosuppressive; Immunomod/Cladribine Onc Inj (10 Mg/5 Ml)
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Cladribine in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-2)
CLINICAL EFFECTS: Concurrent use of cladribine with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections.(1-2)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for cladribine regarding this interaction differ between regulatory approving agencies. The UK and AU manufacturers of Litak state that concomitant use of other myelosuppressive medicinal products with cladribine is contraindicated.(1-2) The Israeli manufacturer of Litak states that cladribine should not be used concomitantly with other myelosuppressive medicinal products.(3)
DISCUSSION: The risk of severe myelotoxicity and long-lasting immunosuppression is increased in patients with a disease-related bone marrow infiltration or a previous myelosuppressive treatment.(1-3)
Immunosuppressives; Immunomodulators/Efalizumab; Natalizumab
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Natalizumab,(1-3) efalizumab,(4) immunosuppressives, and immunomodulators all suppress the immune system.
CLINICAL EFFECTS: Concurrent use of natalizumab(1-3) or efalizumab(4) with immunosuppressives or immunomodulators may result in an increased risk of infections, including progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).
PREDISPOSING FACTORS: Previous JCV infection, longer duration of natalizumab treatment - especially if greater than 2 years, and prior or concomitant treatment with immunosuppressant medication are all independent risk factors which increase the risk for PML.(1,5) The FDA has estimated PML incidence stratified by risk factors: If anti-JCV antibody positive, no prior immunosuppressant use and natalizumab treatment less than 25 months, incidence <1/1,000. If anti-JCV antibody positive, history of prior immunosuppressant use and natalizumab treatment less than 25 months, incidence 2/1,000 If anti-JCV antibody positive, no prior immunosuppressant use and natalizumab treatment 25-48 months, incidence 4/1,000 If anti-JCV antibody positive, history of prior immunosuppressant use and natalizumab treatment 25-48 months, incidence 11/1,000.
PATIENT MANAGEMENT: The US manufacturer of natalizumab states patients with Crohn's disease should not receive concurrent immunosuppressants, with the exception of limited overlap of corticosteroids, due to the increased risk for PML. For new natalizumab patients currently receiving chronic oral corticosteroids for Crohn's Disease, begin corticosteroid taper when therapeutic response to natalizumab has occurred. If corticosteroids cannot be discontinued within six months of starting natalizumab, discontinue natalizumab.(3) The US manufacturer of natalizumab states that natalizumab should not ordinarily be used in multiple sclerosis patients receiving immunosuppressants or immunomodulators due to the increased risk for PML. Immunosuppressives include, but are not limited to azathioprine, cyclophosphamide, cyclosporine, mercaptopurine, methotrexate, mitoxantrone, mycophenolate, and corticosteroids.(3,6) The UK manufacturer of natalizumab states that concurrent use with immunosuppressives or antineoplastic agents is contraindicated.(1) The Canadian manufacturer of natalizumab states that natalizumab should not be used with immunosuppressive or immunomodulatory agents.(2) The US manufacturer of certolizumab states that concurrent therapy with natalizumab is not recommended.(7)
DISCUSSION: Progressive multifocal leukoencephalopathy has been reported in patients receiving concurrent natalizumab were recently or concomitantly taking immunomodulators or immunosuppressants.(1-5,8,9) In a retrospective cohort study of multiple sclerosis patients newly initiated on a disease-modifying therapy, use of high-efficacy agents (alemtuzumab, natalizumab, or ocrelizumab) resulted in the same risk of overall infections as moderate-efficacy agents, but there was an elevated risk of serious infections (adjusted hazard ratio [aHR] = 1.24, 95% confidence interval (CI) = 1.06-1.44) and UTIs (aHR = 1.21, 95% CI = 1.14-1.30).(10)
Selected Biologic Dmards/Abatacept
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Possibly additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of abatacept with anakinra, rituximab, or a tumor necrosis factor (TNF) blocking agent may increase the risk of severe infections without providing any clinical benefit.(1-5)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of abatacept states that abatacept should not be used with TNF blocking agents or other biologic DMARDs. Patients transitioning from TNF blocking agent therapy to abatacept should be closely monitored for signs of infection.(1) The US manufacturers of adalimumab,(2) certolizumab,(3) golimumab,(4) and infliximab(5) state that concurrent therapy with abatacept is not recommended.
DISCUSSION: In clinical trials, patients who received concurrent abatacept and TNF blocking agents experienced more infections (63% versus 43%) and more serious infections (4.4% versus 0.8%) than patients who received TNF agents alone. There was no significant additional efficacy over use of TNF agents alone.(1) In other trials, infections and serious infections were reported in 54% and 3%, respectively, of patients who received abatacept alone.(1)
Selected Immunosuppressants/Nadofaragene Firadenovec
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Nadofaragene firadenovec may contain low levels of replication-competent adenovirus.(1)
CLINICAL EFFECTS: Concurrent use of nadofaragene firadenovec in patients receiving immunosuppressive therapy may cause disseminated adenovirus infection.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Individuals who are immunosuppressed or immune-deficient should not receive nadofaragene firadenovec.(1)
DISCUSSION: Nadofaragene firadenovec is a non-replicating adenoviral vector-based gene therapy but may contain low levels of replication-competent adenovirus. Immunocompromised persons, including those receiving immunosuppressant therapy, may be at risk for disseminated adenovirus infection.(1)
Selected Immunosuppressants/Talimogene Laherparepvec
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Talimogene laherparepvec is a live, attenuated herpes simplex virus.(1)
CLINICAL EFFECTS: Concurrent use of talimogene laherparepvec in patients receiving immunosuppressive therapy may cause a life-threatening disseminated herpetic infection.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Talimogene laherparepvec is contraindicated in immunosuppressed patients.(1) The magnitude of immunocompromise and associated risks due to immunosuppressant drugs should be determined by a physician.
DISCUSSION: Concurrent use of talimogene laherparepvec in patients receiving immunosuppressive therapy may cause a life-threatening disseminated herpetic infection.(1)
Selected Immunosuppressive Agents/Live Vaccines; Live Bcg
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: A variety of disease modifying agents suppress the immune system. Immunocompromised patients may be at increased risk for uninhibited replication after administration of live, attenuated vaccines or intravesicular BCG. Immune response to vaccines may be decreased during periods of immunocompromise.(1)
CLINICAL EFFECTS: The expected serum antibody response may not be obtained and/or the vaccine may result in illness.(1) After instillation of intravesicular BCG, immunosuppression may interfere with local immune response, or increase the severity of mycobacterial infection following inadvertent systemic exposure.(2)
PREDISPOSING FACTORS: Immunosuppressive diseases (e.g. hematologic malignancies, HIV disease), treatments (e.g. radiation) and drugs may all increase the magnitude of immunodeficiency.
PATIENT MANAGEMENT: The Centers for Disease Control(CDC) Advisory Committee on Immunization Practices (ACIP) states that live-virus and live, attenuated vaccines should not be administered to patients who are immunocompromised. The magnitude of immunocompromise and associated risks should be determined by a physician.(1) For patients scheduled to receive chemotherapy, vaccination should ideally precede the initiation of chemotherapy by 14 days. Patients vaccinated while on immunosuppressive therapy or in the 2 weeks prior to starting therapy should be considered unimmunized and should be revaccinated at least 3 months after discontinuation of therapy.(1) Patients who receive anti-B cell therapies should not receive live vaccines for at least 6 months after such therapies due to a prolonged duration of immunosuppression. An exception is the Zoster vaccine, which can be given at least 1 month after receipt of anti-B cell therapies.(1) The US manufacturer of abatacept states live vaccines should not be given during or for up to 3 months after discontinuation of abatacept.(2) The US manufacturer of live BCG for intravesicular treatment of bladder cancer states use is contraindicated in immunosuppressed patients.(3) The US manufacturer of daclizumab states live vaccines are not recommended during and for up to 4 months after discontinuation of treatment.(4) The US manufacturer of guselkumab states that live vaccines should be avoided during treatment with guselkumab.(5) The US manufacturer of inebilizumab-cdon states that live vaccines are not recommended during treatment and after discontinuation until B-cell repletion. Administer all live vaccinations at least 4 weeks prior to initiation of inebilizumab-cdon.(6) The US manufacturer of ocrelizumab states that live vaccines are not recommended during treatment and until B-cell repletion occurs after discontinuation of therapy. Administer all live vaccines at least 4 weeks prior to initiation of ocrelizumab.(7) The US manufacturer of ozanimod states that live vaccines should be avoided during and for up to 3 months after discontinuation of ozanimod.(8) The US manufacturer of siponimod states that live vaccines are not recommended during treatment and for up to 4 weeks after discontinuation of treatment.(9) The US manufacturer of ustekinumab states BCG vaccines should not be given in the year prior to, during, or the year after ustekinumab therapy.(10) The US manufacturer of satralizumab-mwge states that live vaccines are not recommended during treatment and should be administered at least four weeks prior to initiation of satralizumab-mwge.(11) The US manufacturer of ublituximab-xiiy states that live vaccines are not recommended during treatment and until B-cell recovery. Live vaccines should be administered at least 4 weeks prior to initiation of ublituximab-xiiy.(12) The US manufacturer of etrasimod states that live vaccines should be avoided during and for 5 weeks after treatment. Live vaccines should be administered at least 4 weeks prior to initiation of etrasimod.(13) The US manufacturer of emapalumab-lzsg states that live vaccines should not be administered to patients receiving emapalumab-lzsg and for at least 4 weeks after the last dose of emapalumab-lzsg. The safety of immunization with live vaccines during or following emapalumab-lzsg therapy has not been studied.(14) The US manufacturer of sibeprenlimab-szsi states live vaccines should not be given within 30 days prior to initiation or during treatment with sibeprenlimab-szsi.(15)
DISCUSSION: Killed or inactivated vaccines do not pose a danger to immunocompromised patients.(1) Patients with a history of leukemia who are in remission and have not received chemotherapy for at least 3 months are not considered to be immunocompromised.(1)
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Biologic Therapies/Anifrolumab
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of anifrolumab with other biologic therapies may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of anifrolumab with other biologic therapies may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The concurrent use of anifrolumab with other biologic therapies is not recommended.(1)
DISCUSSION: The combination of anifrolumab with other biologic therapies has not been studied and is not recommended.(1)
Igg Antibodies And Derivatives/Efgartigimod-Alfa
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Efgartigimod-alfa binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medicines that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of efgartigimod-alfa states that efgartigimod-alfa should not be combined with long-term use of FcRn-binding medications. If the medication is essential for the patient, efgartigimod-alfa should be discontinued.(3)
DISCUSSION: Clinical drug interaction studies with efgartigimod-alfa have not been performed. Efgartigimod-alfa may decrease concentrations of compounds that bind to the human FcRn.(3)
Igg Antibodies And Derivatives/Nipocalimab-Aahu
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Nipocalimab-aahu binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medicines that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of nipocalimab-aahu states that nipocalimab-aahu should not be combined with long-term use of FcRn-binding medications. If the medication is essential for the patient, nipocalimab-aahu should be discontinued.(3)
DISCUSSION: Clinical drug interaction studies with nipocalimab-aahu have not been performed. Nipocalimab-aahu may decrease concentrations of compounds that bind to the human FcRn.(3)
Immunosuppres;Immunomodul/Selected Multiple Sclerosis Agents
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ocrelizumab or ofatumumab in combination with immunosuppressives and immune-modulators all suppress the immune system.(1,2)
CLINICAL EFFECTS: Concurrent use of ocrelizumab or ofatumumab with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1,2)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The ocrelizumab US prescribing information states: - Ocrelizumab and other immune-modulating or immunosuppressive therapies, (including immunosuppressant doses of corticosteroids) are expected to increase the risk of immunosuppression, and the risk of additive immune system effects must be considered if these therapies are coadministered with ocrelizumab. When switching from drugs with prolonged immune effects, such as daclizumab, fingolimod, natalizumab, teriflunomide, or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating ocrelizumab.(1) The ofatumumab US prescribing information states: - Ofatumumab and other immunosuppressive therapies (including systemic corticosteroids) may have the potential for increased immunosuppressive effects and increase the risk of infection. When switching between therapies, the duration and mechanism of action of each therapy should be considered due to the potential for additive immunosuppressive effects. Ofatumumab for MS therapy has not been studied in combination with other MS agents that suppress the immune system.(2)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1,2) In a retrospective cohort study of multiple sclerosis patients newly initiated on a disease-modifying therapy, use of high-efficacy agents (alemtuzumab, natalizumab, or ocrelizumab) resulted in the same risk of overall infections as moderate-efficacy agents, but there was an elevated risk of serious infections (adjusted hazard ratio [aHR] = 1.24, 95% confidence interval (CI) = 1.06-1.44) and UTIs (aHR = 1.21, 95% CI = 1.14-1.30).(3)
Immunosuppressives; Immunomodulators/Baricitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of baricitinib with other biologic disease-modifying antirheumatic drugs (DMARDs) or potent immunosuppressants such as azathioprine or cyclosporine may result in additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of baricitinib with other biologic DMARDs or potent immunosuppressants such as azathioprine or cyclosporine may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of baricitinib states that concurrent use of baricitinib with biologic DMARDs or potent immunosuppressants is not recommended.(1)
DISCUSSION: Most patients who developed serious infections while being treated with baricitinib were on concomitant immunosuppressants like methotrexate and corticosteroids. The combination of baricitinib with other biologic DMARDs has not been studied.(1)
Immunosuppressives; Immunomodulators/Cladribine Oral
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Cladribine in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-2)
CLINICAL EFFECTS: Concurrent use of cladribine with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1-2)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for cladribine regarding this interaction differ between regulatory approving agencies. The cladribine US prescribing information states: -Concomitant use with myelosuppressive or other immunosuppressive drugs is not recommended. Acute short-term therapy with corticosteroids can be administered. In patients who have previously been treated with immunomodulatory or immunosuppressive drugs, consider potential additive effect, the mode of action, and duration of effect of the other drugs prior to initiation of cladribine.(1) The cladribine Canadian prescribing information states: -Use of cladribine in immunocompromised patients is contraindicated because of a risk of additive effects on the immune system. Acute short-term therapy with corticosteroids can be administered during cladribine treatment.(2)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1-2)
Immunosuppressives; Immunomodulators/Deuruxolitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Deuruxolitinib, immunosuppressives, and immunomodulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of deuruxolitinib and potent immunosuppressants may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of deuruxolitinib states that concurrent use of deuruxolitinib with other JAK inhibitors, biologic immunomodulators, cyclosporine or other potent immunosuppressants is not recommended.(1) If concurrent use cannot be avoided, patients should be monitored for signs and symptoms of infection. If a patient develops a serious or opportunistic infection, interrupt deuruxolitinib treatment until the infection is controlled.
DISCUSSION: Serious infections have been reported in patients receiving treatment with deuruxolitinib.(1)
Immunosuppressives; Immunomodulators/Etrasimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues, resulting in a mean 55% decrease in peripheral blood lymphocyte count at 52 weeks.(1) Other immunosuppressives and immune-modulators also suppress the immune system.
CLINICAL EFFECTS: Concurrent use of etrasimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious and fatal infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications increases the risk of adverse effects.
