Obinutuzumab
/api/v1/drug/obinutuzumabBoxed warning
HEPATITIS B VIRUS REACTIVATION and PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY Hepatitis B Virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death, can occur in patients receiving CD20-directed cytolytic antibodies, including GAZYVA. Screen all patients for HBV infection before treatment initiation. Monitor HBV-positive patients during and after treatment with GAZYVA. Discontinue GAZYVA and concomitant medications in the event of HBV reactivation [see Warnings and Precautions (5.1) ] . Progressive Multifocal Leukoencephalopathy (PML) including fatal PML, can occur in patients receiving GAZYVA [see Warnings and Precautions (5.2) ] . WARNING: HEPATITIS B VIRUS REACTIVATION and PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY See full prescribing information for complete boxed warning. Hepatitis B Virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death. ( 5.1 ) Progressive Multifocal Leukoencephalopathy (PML) resulting in death. ( 5.2 )
Mechanism of action
Sourced from openFDAObinutuzumab is a monoclonal antibody that targets the CD20 antigen expressed on the surface of pre-B and mature B lymphocytes. Upon binding to CD20, obinutuzumab mediates B-cell lysis through (1) engagement of immune effector cells, (2) by directly activating intracellular death signaling pathways (direct cell death), and/or (3) activation of the complement cascade.
Indications
Sourced from openFDA- GAZYVA is a CD20-directed cytolytic antibody indicated: in combination with chlorambucil, for the treatment of patients with previously untreated chronic lymphocytic leukemia (CLL). ( 1.1 , 14 ) in combination with bendamustine followed by GAZYVA monotherapy, for the treatment of patients with follicular lymphoma (FL)who relapsed after, or are refractory to, a rituximab-containing regimen.ICD-10: C85.90, C95.90
Contraindications
Sourced from openFDA- GAZYVA is contraindicated in patients with known hypersensitivity reactions (e.g., anaphylaxis) to obinutuzumab or to any of the excipients, or serum sickness with prior obinutuzumab use [see Warnings and Precautions (5.4) ]. GAZYVA is contraindicated in patients with known hypersensitivity reactions (e.g., anaphylaxis) to obinutuzumab or any of the excipients, including serum sickness with prior obinutuzumab use.contraindicated
Dosage & administration
Sourced from openFDAPremedicate for infusion-related reactions and tumor lysis syndrome. ( 2.1 , 5.3 , 5.4 ) Administer only as intravenous infusion. Do not administer as an intravenous push or bolus. ( 2.1 ) The recommended dosage for chronic lymphocytic leukemia is 100 mg on day 1 and 900 mg on day 2 of Cycle 1, 1,000 mg on day 8 and 15 of Cycle 1, and 1,000 mg on day 1 of Cycles 2–6. ( 2.2 ) The recommended dosage for follicular lymphoma is 1,000 mg on day 1, 8 and 15 of Cycle 1, 1,000 mg on day 1 of Cycles 2-6 or Cycles 2-8, and then 1,000 mg every 2 months for up to 2 years. ( 2.3 ) The recommended dosage for active lupus nephritis is 1,000 mg at the initial infusion, on Week 2, 24, 26, and every 6 months thereafter. ( 2.4 ) 2.1 Important Dosing Information Premedicate before each infusion [see Dosage and Administration (2.4) ] . Provide prophylactic hydration and anti-hyperuricemics to patients at high risk of tumor lysis syndrome [see Dosage and Administration (2.4) and Warnings and Precautions (5.4) ]. Administer only as an intravenous infusion through a dedicated line [see Dosage and Administration (2.6) ] . Do not administer as an intravenous push or bolus. Monitor blood counts at regular intervals. GAZYVA should only be administered by a healthcare professional with appropriate medical support to manage severe infusion-related reactions that can be fatal if they occur [see Warnings and Precautions (5.3) ].
Warnings & precautions
Sourced from openFDAInfusion-Related Reactions : Premedicate patients with glucocorticoid, acetaminophen, and anti-histamine. Monitor patients closely during infusions. Interrupt, reduce rate, or discontinue for infusion-related reactions based on severity. ( 2.1 , 5.3 ) Hypersensitivity Reactions Including Serum Sickness : Discontinue GAZYVA permanently. ( 5.4 ) Tumor Lysis Syndrome : In CLL and FL, premedicate with anti-hyperuricemics and adequate hydration, especially for patients with high tumor burden, high circulating lymphocyte count or renal impairment. Correct electrolyte abnormalities, provide supportive care, and monitor renal function and fluid balance. ( 5.5 ) Serious, Including Fatal, Infections : Do not administer GAZYVA to patients with an active infection. Patients with a history of recurring or chronic infections may be at increased risk of infection. ( 5.6 ) Neutropenia : In patients with Grade 3 to 4 neutropenia, monitor laboratory tests until resolution and for infection. Consider dose delays and infection prophylaxis, as appropriate. ( 5.7 ) Thrombocytopenia : Monitor for decreased platelet counts and bleeding. Transfusion may be necessary. ( 5.8 ) Disseminated Intravascular Coagulation : Evaluate cause and monitor for bleeding, thrombosis, and need for supportive care. ( 5.9 ) Immunization : Avoid administration of live virus vaccines during GAZYVA treatment and until B-cell recovery. ( 5.10 ) Embryo-Fetal Toxicity : Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and use effective contraception.
