RUXOLITINIB 25MG


Description


Jakavi 25mg is a targeted therapy. It is an oral receptor tyrosine kinase inhibitor . Jakavi 25mg works by blocking certain enzymes in the body that affect blood cell production. Jakavi 25mg is prescription drug provided under supervision


Indication


Jakavi 25mg is indicated for the treatment in patients with intermediate and high-risk myelofibrosis.


ADME


Absorption:
rapid absorption and not affected by food maximum plasma level is 1.5 hours.
Distribution:
volume of distribution is 76.6 L plasma protein binding
Metabolism:
metabolized by CYP3A4
Elimination:
excreted through urine 74% and unchanged drug is <1% and through urine 22% ,<1 % as unchanged drug.






Dosage & Administration


Myelofibrosis :
Kinase inhibitor uses for treatment of patients with intermediate or high-risk myelofibrosis, involving mainly myelofibrosis, post-PolycythemiaVera myelofibrosis and post-essential thrombocythemia myelofibrosis
Starting recommended doses for myelofibrosis:
If Platelet count >200 x10^9/L the dose given is 20 mg PO BID If Platelet count 100-200 x10^9/L the dose given is 15 mg PO BID If Platelet count 50 to <100 x10^9/L the dose given is 5 mg PO BID Titrate dose based on response; not to exceed 25 mg PO BID
Polycythemia Vera:
The recommended dose is 10mg PO BID Undergo CBC and platelet count prior starting and q2-4wk until doses are stabilized, and then as clinically used.

Mechanism Of Action


Ruxolitinib belongs to kinase inhibitor which is selective for the Janus analogue Kinases (JAK) 1 and 2. These kinases are necessary for the mediation of cytokine and growth factor signalling which in turn effect immune function and hematopoiesis. The signalling process contains signal transducers and transcription activators (STAT) which modulate gene expression. Patients having myelofibrosis contain abnormal JAK1 and JAK2 activity,henceRuxolitinibfunction to regulate this.

Precautions


Non-melanoma skin cancers including basal cell, squamous cell, and Merkel cell carcinoma have occurred in patients treated with Jakavi 25mg. Perform periodic skin examinations.
Treatment with Jakavi 25mg can resulted in thrombocytopenia, anemia and neutropenia. Control thrombocytopenia by decreasing the dose or temporarily interfere with Jakavi 25mg. Platelet transfusions may be necessary.
Severe problem infection caused by delay initiate treatment with Jakavi 25mg until active severe infection have resolved.
Tuberculosis infection has been resulted in patients getting Jakavi 25mg. Observe patients receiving Jakavi 25mg for signs and symptoms of active tuberculosis and manage promptly.
Progressive multifocal leukoencephalopathy (PML) has occurred with Jakavi 5mgtreatment. If PML is suspected, stop Jakavi 25mg and evaluate

Drug Interaction


Jakavi 25mg combination with fluconazole doses greater than 200mg daily may increase Ruxolitinib exposure leads to increase the risks of exposure related adverse reaction.
Concomitant use of Jakavi 25mg with strong CYP3A4 inhibitors will increases Ruxolitinib exposure.
Concomitant use of Jakavi 25mg with strong CYP3A4 inducers will reduces Ruxolitinib exposure.

Pregnancy


Avoid becoming pregnancy during Jakavi 25mg treatment. There are no studies with the use of Jakavi 25mg in pregnant women to inform drug-along risks.

Side Effects


Common side effects:
Anemia, Thrombocytopenia
Serious side effects :
Increased liver enzymes, Diarrhea, Bruising, Swelling, Neutropenia, Dizziness, Increased cholesterol, Shortness of breath, Nasopharyngitis, Headache, Constipation, Nausea & Vomiting, Insomnia

Missed Dose


If dose is failed to take then have the dose immediately before next dose timing reaches or skip the missed dose and continue the regular schedule.Consult doctors regarding missed dose.



Lactation


During treatment with Jakavi 25mg avoid breast feeding to the infants. Excretion into human milk is unknown.


Storage


Jakavi 25mg stored at 200C to 280C. Protect away from light and moisture Dispense in its original container


Contraindication


Hypersensitivity


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