PATIENT MANAGEMENT: The etrasimod US prescribing information states etrasimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Concomitant administration of these therapies with etrasimod should be avoided because of the risk of additive immune effects during therapy and in the weeks following administration. Etrasimod's effect on peripheral lymphocytes may persist for up to 5 weeks after discontinuation.(1) When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients treated with other sphingosine-1 phosphate receptor modulators.(1)
Immunosuppressives; Immunomodulators/Filgotinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of filgotinib with other immunosuppressants or immunomodulators including azathioprine, cyclosporine, tacrolimus, biologic disease-modifying antirheumatic drugs (DMARDs), or other Janus kinase (JAK) inhibitors may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of filgotinib with other immunosuppressants or immunomodulators including azathioprine, cyclosporine, tacrolimus, biologic DMARDs, or other JAK inhibitors may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The UK manufacturer of filgotinib states that concurrent use of filgotinib with other immunosuppressants or immunomodulators including azathioprine, cyclosporine, tacrolimus, biologic DMARDs, or other JAK inhibitors is not recommended.(1)
DISCUSSION: Serious infections have been reported in patients receiving filgotinib. Caution should be used in patients with a higher incidence of serious infection, including elderly patients aged 75 years and older.(1)
Immunosuppressives; Immunomodulators/Fingolimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Fingolimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-3)
CLINICAL EFFECTS: Concurrent use of fingolimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1-3)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for fingolimod regarding this interaction differ between regulatory approving agencies. The fingolimod US prescribing information states: - Antineoplastic, immune-modulating, or immunosuppressive therapies, (including corticosteroids) are expected to increase the risk of immunosuppression, and the risk of additive immune system effects must be considered if these therapies are coadministered with fingolimod. When switching from drugs with prolonged immune effects, such as natalizumab, teriflunomide or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating fingolimod.(1) The fingolimod Canadian prescribing information states: - Concurrent use with immunosuppressive or immunomodulatory agents is contraindicated due to the risk of additive immune system effects. However, co-administration of a short course of corticosteroids (up to 5 days) did not increase the overall rate of infection in patients participating Phase III clinical trials.(2) The fingolimod UK specific product characteristics states: - Fingolimod is contraindicated in patients currently receiving immunosuppressive therapies or those immunocompromised by prior therapies. When switching patients from another disease modifying therapy to Gilenya, the half-life and mode of action of the other therapy must be considered in order to avoid an additive immune effect whilst at the same time minimizing the risk of disease activation.(3)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1-3)
Immunosuppressives; Immunomodulators/Inebilizumab
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Inebilizumab, immunosuppressives, and immunomodulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of inebilizumab with immunosuppressive or immunomodulating agents may result in myelosuppression including neutropenia resulting in an increased risk for serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of inebilizumab states that the concurrent use of inebilizumab with immunosuppressive agents, including systemic corticosteroids, may increase the risk of infection. If concurrent therapy is warranted, consider the risk of additive immune suppression and monitor based on prescribing information for both agents.(1)
DISCUSSION: Inebilizumab has not been studied in combination with other immunosuppressants. If concurrent therapy is warranted, consider the potential for increased immunosuppressive risks from both agents. The most common infections reported by inebilizumab treated patients in the randomized and open-label clinical trial periods included urinary tract infections (20%), nasopharyngitis (13%), upper respiratory tract infections (8%), and influenza (7%). Although there been no cases of Hepatitis B virus reactivation or progressive multifocal leukoencephalopathy reported in patients taking inebilizumab, these infections have been observed in patients taking other B-cell-depleting antibodies.(1)
Immunosuppressives; Immunomodulators/Ozanimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ozanimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of ozanimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The ozanimod US prescribing information state this information regarding this interaction: -Ozanimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ozanimod after alemtuzumab is not recommended. However, ozanimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1)
Immunosuppressives; Immunomodulators/Ponesimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ponesimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of ponesimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The ponesimod US prescribing information states ponesimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ponesimod after alemtuzumab is not recommended. However, ponesimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1)
Immunosuppressives; Immunomodulators/Ritlecitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ritlecitinib, immunosuppressives, and immunomodulators all suppress the immune system.
CLINICAL EFFECTS: Concurrent use of ritlecitinib with immunosuppressives or immunomodulators may result in an increased risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of ritlecitinib states that concurrent use of ritlecitinib with other JAK inhibitors, biologic immunomodulators, cyclosporine or other potent immunosuppressants is not recommended.(1)
DISCUSSION: Serious infections have been reported in patients receiving ritlecitinib. Reported infections included appendicitis, COVID-19 infection (including pneumonia), and sepsis. Reports of viral reactivation, including herpes virus reactivation was reported in clinical studies with ritlecitinib.(1)
Immunosuppressives; Immunomodulators/Siponimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Siponimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of siponimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The siponimod US prescribing information state this information regarding this interaction: -Siponimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with siponimod after alemtuzumab is not recommended. However, siponimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1)
Immunosuppressives; Immunomodulators/Tofacitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of tofacitinib and azathioprine, other biologic disease-modifying antirheumatic drugs (DMARDs), or potent immunosuppressants may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of tofacitinib and azathioprine, other biologic DMARDs, or potent immunosuppressants use may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Tofacitinib should not be used concurrently with azathioprine, other biologic DMARDs, or cyclosporine.(1) Patient should be monitored for decreases in lymphocytes and neutrophils. Therapy should be adjusted based on the indication. - For all indications: If absolute neutrophil count (ANC) or lymphocyte count is less than 500 cells/mm3, discontinue tofacitinib. - For rheumatoid arthritis or psoriatic arthritis and absolute neutrophil count (ANC) 500 to 1000 cells/mm3: interrupt dosing. When ANC is greater than 1000 cells/mm3, resume Xeljanz 5 mg twice daily or Xeljanz XR 11 mg once daily. - For ulcerative colitis and ANC 500 to 1000 cells/mm3: -If taking Xeljanz 10 mg twice daily, decrease to 5 mg twice daily. When ANC is greater than 1000 cells/mm3, increase to 10 mg twice daily based on clinical response. -If taking Xeljanz 5 mg twice daily, interrupt dosing. When ANC is greater than 1000 cells/mm3, resume 5 mg twice daily. -If taking Xeljanz XR 22 mg once daily, decrease to 11 mg once daily. When ANC is greater than 1000 cells/mm3, increase to 22 mg once daily based on clinical response. -If taking Xeljanz XR 11 mg once daily, interrupt dosing. When ANC is greater than 1000 cells/mm3, resume 11 mg once daily. - For polyarticular course juvenile idiopathic arthritis (pcJIA) and ANC 500 to 1000 cells/mm3: interrupt dosing until ANC is greater than 1000 cells/mm3.(1)
DISCUSSION: Concurrent use of tofacitinib and azathioprine, other biologic DMARDs, or potent immunosuppressants may increase the risk of infection.(1) Serious infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving tofacitinib. Some patients presented with disseminated disease and were often taking concomitant immunomodulating agents. In the ulcerative colitis population, a greater risk of serious infections was seen with a higher tofacitinib dose. In 7 placebo-controlled rheumatoid arthritis trials (0-3 months exposure), the overall frequency of infections was 20% in the tofacitinib 5 mg twice daily group and 22% in the tofacitinib 10 mg twice daily group compared to 18% in the placebo group. Serious infections were reported in 11 patients (1.7 events per 100 patient-years) with a rate difference between treatment groups of 1.1 (-0.4, 2.5) events per 100 patient-years for both tofacitinib 5 mg twice daily and 10 mg twice daily. During 0-12 months exposure, serious infections were reported in 34 patients (2.7 events per 100 patient years) in the tofacitinib 5 mg twice daily group and 33 patients (2.7 events per 100 patient years) in the tofacitinib 10 mg twice daily group.(1)
Immunosuppressives; Immunomodulators/Upadacitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Upadacitinib, immunosuppressives, and immunomodulators all suppress the immune system.
CLINICAL EFFECTS: Concurrent use of upadacitinib with immunosuppressives or immunomodulators may result in an increased risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of upadacitinib states that concurrent use of upadacitinib with immunosuppressives or immunomodulators is not recommended.
DISCUSSION: Serious infections have been reported in patients receiving upadacitinib. Reported infections included pneumonia, cellulitis, tuberculosis, multidermatomal herpes zoster, oral/esophageal candidiasis, cryptococcosis. Reports of viral reactivation, including herpes virus reactivation and hepatitis B reactivation, were reported in clinical studies with upadacitinib.(1)
Myelosuppressives; Immunomodulators/Sodium Iodide I 131
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Sodium iodide I 131 can cause depression of the hematopoetic system. Myelosuppressives and immunomodulators also suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of sodium iodide I 131 with agents that cause bone marrow depression, including myelosuppressives or immunomodulators, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of sodium iodide I 131 states that concurrent use with bone marrow depressants may enhance the depression of the hematopoetic system caused by large doses of sodium iodide I 131.(1) Sodium iodide I 131 causes a dose-dependent bone marrow suppression, including neutropenia or thrombocytopenia, in the 3 to 5 weeks following administration. Patients may be at increased risk of infections or bleeding during this time. Monitor complete blood counts within one month of therapy. If results indicate leukopenia or thrombocytopenia, dosimetry should be used to determine a safe sodium iodide I 131 activity.(1)
DISCUSSION: Hematologic disorders including death have been reported with sodium iodide I 131. The most common hematologic disorders reported include anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia.(1)
Rituximab/Certolizumab
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Possibly additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of certolizumab and rituximab may increase the risk of severe infection and/or neutropenia without providing any clinical benefit.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of certolizumab states that concurrent therapy with rituximab is not recommended.(1) Patients receiving concurrent therapy should be closely monitored for signs of infection and neutropenia.
DISCUSSION: Preliminary data suggest a higher rate of serious infections (7%) in patients treated concurrently with anakinra and etanercept compared to when anakinra is administered alone (2%)(2) or when etanercept is administered alone (0%).(3,4) The most common infections were bacterial pneumonia (4 cases) and cellulitis (4 cases). One patient with pulmonary fibrosis and pneumonia died from respiratory failure.(5) Preliminary data also suggest a higher rate of neutropenia (2-3%) when anakinra is administered with etanercept.(2,3) Data also suggest that the combination provides no added clinical benefit.(5) Similar effects are expected with the combination of certolizumab and rituximab.(1)
Selected Immunosuppressants/Leflunomide; Teriflunomide
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of leflunomide or teriflunomide and potent immunosuppressants may result in additive or synergistic effects on the immune system.(1,2) Leflunomide is a prodrug and is converted to its active metabolite teriflunomide.(1)
CLINICAL EFFECTS: Concurrent use of leflunomide or teriflunomide with immunosuppressants may result in an increased risk of serious infections, including opportunistic infections, especially Pneumocystis jiroveci pneumonia, tuberculosis (including extra-pulmonary tuberculosis), and aspergillosis.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: If leflunomide or teriflunomide is used concurrently with immunosuppressive agents, chronic CBC monitoring should be performed more frequently, every month instead of every 6 to 8 weeks. If bone marrow suppression or a serious infection occurs, leflunomide or teriflunomide should be stopped and rapid drug elimination procedure should be performed.(1,2)
DISCUSSION: Pancytopenia, agranulocytosis and thrombocytopenia have been reported in patients receiving leflunomide or teriflunomide alone, but most frequently in patients taking concurrent immunosuppressants.(1,2) Severe and potentially fatal infections, including sepsis, have been reported in patients receiving leflunomide or teriflunomide, especially Pneumocystis jiroveci pneumonia and aspergillosis. Tuberculosis has also been reported.(1,2)
Selected Myelosuppressive Agents/Clozapine
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Clozapine and other myelosuppressive agents may be associated with neutropenia or agranulocytosis.(2)
CLINICAL EFFECTS: Moderate neutropenia, even if due to combination therapy, may require abrupt discontinuation of clozapine resulting in decompensation of the patient's psychiatric disorder (e.g. schizophrenia). The disease treated by the myelosuppressive agent may be compromised if myelosuppression requires dose reduction, delay, or discontinuation of the myelosuppressive agent. Undetected severe neutropenia or agranulocytosis may be fatal.
PREDISPOSING FACTORS: Low white blood counts prior to initiation of the myelosuppressive agent may increase risk for clinically significant neutropenia.
PATIENT MANAGEMENT: If a patient stabilized on clozapine therapy requires treatment with a myelosuppressive agent, the clozapine prescriber should consult with prescriber of the myelosuppressive agent (e.g. oncologist) to discuss treatment and monitoring options.(2) More frequent absolute neutrophil count (ANC) monitoring or treatment alternatives secondary to neutropenic episodes may need to be considered. The U.S. Food and Drug Administration (FDA) recommends that prescribers monitor patients' ANC according to the monitoring frequencies described in the prescribing information. Severe neutropenia remains a serious, potentially fatal risk that is greatest in the first several months of clozapine treatment. ANC monitoring can help identify neutropenia early to allow for timely intervention.(1-2) Australia, Canada, and U.K.: Clozapine is only available through a restricted distribution system which requires documentation of the ANC prior to dispensing. For most clozapine patients, clozapine treatment must be interrupted for a suspected clozapine-induced ANC < 1000 cells/microliter. For patients with benign ethnic neutropenia (BEN), treatment must be interrupted for suspected clozapine-induced neutropenia < 500 cells/microliter.(2)
DISCUSSION: Concurrent use of clozapine and selected myelosuppressive agents may require more frequent ANC monitoring or consideration of treatment alternatives secondary to neutropenic episodes. Agents linked to this interaction generally have > 5% risk for neutropenia and/or warnings describing risk for myelosuppression in manufacturer prescribing information.(3-26)
Selected Myelosuppressive Agents/Deferiprone
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis may increase the frequency or risk for severe toxicity.(1)
CLINICAL EFFECTS: Concurrent use of deferiprone and myelosuppressive agents may result in severe neutropenia or agranulocytosis, which may be fatal.