Adverse reactions
Sourced from openFDAThe following clinically significant adverse reactions are described elsewhere in the labeling: Hepatitis B virus reactivation [see Warnings and Precautions (5.1) ] Progressive multifocal leukoencephalopathy [see Warnings and Precautions (5.2) ] Infusion-related reactions [see Warnings and Precautions (5.3) ] Hypersensitivity reactions including serum sickness [see Warnings and Precautions (5.4) ] Tumor lysis syndrome [see Warnings and Precautions (5.5) ] Infections [see Warnings and Precautions (5.6) ] Neutropenia [see Warnings and Precautions (5.7) ] Thrombocytopenia [see Warnings and Precautions (5.8) ] Disseminated intravascular coagulation [see Warnings and Precautions (5.9) ] The most common adverse reactions (incidence ≥ 20% and ≥ 2% greater in the GAZYVA treated arm in CLL and NHL, and incidence ≥ 5% in the GAZYVA treated arm in LN) were: Previously untreated CLL : infusion-related reactions and neutropenia. ( 6 ) Relapsed or refractory non-Hodgkin lymphoma (NHL) : infusion-related reactions, fatigue, neutropenia, cough, upper respiratory tract infections, and musculoskeletal pain. ( 6 ) Previously untreated NHL : infusion-related reactions, neutropenia, upper respiratory tract infections, cough, constipation, and diarrhea. ( 6 ) Lupus Nephritis : upper respiratory tract infection, COVID-19, urinary tract infection, bronchitis, pneumonia, infusion-related reactions, and neutropenia. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Genentech at 1-888-835-2555 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Use in specific populations
Sourced from openFDALactation : Advise not to breastfeed. ( 8.1 ) 8.1 Pregnancy Risk Summary Based on findings from animal studies and its mechanism of action, GAZYVA can cause fetal B-cell depletion [see Clinical Pharmacology (12.1) ] . There are no data with GAZYVA use in pregnant women to inform a drug-associated risk. Monoclonal antibodies are transferred across the placenta. In animal reproduction studies, weekly intravenous administration of obinutuzumab to pregnant cynomolgus monkeys from day 20 of pregnancy until parturition which includes the period of organogenesis at doses with exposures up to 2.4 times the exposure at the clinical dose of 1,000 mg monthly produced opportunistic infections and immune complex mediated hypersensitivity reactions. No embryo-toxic or teratogenic effects were observed in the monkeys (see Data ) . Advise pregnant women of the potential risk to the fetus. The background risk of major birth defects and miscarriage for the indicated population is unknown; however, the estimated background risk in the U.S. general population of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies.
Pharmacokinetics
Sourced from openFDA- Metabolism
- The pharmacokinetic parameters of obinutuzumab after 100 mg on day 1 and 900 mg on day 2 of Cycle 1, 1,000 mg on day 8 and 15 of Cycle 1, and 1,000 mg on day 1 of Cycles 2-6 for CLL; after 1,000 mg on day 1, 8 and 15 of Cycle 1, 1,000 mg on day 1 of Cycles 2-6 or Cycles 2-8, and then 1,000 mg every 2 months for up to 2 years for NHL; 1,000 mg on day 1, week 2, 24, 26 and every 6 months for up to 76 Weeks for LN are provided in Table 14 . The dosing regimen is within the linear pharmacokinetic behavior of obinutuzumab.
Overdosage
Sourced from openFDAThere has been no experience with overdose in human clinical trials. For patients who experience overdose, treatment should consist of immediate interruption or reduction of GAZYVA and supportive therapy.
