Ruxolitinib

Ruxolitinib is a prescription medication used to treat certain kinds of myelofibrosis, a condition that causes scar tissue to replace bone marrow. This leads to decreased blood cell production. Ruxolitinib is also used to treat patients with polycythemia vera.

Ruxolitinib belongs to a group of drugs called kinase inhibitors. Ruxolitinib treat certain kinds of myelofibrosis by helping prevent scar tissue from forming in the bone marrow.

Ruxolitinib treats polycythemia vera by inhibiting certain enzymes involved in regulating blood and how your immune system works.

This medication comes in tablet form and is usually taken twice a day, with or without food.

Common side effects of ruxolitinib include headache and constipation. Ruxolitinib can cause dizziness. Do not drive or operate heavy machinery until you know how ruxolitinib affects you.

Ruxolitinib is a prescription medicine used to treat people with intermediate or high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera myelofibrosis and post-essential thrombocythemia myelofibrosis.

Ruxolitinib is also used to treat patients with polycythemia vera, a chronic type of bone marrow disease.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Ruxolitinib may be found in some form under the following brand names:

• Jakafi

Ruxolitinib can cause serious side effects including:

• Low blood cell counts
• Infection

See "Drug Precautions".

The most common side effects of ruxolitinib include:

• dizziness
• constipation
• headache
• shingles

Tell your healthcare provider about any side effect that bothers you or that does not go away.

These are not all the possible side effects of ruxolitinib. Ask your healthcare provider or pharmacist for more information.

Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins and herbal supplements. Taking ruxolitinib with certain other medicines may affect how ruxolitinib works.

Especially tell your healthcare provider if you take medicine for:

• Fungal infections
• Bacterial infections
• HIV-AIDS

Ask your healthcare provider or pharmacist if you are not sure if your medicine is one listed above.

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Ruxolitinib can cause serious side effects including:

Low blood cell counts: Ruxolitinib may cause low platelet counts (thrombocytopenia), low red blood cell counts (anemia), and low white blood cell counts (neutropenia). Your healthcare provider will do a blood test to check your blood cell counts before you start ruxolitinib and regularly during your treatment. Tell your healthcare provider right away if you develop any of these symptoms:

• unusual bleeding
• bruising
• fatigue
• shortness of breath
• fever

Infection: You may be at risk for developing a serious infection while taking ruxolitinib. Tell your healthcare provider if you have:

• chills
• aches
• fever
• nausea
• vomiting
• weakness
• painful skin rash or blisters

Do not take ruxolitinib if you are allergic to any of its ingredients.

Do not drink grapefruit juice while taking ruxolitinib. Grapefruit juice can affect the amount of ruxolitinib in your blood.

Before taking ruxolitinib, tell your healthcare provider if you:

• have an infection.
• have or have had liver or kidney problems.
• are on dialysis. Ruxolitinib should be taken after your dialysis.
• have any other medical conditions.
• are pregnant, or plan to become pregnant.
• are breast-feeding or plan to breast-feed. 

Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins and herbal supplements. Taking ruxolitinib with certain other medicines may affect how ruxolitinib works.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your healthcare provider if you are breastfeeding or plan to breastfeed. It is not known if ruxolitinib passes into your breast milk. You and your healthcare provider should decide if you will take ruxolitinib or breast-feed. You should not do both.

• Take ruxolitinib exactly as your healthcare provider tells you.
• Do not change your dose or stop taking ruxolitinib without first talking to your healthcare provider.
• You can take ruxolitinib with or without food.
• Ruxolitinib may also be given through certain nasogastric tubes.
  • Tell your healthcare provider if you cannot take ruxolitinib by mouth. Your healthcare provider will decide if you can take ruxolitinib through a nasogastric tube.
  • Ask your healthcare provider to give you specific instruction on how to properly take ruxolitinib through a nasogastric tube.
• Do not drink grapefruit juice while taking ruxolitinib. Grapefruit juice can affect the amount of ruxolitinib in your blood.
• If you take too much ruxolitinib call your healthcare provider or go to the nearest hospital emergency room department right away. Take the bottle of ruxolitinib with you.
• If you miss a dose of ruxolitinib, take your next dose at your regular time. Do not take 2 doses at the same time.
• You will have regular blood tests during your treatment with ruxolitinib. Your healthcare provider may change your dose of ruxolitinib or stop your treatment based on the results of your blood tests.

Take ruxolitinib exactly as prescribed. 

The ruxolitinib dose is individualized based on your:

• condition
• platelet count
• response to ruxolitinib
• other medications

The recommended starting dose of ruxolitinib for myelofibrosis is 5 mg, 15 mg, and 20 mg twice daily and the dose will depend on your platelet count. Your healthcare provider may increase or decrease your dose, or tell you to stop taking ruxolitinib, depending on how this medication affects you.  

Continue taking ruxolitinib every day for as long as your healthcare provider tells you to. This is a long-term treatment. Do not change dose or stop taking ruxolitinib without first talking to your healthcare provider.  After stopping treatment, myelofibrosis signs and symptoms are expected to return.

The recommended starting dose of ruxolitinib for polycythemia vera is 10 mg twice daily.

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store ruxolitinib at room temperature between 68°F and 77°F (20°C and 25°C).
• Keep this and all medicines out of the reach of children.