PREDISPOSING FACTORS: Agranulocytosis may be less common in patients receiving deferiprone for thalassemia, and more common in patients treated for other systemic iron overload conditions (e.g. myelodysplastic syndromes, sickle cell disease).(2,3) Inadequate monitoring appears to increase the risk for severe outcomes. Manufacturer post market surveillance found that in all fatal cases of agranulocytosis reported between 1999 and 2005, data on weekly white blood count (WBC) monitoring was missing. In three fatal cases, deferiprone was continued for two to seven days after the detection of neutropenia or agranulocytosis.(2)
PATIENT MANAGEMENT: If possible, discontinue one of the drugs associated with risk for neutropenia or agranulocytosis. If alternative therapy is not available, documentation and adherence to the deferiprone monitoring protocol is essential. Baseline absolute neutrophil count (ANC) must be at least 1,500/uL prior to starting deferiprone. Monitor ANC weekly during therapy. If infection develops, interrupt deferiprone therapy and monitor ANC more frequently. If ANC is less than 1,500/uL but greater than 500/uL, discontinue deferiprone and any other drugs possibly associated with neutropenia. Initiate ANC and platelet counts daily until recovery (i.e. ANC at least 1,500/uL). If ANC is less than 500/uL, discontinue deferiprone, evaluate patient and hospitalize if appropriate. Do not resume deferiprone unless potential benefits outweigh potential risks.(1)
DISCUSSION: Drugs linked to this monograph have an FDA Boxed Warning for risk of neutropenia, agranulocytosis, or pancytopenia, or have > 5% risk for neutropenia and/or warnings describing risk for myelosuppression in manufacturer prescribing information.(1-25) In pooled clinical studies submitted to the FDA, 6.1% of deferiprone patients met criteria for neutropenia and 1.7% of patients developed agranulocytosis.(1) The time to onset of agranulocytosis was highly variable with a range of 65 days to 9.2 years (median, 161 days).(3)
Selected Myelosuppressive Agents/Dipyrone
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of dipyrone with other drugs known to be associated with neutropenia or agranulocytosis may increase the frequency or risk for severe toxicity.(1-29)
CLINICAL EFFECTS: Concurrent use of dipyrone with agents that cause bone marrow depression, including myelosuppressives, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding. Undetected severe neutropenia or agranulocytosis may be fatal.(1-29)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Concurrent use of dipyrone and myelosuppressive agents should be avoided. The European Medicines Agency states dipyrone is contraindicated in patients with a prior medical history of dipyrone-induced agranulocytosis (or from other pyrazolones/pyrazolidines), impaired bone marrow function or diseases of the hematopoietic system.(3) International labeling for dipyrone and methotrexate state that co-administration may increase the hematotoxicity of methotrexate, especially in elderly patients, and therefore should be avoided.(1-2) The European Medicines Agency advises if agranulocytosis is suspected with dipyrone, a complete blood count (including differential blood count) should be performed immediately, and treatment must be stopped while waiting for the results. If confirmed, treatment must not be reintroduced.(1-3)
DISCUSSION: A retrospective cohort study analyzed new users of dipyrone (n=444,972), non-steroidal anti-inflammatory drugs (n=3,814,367) which served as a reference cohort, and opioids-paracetamol (n=3,129,221) which was the negative control. During continuous treatment over a median of 37-40 days, 26 cases of hospitalized agranulocytosis occurred. With the assumption that agranulocytosis onset was 7 days prior to admission, the hazard ratio of agranulocytosis associated with dipyrone was 4.40 [0.90-21.57] compared to NSAIDs and 2.45 [0.68-8.83] compared to opioid-paracetamol. HR of neutropenia from dipyrone was 2.98 [1.57-5.65] compared to NSAIDs and not statistically significant compared to opioids-paracetamol. In a sensitivity analysis assuming that the onset of agranulocytosis was the date of hospitalization, the HR of dipyrone-induced agranulocytosis was 7.20 [95% confidence interval: 1.92-26.99] compared to NSAIDs and 3.31 [1.17-9.34] compared to opioids-paracetamol. Agranulocytosis was very rare but more than 4 times more common with dipyrone than other analgesics.(4) In a review of 1,448 reports of agranulocytosis attributed to dipyrone, patients with fatal outcomes were older and more often had also received methotrexate compared to those with non-fatal outcomes (odds ratio: 5.18; 95% confidence interval: 3.06-8.78).(5) Agents linked to this interaction generally have > 5% risk for neutropenia and/or warnings describing risk for myelosuppression in manufacturer prescribing information.(2,6-26)
Slt Immunosuppress; Immunomodulator/Ropeginterferon Alfa-2B
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ropeginterferon alfa-2b and immunosuppressives both suppress the immune system.
CLINICAL EFFECTS: Concurrent use of ropeginterferon alfa-2b with immunosuppressives may result in an increased risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Avoid concurrent use of myelosuppressive agents.(1-2) If concurrent use cannot be avoided, monitor for effects of excessive immunosuppression.
DISCUSSION: In clinical trials, 20% of patients experienced leukopenia. Interferon alfa products may cause fatal or life-threatening infections.(1-2)
Moderate Interaction: Assess the risk to the patient and take action as needed.
Biologic Therapies/Belimumab
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Concurrent use of belimumab with other biologic therapies may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of belimumab with other biologic therapies may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The concurrent use of belimumab with other biologic therapies should be approached with caution.(1)
DISCUSSION: In a randomized, double-blind, placebo-controlled trial, more patients who received belimumab and rituximab experienced serious adverse events, serious infections, and post-injection systemic reactions (22.2%, 9%, and 13.2%, respectively) than patients who received belimumab with placebo (13.9%, 2.8%, 9.7%) or standard therapy (19.7%, 5.3%, 5.3%).(1) The combination of belimumab with other biologic therapies has not been studied and should be used cautiously.(1)
Igg Antibodies And Derivatives/Rozanolixizumab-Noli
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Rozanolixizumab-noli binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medications that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of rozanolixizumab-noli states that concurrent use with medications that bind to the human neonatal Fc receptor (FcRn) should be closely monitored for reduced effectiveness of these medications. If long-term use of such medications is essential for the patient, consider discontinuing rozanolixizumab-noli and use alternative therapies.(3)
DISCUSSION: Clinical drug interaction studies with rozanolixizumab-noli have not been performed. Rozanolixizumab-noli may decrease concentrations of compounds that bind to the human FcRn.(3)
Immunosuppressives; Immunomodulators/Cladribine Oncology Inj
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Cladribine in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-4)
CLINICAL EFFECTS: Concurrent use of cladribine with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections.(1-4)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for cladribine regarding this interaction differ between regulatory approving agencies. The cladribine US, UK, and Australian prescribing information state: -Caution should be exercised if cladribine injection is administered before, after, or in conjunction with other drugs known to cause immunosuppression or myelosuppression.(1-3) The cladribine Canadian prescribing information states: -Proceed carefully in patients with severe bone marrow impairment of any etiology since further suppression of bone marrow function should be anticipated.(4)
DISCUSSION: Severe bone marrow suppression, including neutropenia, anemia and thrombocytopenia, has been commonly observed in patients treated with cladribine injection, especially at high doses.(1-4)
Immunosuppressives; Immunomodulators/Covid-19 Vaccines
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Immunosuppressants and immunomodulators may prevent the immune system from properly responding to the COVID-19 vaccine.(1-3)
CLINICAL EFFECTS: Administration of a COVID-19 vaccine with immunosuppressants or immunomodulators may interfere with vaccine-induced immune response and impair the efficacy of the vaccine. However, patients should be offered and given a COVID-19 vaccine even if the use and timing of immunosuppressive agents cannot be adjusted.(1-3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The Centers for Disease Control and Prevention (CDC),(1) Infectious Diseases Society of America (IDSA),(2) and the American College of Rheumatology (ACR)(3) have published guidances for COVID-19 vaccination in patients on immunosuppressants. The CDC states that all immunocompromised patients over 6 months of age should receive at least 1 dose of COVID-19 vaccine if eligible. See the CDC's Interim Clinical Considerations for Use of COVID-19 Vaccines for specific recommendations based on age, vaccination history, and vaccine manufacturer.(1) The CDC advises planning for vaccination at least 2 weeks before starting or resuming immunosuppressive therapy.(1) IDSA recommends timing COVID-19 vaccination at least 2 weeks before starting or at least 3 months after completing immunosuppressive therapy.(2) The ACR states that in general, immunosuppressants and immunomodulators should be held for 1-2 weeks after each vaccine dose.(3) Patients should be offered and given a COVID-19 vaccine even if the use and timing of immunosuppressive agents cannot be adjusted, though the immune response will likely be blunted. COVID-19 vaccines should not be delayed in patients taking immunosuppressive therapies.(1-2) See below for specific recommendations for certain agents. B-cell depleting agents, including rituximab: The CDC states that the utility of B-cell quantification to guide clinical care is not known and is not recommended. Patients who receive B-cell depleting therapy on a continuing basis should receive COVID-19 vaccines about 4 weeks before the next scheduled dose. For patients who received 1 or more doses of COVID-19 vaccine during treatment with B-cell-depleting therapies that were administered over a limited period (e.g., as part of a treatment regimen for certain malignancies), revaccination may be considered according to the current CDC recommendations for unvaccinated patients. The suggested interval to start revaccination is about 6 months after completion of the B-cell-depleting therapy.(1) IDSA recommends waiting for at least 3-6 months after the last infusion of B-cell depleting therapy before administering COVID-19 vaccines.(2) The ACR recommends consulting with the rheumatologist to determine optimal timing of COVID-19 vaccination. Measuring CD19 B cells may be considered to determine need for a booster vaccine dose. If B cell levels are not measured, a supplemental vaccine dose 2-4 weeks before the next scheduled dose of rituximab is recommended.(3) Recipients of hematopoietic cell transplant or CAR-T-cell therapy who received one or more doses of COVID-19 vaccine prior to or during treatment should undergo revaccination following the current CDC recommendations for unvaccinated patients. Revaccination should start at least 3 months (12 weeks) after transplant or CAR-T-cell therapy.(1,2) The CDC includes abatacept, cyclophosphamide, and TNF-alpha and cytokine inhibitors in their general recommendation to hold therapy for at least 2 weeks following vaccination (1) while the ACR provides different recommendations:(3) *Abatacept: - Subcutaneous abatacept should be withheld for 1-2 weeks after each vaccine dose, as disease activity allows. - For intravenous abatacept, time administration so that vaccination will occur 1 week before the next abatacept infusion. *Cyclophosphamide: When feasible, administer cyclophosphamide 1 week after each COVID-19 vaccine dose. *TNF-alpha inhibitors and cytokine inhibitors: The ACR was not able to reach consensus on whether to modify dosing or timing of these agents with COVID-19 vaccination.
DISCUSSION: IDSA recommendations are based on cohort and case control studies in immunocompromised patients that found low to modest vaccine effectiveness (37-61%) but lower risks of COVID-19 association hospitalization, COVID-19 related mortality, and critical illness.(2) The ACR convened a COVID-19 Vaccine Guidance Task Force to provide guidance on optimal use of COVID-19 vaccines in rheumatology patients. These recommendations are based on limited clinical evidence of COVID-19 vaccines in patients without rheumatic and musculoskeletal disorders and evidence of other vaccines in this patient population.(3) The ACR recommendation for rituximab is based on studies of humoral immunity following receipt of other vaccines. These studies have uncertain generalizability to vaccination against COVID-19, as it is unknown if efficacy is attributable to induction of host T cells versus B cell (antibody-based) immunity.(3) The ACR recommendation for mycophenolate is based on preexisting data of mycophenolate on non-COVID-19 vaccine immunogenicity. Emerging data suggests that mycophenolate may impair SARS-CoV-2 vaccine response in rheumatic and musculoskeletal disease and transplant patients.(3) The ACR recommendation for methotrexate is based on data from influenza vaccines and pneumococcal vaccines with methotrexate.(3) The ACR recommendation for JAK inhibitors is based on concerns related to the effects of JAK inhibitors on interferon signaling that may result in a diminished vaccine response.(3) The ACR recommendation for subcutaneous abatacept is based on several studies suggesting a negative effect of abatacept on vaccine immunogenicity. The first vaccine dose primes naive T cells, naive T cell priming is inhibited by CTLA-4, and abatacept is a CTLA-4Ig construct. CTLA-4 should not inhibit boosts of already primed T cells at the time of the second vaccine dose.(3)
Immunosuppressives; Immunomodulators/Ustekinumab
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Ustekinumab, immunosuppressives, and immunomodulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of ustekinumab with immunosuppressive or immunomodulating agents may result in an increased risk for serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of ustekinumab recommends caution because the concurrent use of ustekinumab with immunosuppressive agents may increase the risk of infection. If concurrent therapy is warranted, consider the risk of additive immune suppression and monitor based on prescribing information for both agents.(1)
DISCUSSION: Ustekinumab has not been studied in combination with other immunosuppressants in psoriasis studies. In psoriatic arthritis studies, concomitant methotrexate use did not appear to influence the safety or efficacy of ustekinumab. In Crohn's disease and ulcerative colitis studies, concomitant use of immunosuppressants or corticosteroids did not appear to influence the safety or efficacy of ustekinumab. If concurrent therapy is warranted, consider the potential for increased immunosuppressive risks from both agents.(1) The most common infections reported by ustekinumab treated patients in the clinical trial periods included nasopharyngitis(8%) and upper respiratory tract infection(5%). Serious bacterial, mycobacterial, fungal, and viral infections were observed in patients receiving ustekinumab. Cases of interstitial pneumonia, eosinophilic pneumonia, and cryptogenic organizing pneumonia resulting in respiratory failure or prolonged hospitalization have been reported in patients receiving ustekinumab.(1)
Contraindications
*None.
- Lactation
- Progressive multifocal leukoencephalopathy
- Acute renal failure
- Cytomegalovirus disease
- Disease due to west nile virus
- Fungal infection
- Gastrointestinal obstruction
- Gastrointestinal perforation
- Hepatitis B immune due to latent hepatitis B infection
- Herpes simplex infection
- Hyperkalemia
- Hyperphosphatemia
- Hypocalcemia
- Hypogammaglobulinemia
- Infection
- Kidney disease with reduction in glomerular filtration rate (GFr)
- Neutropenic disorder
- Parvovirus infection
- Pneumocystis jirovecii pneumonia
- Pregnancy
- Reactivation of hepatitis B
- Thrombocytopenic disorder
- Varicella zoster virus infection
- Viral hepatitis C
- Anemia
- Angina
- Ventricular arrhythmias
Adverse reactions
In adults receiving IV rituximab for the treatment of NHL, the most common adverse reactions (>=25%) were infusion-related reactions, fever, lymphopenia, chills, infection, and asthenia.
In pediatric patients receiving IV rituximab for diffuse large B-cell lymphoma, Burkitt lymphoma, Burkitt-like lymphoma, or mature B-cell acute leukemia, the most common adverse reactions (grade 3 or higher, >15%) were febrile neutropenia, stomatitis, enteritis, sepsis, elevated alanine aminotransferase, and hypokalemia.
In adults receiving IV rituximab for the treatment of CLL, the most common adverse reactions (>=25%) were infusion-related reactions and neutropenia.
In adults receiving IV rituximab for the treatment of rheumatoid arthritis, the most common adverse reactions (>=10%) were upper respiratory tract infection, nasopharyngitis, urinary tract infection, and bronchitis; other important adverse reactions included infusion-related reactions, serious infections, and cardiovascular events.
In patients receiving IV rituximab for the treatment of GPA/MPA, the most common adverse reactions (>=15%) were infections, nausea, diarrhea, headache, muscle spasms, anemia, peripheral edema, and infusion-related reactions.
In patients receiving IV rituximab for the treatment of pemphigus vulgaris, the most common adverse reactions (>=15%) were infusion-related reactions, depression, upper respiratory tract infection/nasopharyngitis, and headache; other important adverse reactions included infections.
In patients receiving rituximab/hyaluronidase for the treatment of follicular lymphoma, the most common adverse reactions (>=20%) were infections, neutropenia, nausea, constipation, cough, and fatigue.
In patients receiving rituximab/hyaluronidase for the treatment of diffuse large B-cell lymphoma, the most common adverse reactions (>=20%) were infections, neutropenia, alopecia, nausea, and anemia.
In patients receiving rituximab/hyaluronidase for the treatment of CLL, the most common adverse reactions (>=20%) were infections, neutropenia, nausea, thrombocytopenia, pyrexia, vomiting, and injection site erythema.