Approval history
Sourced from openFDA- Nov 1, 2013BLABLA125486Genentech
FAERS reports
- 1Off Label Use1,77311%
- 2Neutropenia1,3128.3%
- 3Covid-191,0766.8%
- 4Febrile Neutropenia1,0316.5%
- 5Pyrexia9686.1%
- 6Disease Progression8995.7%
- 7Thrombocytopenia8975.7%
- 8Infusion Related Reaction8315.3%
- 9Pneumonia7634.8%
- 10Anaemia6984.4%
- 11Infection5933.8%
- 12Atrial Fibrillation5923.7%
- 13Death5243.3%
- 14Nausea5073.2%
- 15No Adverse Event5063.2%
Clinical trials
The 10 most recently updated of 350 ClinicalTrials.gov registrations naming Obinutuzumab as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- A Study Evaluating the Safety, Pharmacokinetics, and Efficacy of Mosunetuzumab or Glofitamab in Combination With CC-220 and/or CC-99282 in Participants With B-Cell Non-Hodgkin LymphomaRecruiting · Phase 1 · Interventional · 121 enrolled · Hoffmann-La RocheNCT05169515updated 2026-06-12
- Testing Early Treatment for Patients With High-Risk Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Leukemia (SLL), EVOLVE CLL/SLL StudyRecruiting · Phase 3 · Interventional · 247 enrolled · National Cancer Institute (NCI)NCT04269902updated 2026-06-12
- PRESERVE: LUPKYNIS in Combination With Belimumab, Obinutuzumab or Anifrolumab in Patients With Lupus NephritisRecruiting · Phase 4 · Interventional · 150 enrolled · Aurinia Pharmaceuticals Inc.NCT07611214updated 2026-06-12
- Acalabrutinib and Obinutuzumab for the Treatment of Chronic Lymphocytic LeukemiaActive not recruiting · Phase 2 · Interventional · 60 enrolled · M.D. Anderson Cancer CenterNCT04505254updated 2026-06-12
- A Study of Zanubrutinib Plus Anti-CD20 Versus Lenalidomide Plus Rituximab in Participants With Relapsed/Refractory Follicular or Marginal Zone LymphomaRecruiting · Phase 3 · Interventional · 780 enrolled · BeOne MedicinesNCT05100862updated 2026-06-10
- A Study to Evaluate the Safety and Anti-cancer Activity of Loncastuximab Tesirine in Combination With Other Anti-cancer Agents in Participants With Relapsed or Refractory B-cell Non-Hodgkin Lymphoma (LOTIS-7)Recruiting · Phase 1 · Interventional · 200 enrolled · ADC Therapeutics S.A.NCT04970901updated 2026-06-09
- Study of MP0533 in Patients Acute Myeloid Leukemia or Myelodysplastic SyndromeActive not recruiting · Phase 1 · Phase 2 · Interventional · 249 enrolled · Molecular Partners AGNCT05673057updated 2026-06-09
- Radiotherapy in Combination With Glofitamab in Relapsed/Refractory Diffuse Large B Cell LymphomaNot yet recruiting · Phase 2 · Interventional · 40 enrolled · Olivia Newton-John Cancer Research InstituteNCT07634289updated 2026-06-08
- A Study of the Combination of Ibrutinib Plus Venetoclax Versus Chlorambucil Plus Obinutuzumab for the First-line Treatment of Participants With Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL)Active not recruiting · Phase 3 · Interventional · 211 enrolled · Janssen Research & Development, LLCNCT03462719updated 2026-06-08
- A Study of Glofitamab-based Treatment in People With Diffuse Large B-cell LymphomaRecruiting · Phase 2 · Interventional · 42 enrolled · Memorial Sloan Kettering Cancer CenterNCT06765317updated 2026-06-05
Frequently asked questions
- How does Obinutuzumab work?
- Obinutuzumab is a monoclonal antibody that targets the CD20 antigen expressed on the surface of pre-B and mature B lymphocytes. Upon binding to CD20, obinutuzumab mediates B-cell lysis through (1) engagement of immune effector cells, (2) by directly activating intracellular death signaling pathways (direct cell death), and/or (3) activation of the complement cascade.
- What is Obinutuzumab used for?
- According to FDA labeling, Obinutuzumab carries indications including: GAZYVA is a CD20-directed cytolytic antibody indicated: in combination with chlorambucil, for the treatment of patients with previously untreated chronic lymphocytic leukemia (CLL). ( 1.1 , 14 ) in combination with bendamustine followed by GAZYVA monotherapy, for the treatment of patients with follicular lymphoma (FL)who relapsed after, or are refractory to, a rituximab-containing regimen.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Obinutuzumab?
- Obinutuzumab is classified as CD20 (Clusters of Differentiation 20) inhibitors, CD20-directed Cytolytic Antibody, CD20-directed Antibody Interactions.
- What are the brand names for Obinutuzumab?
- Obinutuzumab is marketed under brand names including Gazyva.
- What are the contraindications for Obinutuzumab?
- Obinutuzumab labeling lists contraindications including: GAZYVA is contraindicated in patients with known hypersensitivity reactions (e.g., anaphylaxis) to obinutuzumab or to any of the excipients, or serum sickness with prior obinutuzumab use [see Warnings and Precautions (5.4) ]. GAZYVA is contraindicated in patients with known hypersensitivity reactions (e.g., anaphylaxis) to obinutuzumab or any of the excipients, including serum sickness with prior obinutuzumab use.. Always consult the full prescribing information and a clinician.
obinutuzumab is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.