How it is administered

Ruxolitinib is available as oral tablets (for conditions like myelofibrosis, polycythemia vera, and graft-versus-host disease) and as a topical cream (for skin conditions like atopic dermatitis and vitiligo). For blood cancers, it is most commonly taken by mouth as a tablet, with the dose and frequency tailored to your specific condition and blood counts. Tablets should be swallowed whole, with or without food. If you are unable to swallow tablets, they may be administered through a nasogastric tube as a suspension. Always follow your healthcare provider’s instructions for dosing.

The topical cream form is not used for blood cancers.

How it works

Ruxolitinib is a type of medication called a Janus kinase (JAK) inhibitor. It works by blocking the activity of certain enzymes (JAK1 and JAK2) that are involved in signaling pathways important for blood cell production and immune system function. In diseases like myelofibrosis and polycythemia vera, these pathways can become overactive, leading to abnormal blood cell growth and inflammation.

By inhibiting JAK1 and JAK2, ruxolitinib helps to reduce the production of abnormal blood cells and lower levels of inflammatory substances in the body. This can help shrink an enlarged spleen, improve symptoms such as fatigue and night sweats, and reduce the risk of complications. The medication does not cure blood cancers but can help manage symptoms and improve quality of life.

Who Should take it

Ruxolitinib is indicated for adults with intermediate or high-risk myelofibrosis (including primary myelofibrosis, post-polycythemia vera myelofibrosis, and post-essential thrombocythemia myelofibrosis). It is also used in adults with polycythemia vera who have not responded well to or cannot tolerate hydroxyurea.

Additionally, ruxolitinib is approved for the treatment of steroid-refractory acute and chronic graft-versus-host disease in adults and children aged 12 years and older. If you have one of these conditions, your doctor may consider ruxolitinib as part of your treatment plan, especially if other therapies have not worked or caused significant side effects.

Who should not take it

There are no absolute contraindications listed for ruxolitinib, but it should be used with caution in certain situations. Patients with active, serious infections should not start ruxolitinib until the infection is controlled. If you have a history of tuberculosis, hepatitis B, or other chronic infections, your doctor will need to monitor you closely.

Ruxolitinib should be used with caution in patients with low platelet counts, anemia, or neutropenia, as it can worsen these conditions. It is also important to inform your doctor if you are pregnant, breastfeeding, or have a history of skin cancer, cardiovascular disease, or blood clots, as these may affect your suitability for this medication.

Commonly used with

Ruxolitinib may be used alongside other supportive treatments such as blood transfusions for anemia or platelet transfusions for thrombocytopenia. In the setting of graft-versus-host disease, it may be combined with corticosteroids and other immunosuppressive medications. Always inform your healthcare team about all medications and supplements you are taking, as drug interactions can occur.

Commonly tested with

Ruxolitinib has been tested in combination with other therapies in clinical trials, particularly in the context of graft-versus-host disease where it is often used with corticosteroids and other immunosuppressants. In myelofibrosis and polycythemia vera, it has been compared to or used after other treatments like hydroxyurea. Your doctor will determine the best combination based on your specific condition and response to therapy.