More Frequent
- Angioedema
- Bacterial sepsis
- Bronchospastic pulmonary disease
- Chills
- Dyspnea
- Fatigue
- Fever
- Flushing
- Hypogammaglobulinemia
- Hypotension
- Infection
- Leukopenia
- Lymphopenia
- Nausea
- Neutropenic disorder
- Peripheral neuropathy
- Pruritus of skin
- Rhinitis
- Skin rash
- Thrombocytopenic disorder
- Vomiting
Less Frequent
- Anemia
- Chest tightness
- Fungal sepsis
- Herpes zoster
- Hypertension
- Hypophosphatemia
- Influenza
- Injection site sequelae
- Lower respiratory infection
- Peripheral edema
- Respiration changes
- Sinusitis
- Urticaria
Rare or Very Rare
- Acute myocardial infarction
- Acute renal failure
- Acute respiratory distress syndrome
- Anaphylaxis
- Angina
- Bone marrow hypoplasia
- Bronchiolitis obliterans
- Bullous dermatitis
- Cardiac arrhythmia
- Cardiogenic shock
- Enteroviral meningoencephalitis
- Gastrointestinal obstruction
- Gastrointestinal perforation
- Heart failure
- Hepatic failure
- Hyperkalemia
- Hyperphosphatemia
- Hypersensitivity drug reaction
- Hypocalcemia
- Hypoxia
- Ileus
- Interstitial lung disease
- Intestinal perforation
- Lichenoid dermatitis drug eruption
- Lupus-like syndrome
- Muscle weakness in limbs
- Nephrotoxicity
- Optic neuritis
- Pancytopenia
- Paraneoplastic pemphigus
- Pleuritis
- Pneumocystis jirovecii pneumonia
- Pneumonia
- Posterior reversible encephalopathy syndrome
- Progressive multifocal leukoencephalopathy
- Pulmonary infiltrates
- Pyoderma gangrenosum
- Reactivation of hepatitis B
- Serum sickness
- Stevens-johnson syndrome
- Supraventricular arrhythmias
- Toxic epidermal necrolysis
- Tumor lysis syndrome
- Uveitis
- Vasculitis
- Ventricular fibrillation
- Viral infection
More Frequent
- Acute abdominal pain
- Alopecia
- Back pain
- Bronchitis
- Constipation
- Cough
- General weakness
- Headache disorder
- Muscle spasm
- Night sweats
- Paresthesia
- Upper respiratory infection
- Urinary tract infection
Less Frequent
- Abdominal distension
- Arthralgia
- Conjunctivitis
- Cutaneous papilloma
- Depression
- Diarrhea
- Dizziness
- Dyspepsia
- Herpes simplex infection
- Hyperglycemia
- Insomnia
- Irritability
- Migraine
- Musculoskeletal pain
- Myalgia
- Pain
- Pharyngitis
- Sore throat
- Symptoms of anxiety
- Tachycardia
- Weight gain
Precautions
No enhanced messaging available.
The safety and efficacy of IV rituximab in combination with chemotherapy for the treatment of previously untreated, advanced stage, CD20-positive diffuse large B-cell lymphoma, Burkitt lymphoma, Burkitt-like lymphoma, and mature B-cell acute leukemia have been established in pediatric patients >=6 months of age. Use of rituximab for this indication is supported by evidence from an adequate and well-controlled study in pediatric patients >=1 year of age with extrapolation to patients 6 months to <1 year of age based on pharmacokinetic modeling and the expectation that the course of advanced disease is similar between pediatric patients 6 months to <1 year of age and pediatric patients >=1 year of age. Patients <3 years of age had a higher incidence of infections compared with older pediatric patients.
The safety and efficacy of IV rituximab for the treatment of GPA/MPA have been established in pediatric patients >=2 years of age. Use of rituximab in pediatric patients >=6 years of age is supported by evidence from adequate and well-controlled studies of rituximab in adults with GPA/MPA, a trial in pediatric patients >=6 years of age with active GPA/MPA, and population pharmacokinetic analyses showing similar drug exposure levels in adults and pediatric patients 6-17 years of age. Use of rituximab in pediatric patients 2 to <6 years of age is supported by pharmacokinetic modeling in patients 2 years of age and older and safety data from pediatric patients <6 years of age treated with rituximab.
The safety and effectiveness of IV rituximab have not been established in pediatric patients with CLL, pemphigus vulgaris, or rheumatoid arthritis. Rituximab has not been studied in pediatric patients with polyarticular juvenile idiopathic arthritis due to concerns for prolonged immunosuppression as a result of B-cell depletion in the developing juvenile immune system.
The safety and effectiveness of rituximab/hyaluronidase have not been established in pediatric patients.
Based on human data, rituximab-containing products can cause adverse developmental outcomes, including B-cell lymphocytopenia, in infants exposed to the drug in utero. Post-marketing data indicate that B-cell lymphocytopenia following in utero rituximab exposure generally lasts less than 6 months. Rituximab has been detected in the serum of infants exposed to rituximab in utero.
There are no available data on the use of rituximab/hyaluronidase during pregnancy; however, animal studies indicate that subcutaneous hyaluronidase was associated with reduced fetal weight and increased fetal lethality when administered at a dose >2700 times higher than the recommended human dose. Comparable systemic exposure levels could occur in a pregnant patient following accidental IV administration of an entire vial of rituximab/hyaluronidase.
Advise pregnant women of the potential risk to the fetus. Verify pregnancy status in females of reproductive potential prior to initiating rituximab-containing products. If exposure occurs, monitor newborns and infants for signs of infection and manage accordingly.
Data regarding the presence of rituximab in human breast milk and the effect on the breast-fed child are limited; there are no data regarding the effect of rituximab on milk production. Rituximab has been detected in the milk of lactating cynomolgus monkeys, and maternal immunoglobulin G is present in human breast milk. Rituximab has also been reported to be excreted at low concentrations in human breast milk. The clinical significance of these findings for breast-fed children is not known. There are no data on the presence of human hyaluronidase in human breast milk.
Advise women not to breast-feed during treatment with rituximab-containing products and for 6 months after the last dose due to the potential for serious adverse reactions in the breast-fed child.
The manufacturer makes no specific dosage recommendations for geriatric patients.
Among patients with diffuse large B-cell NHL evaluated in 3 randomized controlled trials of IV rituximab, 43% were >=65 years of age and 13% were >=75 years of age. No overall differences in effectiveness were observed between these patients and younger patients; however, cardiac adverse reactions (mostly supraventricular arrhythmias) occurred more frequently among geriatric patients. Serious pulmonary adverse reactions were also more common among the geriatric patients, including pneumonia and pneumonitis.
Among patients with previously untreated follicular NHL evaluated in one randomized study of IV rituximab, 24% of patients were >=65 years of age. No overall differences in safety or effectiveness were observed between these patients and younger patients. Other clinical studies in low-grade or follicular, CD20-positive B-cell NHL did not include sufficient numbers of patients >=65 years of age to determine whether they respond differently from younger subjects.
Among patients with CLL evaluated in 2 randomized controlled trials of IV rituximab, 36% were >=65 years of age and 15% were >=70 years of age. In exploratory analyses of these randomized controlled trials, there was no observed benefit from the addition of rituximab to fludarabine and cyclophosphamide among patients >=70 years of age in either study; there was also no observed benefit from the addition of rituximab to fludarabine and cyclophosphamide among patients >=65 years of age in one of the studies. The incidence of several grade 3 or 4 adverse reactions was higher among patients receiving rituximab with fludarabine and cyclophosphamide who were >=70 years of age compared with younger patients; these adverse reactions included neutropenia (44 versus 31% in study 1 and 56 versus 39% in study 2), anemia (5 versus 2% in study 1 and 21 versus 10% in study 2), thrombocytopenia (19 versus 8% in study 2 only), pancytopenia (7 versus 2% in study 1 and study 2), and infections (30 versus 14% in study 2 only).
Among patients with rheumatoid arthritis evaluated in clinical studies of IV rituximab, 12% were 65-75 years of age and 2% were >=75 years of age. The incidences of adverse reactions were similar between older and younger patients; however, the rates of serious adverse reactions, including serious infections, malignancies, and cardiovascular events, were higher in older patients.
Among the 99 patients with GPA/MPA in a clinical trial of IV rituximab, 36% were >=65 years of age, and 8% were >=75 years of age. No overall differences in efficacy were observed between older and younger patients; however, the overall incidence of serious adverse events was higher in patients >=65 years of age. The study did not include sufficient numbers of patients >=65 years of age to determine whether they respond differently from younger patients. In a second study of patients with GPA/MPA, 26% of patients were >=65 years of age; this study did not include a sufficient number of patients >=65 years of age to determine whether they respond differently from younger patients.
Among 46 patients with pemphigus vulgaris treated with IV rituximab in a clinical study, 33% were >=65 years of age. The clinical study did not include sufficient numbers of patients >=65 years of age to determine whether they respond differently from younger patients.
Among the patients treated with rituximab/hyaluronidase in 3 clinical studies, 37% were >=65 years of age and 10% were >=75 years of age. No overall differences in safety or effectiveness were observed between these patients and younger patients. Other reported clinical experience has not identified differences in responses between geriatric and younger patients, but greater sensitivity of some older patients cannot be ruled out.
ICD codes
| Code | Type | Description |
|---|---|---|
| Burkitt's lymphoma | ||
| C83.7 | ICD10CM | Burkitt lymphoma |
| C83.70 | ICD10CM | Burkitt lymphoma, unspecified site |
| C83.71 | ICD10CM | Burkitt lymphoma, lymph nodes of head, face, and neck |
| C83.72 | ICD10CM | Burkitt lymphoma, intrathoracic lymph nodes |
| C83.73 | ICD10CM | Burkitt lymphoma, intra-abdominal lymph nodes |
| C83.74 | ICD10CM | Burkitt lymphoma, lymph nodes of axilla and upper limb |
| C83.75 | ICD10CM | Burkitt lymphoma, lymph nodes of inguinal region and lower limb |
| C83.76 | ICD10CM | Burkitt lymphoma, intrapelvic lymph nodes |
| C83.77 | ICD10CM | Burkitt lymphoma, spleen |
| C83.78 | ICD10CM | Burkitt lymphoma, lymph nodes of multiple sites |
| C83.79 | ICD10CM | Burkitt lymphoma, extranodal and solid organ sites |
| Cd20 positive non-hodgkin's lymphoma | ||
| C82 | ICD10CM | Follicular lymphoma |
| C82.0 | ICD10CM | Follicular lymphoma grade I |
| C82.00 | ICD10CM | Follicular lymphoma grade i, unspecified site |
| C82.01 | ICD10CM | Follicular lymphoma grade i, lymph nodes of head, face, and neck |
| C82.02 | ICD10CM | Follicular lymphoma grade i, intrathoracic lymph nodes |
| C82.03 | ICD10CM | Follicular lymphoma grade i, intra-abdominal lymph nodes |
| C82.04 | ICD10CM | Follicular lymphoma grade i, lymph nodes of axilla and upper limb |
| C82.05 | ICD10CM | Follicular lymphoma grade i, lymph nodes of inguinal region and lower limb |
| C82.06 | ICD10CM | Follicular lymphoma grade i, intrapelvic lymph nodes |
| C82.07 | ICD10CM | Follicular lymphoma grade i, spleen |
| C82.08 | ICD10CM | Follicular lymphoma grade i, lymph nodes of multiple sites |
| C82.09 | ICD10CM | Follicular lymphoma grade i, extranodal and solid organ sites |
| C82.1 | ICD10CM | Follicular lymphoma grade II |
| C82.10 | ICD10CM | Follicular lymphoma grade Ii, unspecified site |
| C82.11 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of head, face, and neck |
| C82.12 | ICD10CM | Follicular lymphoma grade Ii, intrathoracic lymph nodes |
| C82.13 | ICD10CM | Follicular lymphoma grade Ii, intra-abdominal lymph nodes |
| C82.14 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of axilla and upper limb |
| C82.15 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of inguinal region and lower limb |
| C82.16 | ICD10CM | Follicular lymphoma grade Ii, intrapelvic lymph nodes |
| C82.17 | ICD10CM | Follicular lymphoma grade Ii, spleen |
| C82.18 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of multiple sites |
| C82.19 | ICD10CM | Follicular lymphoma grade Ii, extranodal and solid organ sites |
| C82.2 | ICD10CM | Follicular lymphoma grade IIi, unspecified |
| C82.20 | ICD10CM | Follicular lymphoma grade IIi, unspecified, unspecified site |
| C82.21 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of head, face, and neck |
| C82.22 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intrathoracic lymph nodes |
| C82.23 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intra-abdominal lymph nodes |
| C82.24 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of axilla and upper limb |
| C82.25 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of inguinal region and lower limb |
| C82.26 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intrapelvic lymph nodes |
| C82.27 | ICD10CM | Follicular lymphoma grade IIi, unspecified, spleen |
| C82.28 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of multiple sites |
| C82.29 | ICD10CM | Follicular lymphoma grade IIi, unspecified, extranodal and solid organ sites |
| C82.3 | ICD10CM | Follicular lymphoma grade IIia |
| C82.30 | ICD10CM | Follicular lymphoma grade IIia, unspecified site |
| C82.31 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of head, face, and neck |
| C82.32 | ICD10CM | Follicular lymphoma grade IIia, intrathoracic lymph nodes |
| C82.33 | ICD10CM | Follicular lymphoma grade IIia, intra-abdominal lymph nodes |
| C82.34 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of axilla and upper limb |
| C82.35 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of inguinal region and lower limb |
| C82.36 | ICD10CM | Follicular lymphoma grade IIia, intrapelvic lymph nodes |
| C82.37 | ICD10CM | Follicular lymphoma grade IIia, spleen |
| C82.38 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of multiple sites |
| C82.39 | ICD10CM | Follicular lymphoma grade IIia, extranodal and solid organ sites |
| C82.4 | ICD10CM | Follicular lymphoma grade IIib |
| C82.40 | ICD10CM | Follicular lymphoma grade IIib, unspecified site |
| C82.41 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of head, face, and neck |
| C82.42 | ICD10CM | Follicular lymphoma grade IIib, intrathoracic lymph nodes |
| C82.43 | ICD10CM | Follicular lymphoma grade IIib, intra-abdominal lymph nodes |
| C82.44 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of axilla and upper limb |
| C82.45 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of inguinal region and lower limb |
| C82.46 | ICD10CM | Follicular lymphoma grade IIib, intrapelvic lymph nodes |
| C82.47 | ICD10CM | Follicular lymphoma grade IIib, spleen |
| C82.48 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of multiple sites |
| C82.49 | ICD10CM | Follicular lymphoma grade IIib, extranodal and solid organ sites |
| C82.5 | ICD10CM | Diffuse follicle center lymphoma |
| C82.50 | ICD10CM | Diffuse follicle center lymphoma, unspecified site |
| C82.51 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.52 | ICD10CM | Diffuse follicle center lymphoma, intrathoracic lymph nodes |
| C82.53 | ICD10CM | Diffuse follicle center lymphoma, intra-abdominal lymph nodes |
| C82.54 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.55 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.56 | ICD10CM | Diffuse follicle center lymphoma, intrapelvic lymph nodes |
| C82.57 | ICD10CM | Diffuse follicle center lymphoma, spleen |
| C82.58 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of multiple sites |
| C82.59 | ICD10CM | Diffuse follicle center lymphoma, extranodal and solid organ sites |
| C82.6 | ICD10CM | Cutaneous follicle center lymphoma |
| C82.60 | ICD10CM | Cutaneous follicle center lymphoma, unspecified site |
| C82.61 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.62 | ICD10CM | Cutaneous follicle center lymphoma, intrathoracic lymph nodes |
| C82.63 | ICD10CM | Cutaneous follicle center lymphoma, intra-abdominal lymph nodes |
| C82.64 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.65 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.66 | ICD10CM | Cutaneous follicle center lymphoma, intrapelvic lymph nodes |
| C82.67 | ICD10CM | Cutaneous follicle center lymphoma, spleen |
| C82.68 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of multiple sites |
| C82.69 | ICD10CM | Cutaneous follicle center lymphoma, extranodal and solid organ sites |
| C82.8 | ICD10CM | Other types of follicular lymphoma |
| C82.80 | ICD10CM | Other types of follicular lymphoma, unspecified site |
| C82.81 | ICD10CM | Other types of follicular lymphoma, lymph nodes of head, face, and neck |
| C82.82 | ICD10CM | Other types of follicular lymphoma, intrathoracic lymph nodes |
| C82.83 | ICD10CM | Other types of follicular lymphoma, intra-abdominal lymph nodes |
| C82.84 | ICD10CM | Other types of follicular lymphoma, lymph nodes of axilla and upper limb |
| C82.85 | ICD10CM | Other types of follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C82.86 | ICD10CM | Other types of follicular lymphoma, intrapelvic lymph nodes |
| C82.87 | ICD10CM | Other types of follicular lymphoma, spleen |
| C82.88 | ICD10CM | Other types of follicular lymphoma, lymph nodes of multiple sites |
| C82.89 | ICD10CM | Other types of follicular lymphoma, extranodal and solid organ sites |
| C82.9 | ICD10CM | Follicular lymphoma, unspecified |
| C82.90 | ICD10CM | Follicular lymphoma, unspecified, unspecified site |
