Formulary
Ruxolitinib: Indications, Dosing, Side Effects and Interactions
Ruxolitinib is a selective inhibitor of the Janus-associated tyrosine kinases JAK1 and JAK2.
MedNext Academy | 3 min read
Ruxolitinib: Indications, Dosing, Side Effects and Interactions
Ruxolitinib is a selective inhibitor of the Janus-associated tyrosine kinases JAK1 and JAK2.
Drug action
Ruxolitinib is a selective inhibitor of the Janus-associated tyrosine kinases JAK1 and JAK2.
Indications and dose
**Disease-related splenomegaly or symptoms [in patients with primary myelofibrosis, post-polycythaemia vera myelofibrosis, or post-essential thrombocythaemia myelofibrosis] (specialist use only),Polycythaemia vera (specialist use only)**
- **Adult** (By Mouth): Specialist indication - access specialist resources for dosing information.
**Graft-versus-host disease [with inadequate response to corticosteroids] (under expert supervision)**
- **Adult** (By Mouth): 10 mg twice daily, for dose adjustments or interruption due to side-effects, or for tapering after response seen-consult product literature.
**Graft-versus-host disease [with inadequate response to corticosteroids] (under expert supervision) for ruxolitinib**
- **Child 6-11 years** (By mouth): 5 mg twice daily, for dose adjustments or interruption due to side-effects, or for tapering after response seen-consult product literature.
- **Child 12-17 years** (By mouth): 10 mg twice daily, for dose adjustments or interruption due to side-effects, or for tapering after response seen-consult product literature.
Cautions
Major adverse cardiovascular events; thromboembolic events (history of, or risk factors for) Cautions, further information Major adverse cardiovascular events The benefits versus risks of treatment should be considered prior to starting or continuing treatment for patients with risk factors for major adverse cardiovascular events, such as those aged 65 years or older, current or past long-time smokers, those with a history of atherosclerotic cardiovascular disease, or those with other cardiovascular risk factors. M
Contraindications
Active serious infection (delay treatment until infection resolved)
Side effects
Common or very common Anaemia; BK virus infection; bruising; constipation; dizziness; dyslipidaemia; flatulence; haemorrhage; headache; hypertension; increased risk of infection; intracranial haemorrhage; nausea; neutropenia; pancytopenia; sepsis; thrombocytopenia; weight increased Uncommon Hepatitis B reactivation Frequency not known Cardiac death; embolism and thrombosis; malignancy; myocardial infarction; neoplasms; progressive multifocal leukoencephalopathy (PML) (withhold treatment); stroke
Interactions
**Other interactions (7):**
- No interaction studies have been performed with topically administered ruxolitinib.
- The potential for interactions with ruxolitinib is considered to be low because of the limited systemic exposure following topical administration.
- Based on in vitro data, ruxolitinib is predominantly cleared by cytochrome P450 3A4 (CYP3A4) metabolism.
- Interaction potential was evaluated for oral ruxolitinib in dedicated clinical pharmacology studies that included co-administration of strong or moderate CYP3A4 inhibitors or a strong inducer.
- The use of ruxolitinib cream in combination with other topical medicinal products used to treat vitiligo has not been evaluated and co-application on the same skin areas is not recommended.
- The efficacy and safety of the combination of ruxolitinib cream with narrow-band ultraviolet B (NB-UVB) phototherapy has not been established; no recommendation can be made.
Pregnancy
Avoid (toxicity in animal studies); M recommendation also supported by specialist sources.
Breast feeding
Specialist sources indicate avoid breast-feeding during and for at least 2 weeks after treatment (no human data available).
Hepatic impairment
Caution (risk of reduced elimination). M Dose adjustments When used for Disease-related splenomegaly or symptoms [in patients with primary myelofibrosis, post-polycythaemia vera myelofibrosis, or post-essential thrombocythaemia myelofibrosis] or Polycythaemia vera: Consult specialist resources for dosing information. When used for Graft-versus-host disease [with inadequate response to corticosteroids]: In hepatic impairment not caused by Graft-versus-host disease, reduce starting dose by 50%. M In Graft-versus-host disease with hepatic involvement and raised total bilirubin exceeding 3 times the upper limit of normal, monitor blood counts more frequently for toxicity and consider dose reduction M -consult product literature.
Renal impairment
Dose adjustments When used for Disease-related splenomegaly or symptoms [in patients with primary myelofibrosis, post-polycythaemia vera myelofibrosis, or post-essential thrombocythaemia myelofibrosis] or Polycythaemia vera: Consult specialist resources for dosing information. When used for Graft-versus-host disease [with inadequate response to corticosteroids]: Reduce starting dose by 50% and administer twice daily if creatinine clearance less than 30 mL/minute. M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Ruxolitinib in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