| C82.91 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of head, face, and neck |
| C82.92 | ICD10CM | Follicular lymphoma, unspecified, intrathoracic lymph nodes |
| C82.93 | ICD10CM | Follicular lymphoma, unspecified, intra-abdominal lymph nodes |
| C82.94 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C82.95 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C82.96 | ICD10CM | Follicular lymphoma, unspecified, intrapelvic lymph nodes |
| C82.97 | ICD10CM | Follicular lymphoma, unspecified, spleen |
| C82.98 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of multiple sites |
| C82.99 | ICD10CM | Follicular lymphoma, unspecified, extranodal and solid organ sites |
| C83 | ICD10CM | Non-follicular lymphoma |
| C83.0 | ICD10CM | Small cell b-cell lymphoma |
| C83.00 | ICD10CM | Small cell b-cell lymphoma, unspecified site |
| C83.01 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of head, face, and neck |
| C83.02 | ICD10CM | Small cell b-cell lymphoma, intrathoracic lymph nodes |
| C83.03 | ICD10CM | Small cell b-cell lymphoma, intra-abdominal lymph nodes |
| C83.04 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of axilla and upper limb |
| C83.05 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.06 | ICD10CM | Small cell b-cell lymphoma, intrapelvic lymph nodes |
| C83.07 | ICD10CM | Small cell b-cell lymphoma, spleen |
| C83.08 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of multiple sites |
| C83.09 | ICD10CM | Small cell b-cell lymphoma, extranodal and solid organ sites |
| C83.1 | ICD10CM | Mantle cell lymphoma |
| C83.10 | ICD10CM | Mantle cell lymphoma, unspecified site |
| C83.11 | ICD10CM | Mantle cell lymphoma, lymph nodes of head, face, and neck |
| C83.12 | ICD10CM | Mantle cell lymphoma, intrathoracic lymph nodes |
| C83.13 | ICD10CM | Mantle cell lymphoma, intra-abdominal lymph nodes |
| C83.14 | ICD10CM | Mantle cell lymphoma, lymph nodes of axilla and upper limb |
| C83.15 | ICD10CM | Mantle cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.16 | ICD10CM | Mantle cell lymphoma, intrapelvic lymph nodes |
| C83.17 | ICD10CM | Mantle cell lymphoma, spleen |
| C83.18 | ICD10CM | Mantle cell lymphoma, lymph nodes of multiple sites |
| C83.19 | ICD10CM | Mantle cell lymphoma, extranodal and solid organ sites |
| C83.3 | ICD10CM | Diffuse large b-cell lymphoma |
| C83.30 | ICD10CM | Diffuse large b-cell lymphoma, unspecified site |
| C83.31 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of head, face, and neck |
| C83.32 | ICD10CM | Diffuse large b-cell lymphoma, intrathoracic lymph nodes |
| C83.33 | ICD10CM | Diffuse large b-cell lymphoma, intra-abdominal lymph nodes |
| C83.34 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of axilla and upper limb |
| C83.35 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.36 | ICD10CM | Diffuse large b-cell lymphoma, intrapelvic lymph nodes |
| C83.37 | ICD10CM | Diffuse large b-cell lymphoma, spleen |
| C83.38 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of multiple sites |
| C83.39 | ICD10CM | Diffuse large b-cell lymphoma, extranodal and solid organ sites |
| C83.7 | ICD10CM | Burkitt lymphoma |
| C83.70 | ICD10CM | Burkitt lymphoma, unspecified site |
| C83.71 | ICD10CM | Burkitt lymphoma, lymph nodes of head, face, and neck |
| C83.72 | ICD10CM | Burkitt lymphoma, intrathoracic lymph nodes |
| C83.73 | ICD10CM | Burkitt lymphoma, intra-abdominal lymph nodes |
| C83.74 | ICD10CM | Burkitt lymphoma, lymph nodes of axilla and upper limb |
| C83.75 | ICD10CM | Burkitt lymphoma, lymph nodes of inguinal region and lower limb |
| C83.76 | ICD10CM | Burkitt lymphoma, intrapelvic lymph nodes |
| C83.77 | ICD10CM | Burkitt lymphoma, spleen |
| C83.78 | ICD10CM | Burkitt lymphoma, lymph nodes of multiple sites |
| C83.79 | ICD10CM | Burkitt lymphoma, extranodal and solid organ sites |
| C83.8 | ICD10CM | Other non-follicular lymphoma |
| C83.80 | ICD10CM | Other non-follicular lymphoma, unspecified site |
| C83.81 | ICD10CM | Other non-follicular lymphoma, lymph nodes of head, face, and neck |
| C83.82 | ICD10CM | Other non-follicular lymphoma, intrathoracic lymph nodes |
| C83.83 | ICD10CM | Other non-follicular lymphoma, intra-abdominal lymph nodes |
| C83.84 | ICD10CM | Other non-follicular lymphoma, lymph nodes of axilla and upper limb |
| C83.85 | ICD10CM | Other non-follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C83.86 | ICD10CM | Other non-follicular lymphoma, intrapelvic lymph nodes |
| C83.87 | ICD10CM | Other non-follicular lymphoma, spleen |
| C83.88 | ICD10CM | Other non-follicular lymphoma, lymph nodes of multiple sites |
| C83.89 | ICD10CM | Other non-follicular lymphoma, extranodal and solid organ sites |
| C85 | ICD10CM | Other specified and unspecified types of non-hodgkin lymphoma |
| C85.1 | ICD10CM | Unspecified b-cell lymphoma |
| C85.10 | ICD10CM | Unspecified b-cell lymphoma, unspecified site |
| C85.11 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of head, face, and neck |
| C85.12 | ICD10CM | Unspecified b-cell lymphoma, intrathoracic lymph nodes |
| C85.13 | ICD10CM | Unspecified b-cell lymphoma, intra-abdominal lymph nodes |
| C85.14 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of axilla and upper limb |
| C85.15 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C85.16 | ICD10CM | Unspecified b-cell lymphoma, intrapelvic lymph nodes |
| C85.17 | ICD10CM | Unspecified b-cell lymphoma, spleen |
| C85.18 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of multiple sites |
| C85.19 | ICD10CM | Unspecified b-cell lymphoma, extranodal and solid organ sites |
| C85.2 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma |
| C85.20 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, unspecified site |
| C85.21 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of head, face, and neck |
| C85.22 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, intrathoracic lymph nodes |
| C85.23 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, intra-abdominal lymph nodes |
| C85.24 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of axilla and upper limb |
| C85.25 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C85.26 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, intrapelvic lymph nodes |
| C85.27 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, spleen |
| C85.28 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of multiple sites |
| C85.29 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, extranodal and solid organ sites |
| C85.8 | ICD10CM | Other specified types of non-hodgkin lymphoma |
| C85.80 | ICD10CM | Other specified types of non-hodgkin lymphoma, unspecified site |
| C85.81 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of head, face, and neck |
| C85.82 | ICD10CM | Other specified types of non-hodgkin lymphoma, intrathoracic lymph nodes |
| C85.83 | ICD10CM | Other specified types of non-hodgkin lymphoma, intra-abdominal lymph nodes |
| C85.84 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C85.85 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C85.86 | ICD10CM | Other specified types of non-hodgkin lymphoma, intrapelvic lymph nodes |
| C85.87 | ICD10CM | Other specified types of non-hodgkin lymphoma, spleen |
| C85.88 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of multiple sites |
| C85.89 | ICD10CM | Other specified types of non-hodgkin lymphoma, extranodal and solid organ sites |
| C88.4 | ICD10CM | Extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue [MALt-lymphoma] |
| Chronic lymphocytic leukemia | ||
| C91.1 | ICD10CM | Chronic lymphocytic leukemia of b-cell type |
| C91.10 | ICD10CM | Chronic lymphocytic leukemia of b-cell type not having achieved remission |
| C91.12 | ICD10CM | Chronic lymphocytic leukemia of b-cell type in relapse |
| Diffuse large b-cell lymphoma | ||
| C83.3 | ICD10CM | Diffuse large b-cell lymphoma |
| C83.30 | ICD10CM | Diffuse large b-cell lymphoma, unspecified site |
| C83.31 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of head, face, and neck |
| C83.32 | ICD10CM | Diffuse large b-cell lymphoma, intrathoracic lymph nodes |
| C83.33 | ICD10CM | Diffuse large b-cell lymphoma, intra-abdominal lymph nodes |
| C83.34 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of axilla and upper limb |
| C83.35 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.36 | ICD10CM | Diffuse large b-cell lymphoma, intrapelvic lymph nodes |
| C83.37 | ICD10CM | Diffuse large b-cell lymphoma, spleen |
| C83.38 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of multiple sites |
| C83.39 | ICD10CM | Diffuse large b-cell lymphoma, extranodal and solid organ sites |
| C83.398 | ICD10CM | Diffuse large b-cell lymphoma of other extranodal and solid organ sites |
| Follicular lymphoma | ||
| C82 | ICD10CM | Follicular lymphoma |
| C82.0 | ICD10CM | Follicular lymphoma grade I |
| C82.00 | ICD10CM | Follicular lymphoma grade i, unspecified site |
| C82.01 | ICD10CM | Follicular lymphoma grade i, lymph nodes of head, face, and neck |
| C82.02 | ICD10CM | Follicular lymphoma grade i, intrathoracic lymph nodes |
| C82.03 | ICD10CM | Follicular lymphoma grade i, intra-abdominal lymph nodes |
| C82.04 | ICD10CM | Follicular lymphoma grade i, lymph nodes of axilla and upper limb |
| C82.05 | ICD10CM | Follicular lymphoma grade i, lymph nodes of inguinal region and lower limb |
| C82.06 | ICD10CM | Follicular lymphoma grade i, intrapelvic lymph nodes |
| C82.07 | ICD10CM | Follicular lymphoma grade i, spleen |
| C82.08 | ICD10CM | Follicular lymphoma grade i, lymph nodes of multiple sites |
| C82.09 | ICD10CM | Follicular lymphoma grade i, extranodal and solid organ sites |
| C82.1 | ICD10CM | Follicular lymphoma grade II |
| C82.10 | ICD10CM | Follicular lymphoma grade Ii, unspecified site |
| C82.11 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of head, face, and neck |
| C82.12 | ICD10CM | Follicular lymphoma grade Ii, intrathoracic lymph nodes |
| C82.13 | ICD10CM | Follicular lymphoma grade Ii, intra-abdominal lymph nodes |
| C82.14 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of axilla and upper limb |
| C82.15 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of inguinal region and lower limb |
| C82.16 | ICD10CM | Follicular lymphoma grade Ii, intrapelvic lymph nodes |
| C82.17 | ICD10CM | Follicular lymphoma grade Ii, spleen |
| C82.18 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of multiple sites |
| C82.19 | ICD10CM | Follicular lymphoma grade Ii, extranodal and solid organ sites |
| C82.2 | ICD10CM | Follicular lymphoma grade IIi, unspecified |
| C82.20 | ICD10CM | Follicular lymphoma grade IIi, unspecified, unspecified site |
| C82.21 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of head, face, and neck |
| C82.22 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intrathoracic lymph nodes |
| C82.23 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intra-abdominal lymph nodes |
| C82.24 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of axilla and upper limb |
| C82.25 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of inguinal region and lower limb |
| C82.26 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intrapelvic lymph nodes |
| C82.27 | ICD10CM | Follicular lymphoma grade IIi, unspecified, spleen |
| C82.28 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of multiple sites |
| C82.29 | ICD10CM | Follicular lymphoma grade IIi, unspecified, extranodal and solid organ sites |
| C82.3 | ICD10CM | Follicular lymphoma grade IIia |
| C82.30 | ICD10CM | Follicular lymphoma grade IIia, unspecified site |
| C82.31 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of head, face, and neck |
| C82.32 | ICD10CM | Follicular lymphoma grade IIia, intrathoracic lymph nodes |
| C82.33 | ICD10CM | Follicular lymphoma grade IIia, intra-abdominal lymph nodes |
| C82.34 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of axilla and upper limb |
| C82.35 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of inguinal region and lower limb |
| C82.36 | ICD10CM | Follicular lymphoma grade IIia, intrapelvic lymph nodes |
| C82.37 | ICD10CM | Follicular lymphoma grade IIia, spleen |
| C82.38 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of multiple sites |
| C82.39 | ICD10CM | Follicular lymphoma grade IIia, extranodal and solid organ sites |
| C82.4 | ICD10CM | Follicular lymphoma grade IIib |
| C82.40 | ICD10CM | Follicular lymphoma grade IIib, unspecified site |
| C82.41 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of head, face, and neck |
| C82.42 | ICD10CM | Follicular lymphoma grade IIib, intrathoracic lymph nodes |
| C82.43 | ICD10CM | Follicular lymphoma grade IIib, intra-abdominal lymph nodes |
| C82.44 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of axilla and upper limb |
| C82.45 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of inguinal region and lower limb |
| C82.46 | ICD10CM | Follicular lymphoma grade IIib, intrapelvic lymph nodes |
| C82.47 | ICD10CM | Follicular lymphoma grade IIib, spleen |
| C82.48 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of multiple sites |
| C82.49 | ICD10CM | Follicular lymphoma grade IIib, extranodal and solid organ sites |
| C82.5 | ICD10CM | Diffuse follicle center lymphoma |
| C82.50 | ICD10CM | Diffuse follicle center lymphoma, unspecified site |
| C82.51 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.52 | ICD10CM | Diffuse follicle center lymphoma, intrathoracic lymph nodes |
| C82.53 | ICD10CM | Diffuse follicle center lymphoma, intra-abdominal lymph nodes |
| C82.54 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.55 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.56 | ICD10CM | Diffuse follicle center lymphoma, intrapelvic lymph nodes |
| C82.57 | ICD10CM | Diffuse follicle center lymphoma, spleen |
| C82.58 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of multiple sites |
| C82.59 | ICD10CM | Diffuse follicle center lymphoma, extranodal and solid organ sites |
| C82.6 | ICD10CM | Cutaneous follicle center lymphoma |
| C82.60 | ICD10CM | Cutaneous follicle center lymphoma, unspecified site |
| C82.61 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.62 | ICD10CM | Cutaneous follicle center lymphoma, intrathoracic lymph nodes |
| C82.63 | ICD10CM | Cutaneous follicle center lymphoma, intra-abdominal lymph nodes |
| C82.64 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.65 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.66 | ICD10CM | Cutaneous follicle center lymphoma, intrapelvic lymph nodes |
| C82.67 | ICD10CM | Cutaneous follicle center lymphoma, spleen |
| C82.68 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of multiple sites |
| C82.69 | ICD10CM | Cutaneous follicle center lymphoma, extranodal and solid organ sites |
| C82.8 | ICD10CM | Other types of follicular lymphoma |
| C82.80 | ICD10CM | Other types of follicular lymphoma, unspecified site |
| C82.81 | ICD10CM | Other types of follicular lymphoma, lymph nodes of head, face, and neck |
| C82.82 | ICD10CM | Other types of follicular lymphoma, intrathoracic lymph nodes |
| C82.83 | ICD10CM | Other types of follicular lymphoma, intra-abdominal lymph nodes |
| C82.84 | ICD10CM | Other types of follicular lymphoma, lymph nodes of axilla and upper limb |
| C82.85 | ICD10CM | Other types of follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C82.86 | ICD10CM | Other types of follicular lymphoma, intrapelvic lymph nodes |
| C82.87 | ICD10CM | Other types of follicular lymphoma, spleen |
| C82.88 | ICD10CM | Other types of follicular lymphoma, lymph nodes of multiple sites |
| C82.89 | ICD10CM | Other types of follicular lymphoma, extranodal and solid organ sites |
| C82.9 | ICD10CM | Follicular lymphoma, unspecified |
| C82.90 | ICD10CM | Follicular lymphoma, unspecified, unspecified site |
| C82.91 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of head, face, and neck |
| C82.92 | ICD10CM | Follicular lymphoma, unspecified, intrathoracic lymph nodes |
| C82.93 | ICD10CM | Follicular lymphoma, unspecified, intra-abdominal lymph nodes |
| C82.94 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C82.95 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C82.96 | ICD10CM | Follicular lymphoma, unspecified, intrapelvic lymph nodes |
| C82.97 | ICD10CM | Follicular lymphoma, unspecified, spleen |
| C82.98 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of multiple sites |
| C82.99 | ICD10CM | Follicular lymphoma, unspecified, extranodal and solid organ sites |
| Granulomatosis with polyangiitis | ||
| M31.3 | ICD10CM | Wegener's granulomatosis |
| M31.30 | ICD10CM | Wegener's granulomatosis without renal involvement |
| M31.31 | ICD10CM | Wegener's granulomatosis with renal involvement |
| Microscopic polyangiitis | ||
| M31.7 | ICD10CM | Microscopic polyangiitis |
| Pemphigus vulgaris | ||
| L10.0 | ICD10CM | Pemphigus vulgaris |
| Progressive chronic lymphocytic leukemia | ||
| C91.1 | ICD10CM | Chronic lymphocytic leukemia of b-cell type |
| C91.10 | ICD10CM | Chronic lymphocytic leukemia of b-cell type not having achieved remission |
| C91.12 | ICD10CM | Chronic lymphocytic leukemia of b-cell type in relapse |
| Relapse or refractory non-hodgkin's lymphoma | ||
| C82 | ICD10CM | Follicular lymphoma |
| C82.0 | ICD10CM | Follicular lymphoma grade I |
| C82.00 | ICD10CM | Follicular lymphoma grade i, unspecified site |
| C82.01 | ICD10CM | Follicular lymphoma grade i, lymph nodes of head, face, and neck |
| C82.02 | ICD10CM | Follicular lymphoma grade i, intrathoracic lymph nodes |
| C82.03 | ICD10CM | Follicular lymphoma grade i, intra-abdominal lymph nodes |
| C82.04 | ICD10CM | Follicular lymphoma grade i, lymph nodes of axilla and upper limb |
| C82.05 | ICD10CM | Follicular lymphoma grade i, lymph nodes of inguinal region and lower limb |
| C82.06 | ICD10CM | Follicular lymphoma grade i, intrapelvic lymph nodes |
| C82.07 | ICD10CM | Follicular lymphoma grade i, spleen |
| C82.08 | ICD10CM | Follicular lymphoma grade i, lymph nodes of multiple sites |
| C82.09 | ICD10CM | Follicular lymphoma grade i, extranodal and solid organ sites |
| C82.1 | ICD10CM | Follicular lymphoma grade II |
| C82.10 | ICD10CM | Follicular lymphoma grade Ii, unspecified site |
| C82.11 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of head, face, and neck |
| C82.12 | ICD10CM | Follicular lymphoma grade Ii, intrathoracic lymph nodes |
| C82.13 | ICD10CM | Follicular lymphoma grade Ii, intra-abdominal lymph nodes |
| C82.14 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of axilla and upper limb |
| C82.15 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of inguinal region and lower limb |
| C82.16 | ICD10CM | Follicular lymphoma grade Ii, intrapelvic lymph nodes |
| C82.17 | ICD10CM | Follicular lymphoma grade Ii, spleen |
| C82.18 | ICD10CM | Follicular lymphoma grade Ii, lymph nodes of multiple sites |
| C82.19 | ICD10CM | Follicular lymphoma grade Ii, extranodal and solid organ sites |
| C82.2 | ICD10CM | Follicular lymphoma grade IIi, unspecified |
| C82.20 | ICD10CM | Follicular lymphoma grade IIi, unspecified, unspecified site |
| C82.21 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of head, face, and neck |
| C82.22 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intrathoracic lymph nodes |
| C82.23 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intra-abdominal lymph nodes |
| C82.24 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of axilla and upper limb |
| C82.25 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of inguinal region and lower limb |
| C82.26 | ICD10CM | Follicular lymphoma grade IIi, unspecified, intrapelvic lymph nodes |
| C82.27 | ICD10CM | Follicular lymphoma grade IIi, unspecified, spleen |
| C82.28 | ICD10CM | Follicular lymphoma grade IIi, unspecified, lymph nodes of multiple sites |
| C82.29 | ICD10CM | Follicular lymphoma grade IIi, unspecified, extranodal and solid organ sites |
| C82.3 | ICD10CM | Follicular lymphoma grade IIia |
| C82.30 | ICD10CM | Follicular lymphoma grade IIia, unspecified site |
| C82.31 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of head, face, and neck |
| C82.32 | ICD10CM | Follicular lymphoma grade IIia, intrathoracic lymph nodes |
| C82.33 | ICD10CM | Follicular lymphoma grade IIia, intra-abdominal lymph nodes |
| C82.34 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of axilla and upper limb |
| C82.35 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of inguinal region and lower limb |
| C82.36 | ICD10CM | Follicular lymphoma grade IIia, intrapelvic lymph nodes |
| C82.37 | ICD10CM | Follicular lymphoma grade IIia, spleen |
| C82.38 | ICD10CM | Follicular lymphoma grade IIia, lymph nodes of multiple sites |
| C82.39 | ICD10CM | Follicular lymphoma grade IIia, extranodal and solid organ sites |
| C82.4 | ICD10CM | Follicular lymphoma grade IIib |
| C82.40 | ICD10CM | Follicular lymphoma grade IIib, unspecified site |
| C82.41 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of head, face, and neck |
| C82.42 | ICD10CM | Follicular lymphoma grade IIib, intrathoracic lymph nodes |
| C82.43 | ICD10CM | Follicular lymphoma grade IIib, intra-abdominal lymph nodes |
| C82.44 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of axilla and upper limb |
| C82.45 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of inguinal region and lower limb |
| C82.46 | ICD10CM | Follicular lymphoma grade IIib, intrapelvic lymph nodes |
| C82.47 | ICD10CM | Follicular lymphoma grade IIib, spleen |
| C82.48 | ICD10CM | Follicular lymphoma grade IIib, lymph nodes of multiple sites |
| C82.49 | ICD10CM | Follicular lymphoma grade IIib, extranodal and solid organ sites |
| C82.5 | ICD10CM | Diffuse follicle center lymphoma |
| C82.50 | ICD10CM | Diffuse follicle center lymphoma, unspecified site |
| C82.51 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.52 | ICD10CM | Diffuse follicle center lymphoma, intrathoracic lymph nodes |
| C82.53 | ICD10CM | Diffuse follicle center lymphoma, intra-abdominal lymph nodes |
| C82.54 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.55 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.56 | ICD10CM | Diffuse follicle center lymphoma, intrapelvic lymph nodes |
| C82.57 | ICD10CM | Diffuse follicle center lymphoma, spleen |
| C82.58 | ICD10CM | Diffuse follicle center lymphoma, lymph nodes of multiple sites |
| C82.59 | ICD10CM | Diffuse follicle center lymphoma, extranodal and solid organ sites |
| C82.6 | ICD10CM | Cutaneous follicle center lymphoma |
| C82.60 | ICD10CM | Cutaneous follicle center lymphoma, unspecified site |
| C82.61 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.62 | ICD10CM | Cutaneous follicle center lymphoma, intrathoracic lymph nodes |
| C82.63 | ICD10CM | Cutaneous follicle center lymphoma, intra-abdominal lymph nodes |
| C82.64 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.65 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.66 | ICD10CM | Cutaneous follicle center lymphoma, intrapelvic lymph nodes |
| C82.67 | ICD10CM | Cutaneous follicle center lymphoma, spleen |
| C82.68 | ICD10CM | Cutaneous follicle center lymphoma, lymph nodes of multiple sites |
| C82.69 | ICD10CM | Cutaneous follicle center lymphoma, extranodal and solid organ sites |
| C82.8 | ICD10CM | Other types of follicular lymphoma |
| C82.80 | ICD10CM | Other types of follicular lymphoma, unspecified site |
| C82.81 | ICD10CM | Other types of follicular lymphoma, lymph nodes of head, face, and neck |
| C82.82 | ICD10CM | Other types of follicular lymphoma, intrathoracic lymph nodes |
| C82.83 | ICD10CM | Other types of follicular lymphoma, intra-abdominal lymph nodes |
| C82.84 | ICD10CM | Other types of follicular lymphoma, lymph nodes of axilla and upper limb |
| C82.85 | ICD10CM | Other types of follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C82.86 | ICD10CM | Other types of follicular lymphoma, intrapelvic lymph nodes |
| C82.87 | ICD10CM | Other types of follicular lymphoma, spleen |
| C82.88 | ICD10CM | Other types of follicular lymphoma, lymph nodes of multiple sites |
| C82.89 | ICD10CM | Other types of follicular lymphoma, extranodal and solid organ sites |
| C82.9 | ICD10CM | Follicular lymphoma, unspecified |
| C82.90 | ICD10CM | Follicular lymphoma, unspecified, unspecified site |
| C82.91 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of head, face, and neck |
| C82.92 | ICD10CM | Follicular lymphoma, unspecified, intrathoracic lymph nodes |
| C82.93 | ICD10CM | Follicular lymphoma, unspecified, intra-abdominal lymph nodes |
| C82.94 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C82.95 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C82.96 | ICD10CM | Follicular lymphoma, unspecified, intrapelvic lymph nodes |
| C82.97 | ICD10CM | Follicular lymphoma, unspecified, spleen |
| C82.98 | ICD10CM | Follicular lymphoma, unspecified, lymph nodes of multiple sites |
| C82.99 | ICD10CM | Follicular lymphoma, unspecified, extranodal and solid organ sites |
| C83 | ICD10CM | Non-follicular lymphoma |
| C83.0 | ICD10CM | Small cell b-cell lymphoma |
| C83.00 | ICD10CM | Small cell b-cell lymphoma, unspecified site |
| C83.01 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of head, face, and neck |
| C83.02 | ICD10CM | Small cell b-cell lymphoma, intrathoracic lymph nodes |
| C83.03 | ICD10CM | Small cell b-cell lymphoma, intra-abdominal lymph nodes |
| C83.04 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of axilla and upper limb |
| C83.05 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.06 | ICD10CM | Small cell b-cell lymphoma, intrapelvic lymph nodes |
| C83.07 | ICD10CM | Small cell b-cell lymphoma, spleen |
| C83.08 | ICD10CM | Small cell b-cell lymphoma, lymph nodes of multiple sites |
| C83.09 | ICD10CM | Small cell b-cell lymphoma, extranodal and solid organ sites |
| C83.1 | ICD10CM | Mantle cell lymphoma |
| C83.10 | ICD10CM | Mantle cell lymphoma, unspecified site |
| C83.11 | ICD10CM | Mantle cell lymphoma, lymph nodes of head, face, and neck |
| C83.12 | ICD10CM | Mantle cell lymphoma, intrathoracic lymph nodes |
| C83.13 | ICD10CM | Mantle cell lymphoma, intra-abdominal lymph nodes |
| C83.14 | ICD10CM | Mantle cell lymphoma, lymph nodes of axilla and upper limb |
| C83.15 | ICD10CM | Mantle cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.16 | ICD10CM | Mantle cell lymphoma, intrapelvic lymph nodes |
| C83.17 | ICD10CM | Mantle cell lymphoma, spleen |
| C83.18 | ICD10CM | Mantle cell lymphoma, lymph nodes of multiple sites |
| C83.19 | ICD10CM | Mantle cell lymphoma, extranodal and solid organ sites |
| C83.3 | ICD10CM | Diffuse large b-cell lymphoma |
| C83.30 | ICD10CM | Diffuse large b-cell lymphoma, unspecified site |
| C83.31 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of head, face, and neck |
| C83.32 | ICD10CM | Diffuse large b-cell lymphoma, intrathoracic lymph nodes |
| C83.33 | ICD10CM | Diffuse large b-cell lymphoma, intra-abdominal lymph nodes |
| C83.34 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of axilla and upper limb |
| C83.35 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.36 | ICD10CM | Diffuse large b-cell lymphoma, intrapelvic lymph nodes |
| C83.37 | ICD10CM | Diffuse large b-cell lymphoma, spleen |
| C83.38 | ICD10CM | Diffuse large b-cell lymphoma, lymph nodes of multiple sites |
| C83.39 | ICD10CM | Diffuse large b-cell lymphoma, extranodal and solid organ sites |
| C83.5 | ICD10CM | Lymphoblastic (diffuse) lymphoma |
| C83.50 | ICD10CM | Lymphoblastic (diffuse) lymphoma, unspecified site |
| C83.51 | ICD10CM | Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck |
| C83.52 | ICD10CM | Lymphoblastic (diffuse) lymphoma, intrathoracic lymph nodes |
| C83.53 | ICD10CM | Lymphoblastic (diffuse) lymphoma, intra-abdominal lymph nodes |
| C83.54 | ICD10CM | Lymphoblastic (diffuse) lymphoma, lymph nodes of axilla and upper limb |
| C83.55 | ICD10CM | Lymphoblastic (diffuse) lymphoma, lymph nodes of inguinal region and lower limb |
| C83.56 | ICD10CM | Lymphoblastic (diffuse) lymphoma, intrapelvic lymph nodes |
| C83.57 | ICD10CM | Lymphoblastic (diffuse) lymphoma, spleen |
| C83.58 | ICD10CM | Lymphoblastic (diffuse) lymphoma, lymph nodes of multiple sites |
| C83.59 | ICD10CM | Lymphoblastic (diffuse) lymphoma, extranodal and solid organ sites |
| C83.7 | ICD10CM | Burkitt lymphoma |
| C83.70 | ICD10CM | Burkitt lymphoma, unspecified site |
| C83.71 | ICD10CM | Burkitt lymphoma, lymph nodes of head, face, and neck |
| C83.72 | ICD10CM | Burkitt lymphoma, intrathoracic lymph nodes |
| C83.73 | ICD10CM | Burkitt lymphoma, intra-abdominal lymph nodes |
| C83.74 | ICD10CM | Burkitt lymphoma, lymph nodes of axilla and upper limb |
| C83.75 | ICD10CM | Burkitt lymphoma, lymph nodes of inguinal region and lower limb |
| C83.76 | ICD10CM | Burkitt lymphoma, intrapelvic lymph nodes |
| C83.77 | ICD10CM | Burkitt lymphoma, spleen |
| C83.78 | ICD10CM | Burkitt lymphoma, lymph nodes of multiple sites |
| C83.79 | ICD10CM | Burkitt lymphoma, extranodal and solid organ sites |
| C83.8 | ICD10CM | Other non-follicular lymphoma |
| C83.80 | ICD10CM | Other non-follicular lymphoma, unspecified site |
| C83.81 | ICD10CM | Other non-follicular lymphoma, lymph nodes of head, face, and neck |
| C83.82 | ICD10CM | Other non-follicular lymphoma, intrathoracic lymph nodes |
| C83.83 | ICD10CM | Other non-follicular lymphoma, intra-abdominal lymph nodes |
| C83.84 | ICD10CM | Other non-follicular lymphoma, lymph nodes of axilla and upper limb |
| C83.85 | ICD10CM | Other non-follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C83.86 | ICD10CM | Other non-follicular lymphoma, intrapelvic lymph nodes |
| C83.87 | ICD10CM | Other non-follicular lymphoma, spleen |
| C83.88 | ICD10CM | Other non-follicular lymphoma, lymph nodes of multiple sites |
| C83.89 | ICD10CM | Other non-follicular lymphoma, extranodal and solid organ sites |
| C83.9 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified |
| C83.90 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, unspecified site |
| C83.91 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of head, face, and neck |
| C83.92 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, intrathoracic lymph nodes |
| C83.93 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, intra-abdominal lymph nodes |
| C83.94 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C83.95 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C83.96 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, intrapelvic lymph nodes |
| C83.97 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, spleen |
| C83.98 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites |
| C83.99 | ICD10CM | Non-follicular (diffuse) lymphoma, unspecified, extranodal and solid organ sites |
| C84 | ICD10CM | Mature t/Nk-cell lymphomas |
| C84.0 | ICD10CM | Mycosis fungoides |
| C84.00 | ICD10CM | Mycosis fungoides, unspecified site |
| C84.01 | ICD10CM | Mycosis fungoides, lymph nodes of head, face, and neck |
| C84.02 | ICD10CM | Mycosis fungoides, intrathoracic lymph nodes |
| C84.03 | ICD10CM | Mycosis fungoides, intra-abdominal lymph nodes |
| C84.04 | ICD10CM | Mycosis fungoides, lymph nodes of axilla and upper limb |
| C84.05 | ICD10CM | Mycosis fungoides, lymph nodes of inguinal region and lower limb |
| C84.06 | ICD10CM | Mycosis fungoides, intrapelvic lymph nodes |
| C84.07 | ICD10CM | Mycosis fungoides, spleen |
| C84.08 | ICD10CM | Mycosis fungoides, lymph nodes of multiple sites |
| C84.09 | ICD10CM | Mycosis fungoides, extranodal and solid organ sites |
| C84.1 | ICD10CM | Sezary disease |
| C84.10 | ICD10CM | Sezary disease, unspecified site |
| C84.11 | ICD10CM | Sezary disease, lymph nodes of head, face, and neck |
| C84.12 | ICD10CM | Sezary disease, intrathoracic lymph nodes |
| C84.13 | ICD10CM | Sezary disease, intra-abdominal lymph nodes |
| C84.14 | ICD10CM | Sezary disease, lymph nodes of axilla and upper limb |
| C84.15 | ICD10CM | Sezary disease, lymph nodes of inguinal region and lower limb |
| C84.16 | ICD10CM | Sezary disease, intrapelvic lymph nodes |
| C84.17 | ICD10CM | Sezary disease, spleen |
| C84.18 | ICD10CM | Sezary disease, lymph nodes of multiple sites |
| C84.19 | ICD10CM | Sezary disease, extranodal and solid organ sites |
| C84.4 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified |
| C84.40 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, unspecified site |
| C84.41 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of head, face, and neck |
| C84.42 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, intrathoracic lymph nodes |
| C84.43 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, intra-abdominal lymph nodes |
| C84.44 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of axilla and upper limb |
| C84.45 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of inguinal region and lower limb |
| C84.46 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, intrapelvic lymph nodes |
| C84.47 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, spleen |
| C84.48 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of multiple sites |
| C84.49 | ICD10CM | Peripheral t-cell lymphoma, not elsewhere classified, extranodal and solid organ sites |
| C84.6 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive |
| C84.60 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, unspecified site |
| C84.61 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of head, face, and neck |
| C84.62 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, intrathoracic lymph nodes |
| C84.63 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, intra-abdominal lymph nodes |
| C84.64 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of axilla and upper limb |
| C84.65 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of inguinal region and lower limb |
| C84.66 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, intrapelvic lymph nodes |
| C84.67 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, spleen |
| C84.68 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of multiple sites |
| C84.69 | ICD10CM | Anaplastic large cell lymphoma, ALk-positive, extranodal and solid organ sites |
| C84.7 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative |
| C84.70 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, unspecified site |
| C84.71 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of head, face, and neck |
| C84.72 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, intrathoracic lymph nodes |
| C84.73 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, intra-abdominal lymph nodes |
| C84.74 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of axilla and upper limb |
| C84.75 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of inguinal region and lower limb |
| C84.76 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, intrapelvic lymph nodes |
| C84.77 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, spleen |
| C84.78 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of multiple sites |
| C84.79 | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, extranodal and solid organ sites |
| C84.7A | ICD10CM | Anaplastic large cell lymphoma, ALk-negative, breast |
| C84.9 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified |
| C84.90 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, unspecified site |
| C84.91 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of head, face, and neck |
| C84.92 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, intrathoracic lymph nodes |
| C84.93 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, intra-abdominal lymph nodes |
| C84.94 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of axilla and upper limb |
| C84.95 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of inguinal region and lower limb |
| C84.96 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, intrapelvic lymph nodes |
| C84.97 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, spleen |
| C84.98 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of multiple sites |
| C84.99 | ICD10CM | Mature t/Nk-cell lymphomas, unspecified, extranodal and solid organ sites |
| C84.A | ICD10CM | Cutaneous t-cell lymphoma, unspecified |
| C84.A0 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, unspecified site |
| C84.A1 | ICD10CM | Cutaneous t-cell lymphoma, unspecified lymph nodes of head, face, and neck |
| C84.A2 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, intrathoracic lymph nodes |
| C84.A3 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, intra-abdominal lymph nodes |
| C84.A4 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C84.A5 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C84.A6 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, intrapelvic lymph nodes |
| C84.A7 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, spleen |
| C84.A8 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, lymph nodes of multiple sites |
| C84.A9 | ICD10CM | Cutaneous t-cell lymphoma, unspecified, extranodal and solid organ sites |
| C84.Z | ICD10CM | Other mature t/Nk-cell lymphomas |
| C84.Z0 | ICD10CM | Other mature t/Nk-cell lymphomas, unspecified site |
| C84.Z1 | ICD10CM | Other mature t/Nk-cell lymphomas, lymph nodes of head, face, and neck |
| C84.Z2 | ICD10CM | Other mature t/Nk-cell lymphomas, intrathoracic lymph nodes |
| C84.Z3 | ICD10CM | Other mature t/Nk-cell lymphomas, intra-abdominal lymph nodes |
| C84.Z4 | ICD10CM | Other mature t/Nk-cell lymphomas, lymph nodes of axilla and upper limb |
| C84.Z5 | ICD10CM | Other mature t/Nk-cell lymphomas, lymph nodes of inguinal region and lower limb |
| C84.Z6 | ICD10CM | Other mature t/Nk-cell lymphomas, intrapelvic lymph nodes |
| C84.Z7 | ICD10CM | Other mature t/Nk-cell lymphomas, spleen |
| C84.Z8 | ICD10CM | Other mature t/Nk-cell lymphomas, lymph nodes of multiple sites |
| C84.Z9 | ICD10CM | Other mature t/Nk-cell lymphomas, extranodal and solid organ sites |
| C85 | ICD10CM | Other specified and unspecified types of non-hodgkin lymphoma |
| C85.1 | ICD10CM | Unspecified b-cell lymphoma |
| C85.10 | ICD10CM | Unspecified b-cell lymphoma, unspecified site |
| C85.11 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of head, face, and neck |
| C85.12 | ICD10CM | Unspecified b-cell lymphoma, intrathoracic lymph nodes |
| C85.13 | ICD10CM | Unspecified b-cell lymphoma, intra-abdominal lymph nodes |
| C85.14 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of axilla and upper limb |
| C85.15 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C85.16 | ICD10CM | Unspecified b-cell lymphoma, intrapelvic lymph nodes |
| C85.17 | ICD10CM | Unspecified b-cell lymphoma, spleen |
| C85.18 | ICD10CM | Unspecified b-cell lymphoma, lymph nodes of multiple sites |
| C85.19 | ICD10CM | Unspecified b-cell lymphoma, extranodal and solid organ sites |
| C85.2 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma |
| C85.20 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, unspecified site |
| C85.21 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of head, face, and neck |
| C85.22 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, intrathoracic lymph nodes |
| C85.23 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, intra-abdominal lymph nodes |
| C85.24 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of axilla and upper limb |
| C85.25 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C85.26 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, intrapelvic lymph nodes |
| C85.27 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, spleen |
| C85.28 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of multiple sites |
| C85.29 | ICD10CM | Mediastinal (thymic) large b-cell lymphoma, extranodal and solid organ sites |
| C85.8 | ICD10CM | Other specified types of non-hodgkin lymphoma |
| C85.80 | ICD10CM | Other specified types of non-hodgkin lymphoma, unspecified site |
| C85.81 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of head, face, and neck |
| C85.82 | ICD10CM | Other specified types of non-hodgkin lymphoma, intrathoracic lymph nodes |
| C85.83 | ICD10CM | Other specified types of non-hodgkin lymphoma, intra-abdominal lymph nodes |
| C85.84 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C85.85 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C85.86 | ICD10CM | Other specified types of non-hodgkin lymphoma, intrapelvic lymph nodes |
| C85.87 | ICD10CM | Other specified types of non-hodgkin lymphoma, spleen |
| C85.88 | ICD10CM | Other specified types of non-hodgkin lymphoma, lymph nodes of multiple sites |
| C85.89 | ICD10CM | Other specified types of non-hodgkin lymphoma, extranodal and solid organ sites |
| C85.9 | ICD10CM | Non-hodgkin lymphoma, unspecified |
| C85.90 | ICD10CM | Non-hodgkin lymphoma, unspecified, unspecified site |
| C85.91 | ICD10CM | Non-hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck |
| C85.92 | ICD10CM | Non-hodgkin lymphoma, unspecified, intrathoracic lymph nodes |
| C85.93 | ICD10CM | Non-hodgkin lymphoma, unspecified, intra-abdominal lymph nodes |
| C85.94 | ICD10CM | Non-hodgkin lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C85.95 | ICD10CM | Non-hodgkin lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C85.96 | ICD10CM | Non-hodgkin lymphoma, unspecified, intrapelvic lymph nodes |
| C85.97 | ICD10CM | Non-hodgkin lymphoma, unspecified, spleen |
| C85.98 | ICD10CM | Non-hodgkin lymphoma, unspecified, lymph nodes of multiple sites |
| C85.99 | ICD10CM | Non-hodgkin lymphoma, unspecified, extranodal and solid organ sites |
| C86 | ICD10CM | Other specified types of t/Nk-cell lymphoma |
| C86.0 | ICD10CM | Extranodal Nk/t-cell lymphoma, nasal type |
| C86.00 | ICD10CM | Extranodal Nk/t-cell lymphoma, nasal type not having achieved remission |
| C86.1 | ICD10CM | Hepatosplenic t-cell lymphoma |
| C86.10 | ICD10CM | Hepatosplenic t-cell lymphoma not having achieved remission |
| C86.2 | ICD10CM | Enteropathy-type (intestinal) t-cell lymphoma |
| C86.20 | ICD10CM | Enteropathy-type (intestinal) t-cell lymphoma not having achieved remission |
| C86.3 | ICD10CM | Subcutaneous panniculitis-like t-cell lymphoma |
| C86.30 | ICD10CM | Subcutaneous panniculitis-like t-cell lymphoma not having achieved remission |
| C86.4 | ICD10CM | Blastic Nk-cell lymphoma |
| C86.5 | ICD10CM | Angioimmunoblastic t-cell lymphoma |
| C86.50 | ICD10CM | Angioimmunoblastic t-cell lymphoma not having achieved remission |
| C86.6 | ICD10CM | Primary cutaneous Cd30-positive t-cell proliferations |
| C86.60 | ICD10CM | Primary cutaneous Cd30-positive t-cell proliferations not having achieved remission |
| C88.0 | ICD10CM | Waldenstrom macroglobulinemia |
| C88.00 | ICD10CM | Waldenstrom macroglobulinemia not having achieved remission |
| C88.4 | ICD10CM | Extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue [MALt-lymphoma] |
| C88.40 | ICD10CM | Extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue [MALt-lymphoma] not having achieved remission |
| C91.5 | ICD10CM | Adult t-cell lymphoma/leukemia (HTLv-1-associated) |
| C91.50 | ICD10CM | Adult t-cell lymphoma/leukemia (HTLv-1-associated) not having achieved remission |
| C91.52 | ICD10CM | Adult t-cell lymphoma/leukemia (HTLv-1-associated), in relapse |
| Rheumatoid arthritis | ||
| M05 | ICD10CM | Rheumatoid arthritis with rheumatoid factor |
| M05.0 | ICD10CM | Felty's syndrome |
| M05.00 | ICD10CM | Felty's syndrome, unspecified site |
| M05.01 | ICD10CM | Felty's syndrome, shoulder |
| M05.011 | ICD10CM | Felty's syndrome, right shoulder |
| M05.012 | ICD10CM | Felty's syndrome, left shoulder |
| M05.019 | ICD10CM | Felty's syndrome, unspecified shoulder |
| M05.02 | ICD10CM | Felty's syndrome, elbow |
| M05.021 | ICD10CM | Felty's syndrome, right elbow |
| M05.022 | ICD10CM | Felty's syndrome, left elbow |
| M05.029 | ICD10CM | Felty's syndrome, unspecified elbow |
| M05.03 | ICD10CM | Felty's syndrome, wrist |
| M05.031 | ICD10CM | Felty's syndrome, right wrist |
| M05.032 | ICD10CM | Felty's syndrome, left wrist |
| M05.039 | ICD10CM | Felty's syndrome, unspecified wrist |
| M05.04 | ICD10CM | Felty's syndrome, hand |
| M05.041 | ICD10CM | Felty's syndrome, right hand |
| M05.042 | ICD10CM | Felty's syndrome, left hand |
| M05.049 | ICD10CM | Felty's syndrome, unspecified hand |
| M05.05 | ICD10CM | Felty's syndrome, hip |
| M05.051 | ICD10CM | Felty's syndrome, right hip |
| M05.052 | ICD10CM | Felty's syndrome, left hip |
| M05.059 | ICD10CM | Felty's syndrome, unspecified hip |
| M05.06 | ICD10CM | Felty's syndrome, knee |
| M05.061 | ICD10CM | Felty's syndrome, right knee |
| M05.062 | ICD10CM | Felty's syndrome, left knee |
| M05.069 | ICD10CM | Felty's syndrome, unspecified knee |
| M05.07 | ICD10CM | Felty's syndrome, ankle and foot |
| M05.071 | ICD10CM | Felty's syndrome, right ankle and foot |
| M05.072 | ICD10CM | Felty's syndrome, left ankle and foot |
| M05.079 | ICD10CM | Felty's syndrome, unspecified ankle and foot |
| M05.09 | ICD10CM | Felty's syndrome, multiple sites |
| M05.1 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis |
| M05.10 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified site |
| M05.11 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of shoulder |
| M05.111 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right shoulder |
| M05.112 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left shoulder |
| M05.119 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified shoulder |
| M05.12 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of elbow |
| M05.121 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right elbow |
| M05.122 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left elbow |
| M05.129 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified elbow |
| M05.13 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of wrist |
| M05.131 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right wrist |
| M05.132 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left wrist |
| M05.139 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified wrist |
| M05.14 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of hand |
| M05.141 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right hand |
| M05.142 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left hand |
| M05.149 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified hand |
| M05.15 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of hip |
| M05.151 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right hip |
| M05.152 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left hip |
| M05.159 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified hip |
| M05.16 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of knee |
| M05.161 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right knee |
| M05.162 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left knee |
| M05.169 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified knee |
| M05.17 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of ankle and foot |
| M05.171 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right ankle and foot |
| M05.172 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left ankle and foot |
| M05.179 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified ankle and foot |
| M05.19 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of multiple sites |
| M05.2 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis |
| M05.20 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified site |
| M05.21 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of shoulder |
| M05.211 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right shoulder |
| M05.212 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left shoulder |
| M05.219 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified shoulder |
| M05.22 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of elbow |
| M05.221 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right elbow |
| M05.222 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left elbow |
| M05.229 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified elbow |
| M05.23 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of wrist |
| M05.231 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right wrist |
| M05.232 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left wrist |
| M05.239 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified wrist |
| M05.24 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of hand |
| M05.241 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right hand |
| M05.242 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left hand |
| M05.249 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified hand |
| M05.25 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of hip |
| M05.251 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right hip |
| M05.252 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left hip |
| M05.259 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified hip |
| M05.26 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of knee |
| M05.261 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right knee |
| M05.262 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left knee |
| M05.269 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified knee |
| M05.27 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of ankle and foot |
| M05.271 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right ankle and foot |
| M05.272 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left ankle and foot |
| M05.279 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified ankle and foot |
| M05.29 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of multiple sites |
| M05.3 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis |
| M05.30 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified site |
| M05.31 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of shoulder |
| M05.311 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right shoulder |
| M05.312 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left shoulder |
| M05.319 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified shoulder |
| M05.32 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of elbow |
| M05.321 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right elbow |
| M05.322 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left elbow |
| M05.329 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified elbow |
| M05.33 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of wrist |
| M05.331 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right wrist |
| M05.332 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left wrist |
| M05.339 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified wrist |
| M05.34 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of hand |
| M05.341 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right hand |
| M05.342 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left hand |
| M05.349 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified hand |
| M05.35 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of hip |
| M05.351 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right hip |
| M05.352 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left hip |
| M05.359 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified hip |
| M05.36 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of knee |
| M05.361 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right knee |
| M05.362 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left knee |
| M05.369 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified knee |
| M05.37 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of ankle and foot |
| M05.371 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right ankle and foot |
| M05.372 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left ankle and foot |
| M05.379 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified ankle and foot |
| M05.39 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of multiple sites |
| M05.4 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis |
| M05.40 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified site |
| M05.41 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of shoulder |
| M05.411 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right shoulder |
| M05.412 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left shoulder |
| M05.419 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified shoulder |
| M05.42 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of elbow |
| M05.421 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right elbow |
| M05.422 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left elbow |
| M05.429 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified elbow |
| M05.43 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of wrist |
| M05.431 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right wrist |
| M05.432 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left wrist |
| M05.439 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified wrist |
| M05.44 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of hand |
| M05.441 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right hand |
| M05.442 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left hand |
| M05.449 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified hand |
| M05.45 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of hip |
| M05.451 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right hip |
| M05.452 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left hip |
| M05.459 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified hip |
| M05.46 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of knee |
| M05.461 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right knee |
| M05.462 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left knee |
| M05.469 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified knee |
| M05.47 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of ankle and foot |
| M05.471 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right ankle and foot |
| M05.472 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left ankle and foot |
| M05.479 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified ankle and foot |
| M05.49 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of multiple sites |
| M05.5 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis |
| M05.50 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site |
| M05.51 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of shoulder |
| M05.511 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder |
| M05.512 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left shoulder |
| M05.519 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified shoulder |
| M05.52 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of elbow |
| M05.521 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right elbow |
| M05.522 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left elbow |
| M05.529 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified elbow |
| M05.53 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of wrist |
| M05.531 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right wrist |
| M05.532 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left wrist |
| M05.539 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified wrist |
| M05.54 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of hand |
| M05.541 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right hand |
| M05.542 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left hand |
| M05.549 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hand |
| M05.55 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of hip |
| M05.551 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right hip |
| M05.552 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left hip |
| M05.559 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hip |
| M05.56 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of knee |
| M05.561 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right knee |
| M05.562 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left knee |
| M05.569 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified knee |
| M05.57 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of ankle and foot |
| M05.571 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot |
| M05.572 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle and foot |
| M05.579 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified ankle and foot |
| M05.59 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites |
| M05.6 | ICD10CM | Rheumatoid arthritis with involvement of other organs and systems |
| M05.60 | ICD10CM | Rheumatoid arthritis of unspecified site with involvement of other organs and systems |
| M05.61 | ICD10CM | Rheumatoid arthritis of shoulder with involvement of other organs and systems |
| M05.611 | ICD10CM | Rheumatoid arthritis of right shoulder with involvement of other organs and systems |
| M05.612 | ICD10CM | Rheumatoid arthritis of left shoulder with involvement of other organs and systems |
| M05.619 | ICD10CM | Rheumatoid arthritis of unspecified shoulder with involvement of other organs and systems |
| M05.62 | ICD10CM | Rheumatoid arthritis of elbow with involvement of other organs and systems |
| M05.621 | ICD10CM | Rheumatoid arthritis of right elbow with involvement of other organs and systems |
| M05.622 | ICD10CM | Rheumatoid arthritis of left elbow with involvement of other organs and systems |
| M05.629 | ICD10CM | Rheumatoid arthritis of unspecified elbow with involvement of other organs and systems |
| M05.63 | ICD10CM | Rheumatoid arthritis of wrist with involvement of other organs and systems |
| M05.631 | ICD10CM | Rheumatoid arthritis of right wrist with involvement of other organs and systems |
| M05.632 | ICD10CM | Rheumatoid arthritis of left wrist with involvement of other organs and systems |
| M05.639 | ICD10CM | Rheumatoid arthritis of unspecified wrist with involvement of other organs and systems |
| M05.64 | ICD10CM | Rheumatoid arthritis of hand with involvement of other organs and systems |
| M05.641 | ICD10CM | Rheumatoid arthritis of right hand with involvement of other organs and systems |
| M05.642 | ICD10CM | Rheumatoid arthritis of left hand with involvement of other organs and systems |
| M05.649 | ICD10CM | Rheumatoid arthritis of unspecified hand with involvement of other organs and systems |
| M05.65 | ICD10CM | Rheumatoid arthritis of hip with involvement of other organs and systems |
| M05.651 | ICD10CM | Rheumatoid arthritis of right hip with involvement of other organs and systems |
| M05.652 | ICD10CM | Rheumatoid arthritis of left hip with involvement of other organs and systems |
| M05.659 | ICD10CM | Rheumatoid arthritis of unspecified hip with involvement of other organs and systems |
| M05.66 | ICD10CM | Rheumatoid arthritis of knee with involvement of other organs and systems |
| M05.661 | ICD10CM | Rheumatoid arthritis of right knee with involvement of other organs and systems |
| M05.662 | ICD10CM | Rheumatoid arthritis of left knee with involvement of other organs and systems |
| M05.669 | ICD10CM | Rheumatoid arthritis of unspecified knee with involvement of other organs and systems |
| M05.67 | ICD10CM | Rheumatoid arthritis of ankle and foot with involvement of other organs and systems |
| M05.671 | ICD10CM | Rheumatoid arthritis of right ankle and foot with involvement of other organs and systems |
| M05.672 | ICD10CM | Rheumatoid arthritis of left ankle and foot with involvement of other organs and systems |
| M05.679 | ICD10CM | Rheumatoid arthritis of unspecified ankle and foot with involvement of other organs and systems |
| M05.69 | ICD10CM | Rheumatoid arthritis of multiple sites with involvement of other organs and systems |
| M05.7 | ICD10CM | Rheumatoid arthritis with rheumatoid factor without organ or systems involvement |
| M05.70 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement |
| M05.71 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of shoulder without organ or systems involvement |
| M05.711 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right shoulder without organ or systems involvement |
| M05.712 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left shoulder without organ or systems involvement |
| M05.719 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified shoulder without organ or systems involvement |
| M05.72 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of elbow without organ or systems involvement |
| M05.721 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right elbow without organ or systems involvement |
| M05.722 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left elbow without organ or systems involvement |
| M05.729 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified elbow without organ or systems involvement |
| M05.73 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of wrist without organ or systems involvement |
| M05.731 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right wrist without organ or systems involvement |
| M05.732 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left wrist without organ or systems involvement |
| M05.739 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified wrist without organ or systems involvement |
| M05.74 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of hand without organ or systems involvement |
| M05.741 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right hand without organ or systems involvement |
| M05.742 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left hand without organ or systems involvement |
| M05.749 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified hand without organ or systems involvement |
| M05.75 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of hip without organ or systems involvement |
| M05.751 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right hip without organ or systems involvement |
| M05.752 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left hip without organ or systems involvement |
| M05.759 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified hip without organ or systems involvement |
| M05.76 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of knee without organ or systems involvement |
| M05.761 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right knee without organ or systems involvement |
| M05.762 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left knee without organ or systems involvement |
| M05.769 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified knee without organ or systems involvement |
| M05.77 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or systems involvement |
| M05.771 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right ankle and foot without organ or systems involvement |
| M05.772 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left ankle and foot without organ or systems involvement |
| M05.779 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified ankle and foot without organ or systems involvement |
| M05.79 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement |
| M05.7A | ICD10CM | Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvement |
| M05.8 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor |
| M05.80 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified site |
| M05.81 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of shoulder |
| M05.811 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right shoulder |
| M05.812 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left shoulder |
| M05.819 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified shoulder |
| M05.82 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of elbow |
| M05.821 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right elbow |
| M05.822 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left elbow |
| M05.829 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified elbow |
| M05.83 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of wrist |
| M05.831 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right wrist |
| M05.832 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left wrist |
| M05.839 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified wrist |
| M05.84 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of hand |
| M05.841 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right hand |
| M05.842 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left hand |
| M05.849 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified hand |
| M05.85 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of hip |
| M05.851 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right hip |
| M05.852 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left hip |
| M05.859 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified hip |
| M05.86 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of knee |
| M05.861 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right knee |
| M05.862 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left knee |
| M05.869 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified knee |
| M05.87 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of ankle and foot |
| M05.871 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right ankle and foot |
| M05.872 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left ankle and foot |
| M05.879 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified ankle and foot |
| M05.89 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of multiple sites |
| M05.8A | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of other specified site |
| M05.9 | ICD10CM | Rheumatoid arthritis with rheumatoid factor, unspecified |
| M05.A | ICD10CM | Abnormal rheumatoid factor and anti-citrullinated protein antibody with rheumatoid arthritis |
| M06 | ICD10CM | Other rheumatoid arthritis |
| M06.0 | ICD10CM | Rheumatoid arthritis without rheumatoid factor |
| M06.00 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified site |
| M06.01 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, shoulder |
| M06.011 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right shoulder |
| M06.012 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left shoulder |
| M06.019 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified shoulder |
| M06.02 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, elbow |
| M06.021 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right elbow |
| M06.022 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left elbow |
| M06.029 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified elbow |
| M06.03 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, wrist |
| M06.031 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right wrist |
| M06.032 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left wrist |
| M06.039 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified wrist |
| M06.04 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, hand |
| M06.041 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right hand |
| M06.042 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left hand |
| M06.049 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified hand |
| M06.05 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, hip |
| M06.051 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right hip |
| M06.052 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left hip |
| M06.059 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified hip |
| M06.06 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, knee |
| M06.061 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right knee |
| M06.062 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left knee |
| M06.069 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified knee |
| M06.07 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, ankle and foot |
| M06.071 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right ankle and foot |
| M06.072 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left ankle and foot |
| M06.079 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified ankle and foot |
| M06.08 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, vertebrae |
| M06.09 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, multiple sites |
| M06.0A | ICD10CM | Rheumatoid arthritis without rheumatoid factor, other specified site |
| M06.8 | ICD10CM | Other specified rheumatoid arthritis |
| M06.80 | ICD10CM | Other specified rheumatoid arthritis, unspecified site |
| M06.81 | ICD10CM | Other specified rheumatoid arthritis, shoulder |
| M06.811 | ICD10CM | Other specified rheumatoid arthritis, right shoulder |
| M06.812 | ICD10CM | Other specified rheumatoid arthritis, left shoulder |
| M06.819 | ICD10CM | Other specified rheumatoid arthritis, unspecified shoulder |
| M06.82 | ICD10CM | Other specified rheumatoid arthritis, elbow |
| M06.821 | ICD10CM | Other specified rheumatoid arthritis, right elbow |
| M06.822 | ICD10CM | Other specified rheumatoid arthritis, left elbow |
| M06.829 | ICD10CM | Other specified rheumatoid arthritis, unspecified elbow |
| M06.83 | ICD10CM | Other specified rheumatoid arthritis, wrist |
| M06.831 | ICD10CM | Other specified rheumatoid arthritis, right wrist |
| M06.832 | ICD10CM | Other specified rheumatoid arthritis, left wrist |
| M06.839 | ICD10CM | Other specified rheumatoid arthritis, unspecified wrist |
| M06.84 | ICD10CM | Other specified rheumatoid arthritis, hand |
| M06.841 | ICD10CM | Other specified rheumatoid arthritis, right hand |
| M06.842 | ICD10CM | Other specified rheumatoid arthritis, left hand |
| M06.849 | ICD10CM | Other specified rheumatoid arthritis, unspecified hand |
| M06.85 | ICD10CM | Other specified rheumatoid arthritis, hip |
| M06.851 | ICD10CM | Other specified rheumatoid arthritis, right hip |
| M06.852 | ICD10CM | Other specified rheumatoid arthritis, left hip |
| M06.859 | ICD10CM | Other specified rheumatoid arthritis, unspecified hip |
| M06.86 | ICD10CM | Other specified rheumatoid arthritis, knee |
| M06.861 | ICD10CM | Other specified rheumatoid arthritis, right knee |
| M06.862 | ICD10CM | Other specified rheumatoid arthritis, left knee |
| M06.869 | ICD10CM | Other specified rheumatoid arthritis, unspecified knee |
| M06.87 | ICD10CM | Other specified rheumatoid arthritis, ankle and foot |
| M06.871 | ICD10CM | Other specified rheumatoid arthritis, right ankle and foot |
| M06.872 | ICD10CM | Other specified rheumatoid arthritis, left ankle and foot |
| M06.879 | ICD10CM | Other specified rheumatoid arthritis, unspecified ankle and foot |
| M06.88 | ICD10CM | Other specified rheumatoid arthritis, vertebrae |
| M06.89 | ICD10CM | Other specified rheumatoid arthritis, multiple sites |
| M06.8A | ICD10CM | Other specified rheumatoid arthritis, other specified site |
| M06.9 | ICD10CM | Rheumatoid arthritis, unspecified |
ICD code information from First Databank (FDB).
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Last reviewed · Source: First Databank (FDB) drug data
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