How it is administered
Ruxolitinib is available as oral tablets (for example, 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg strengths) and as a topical cream (for skin conditions). For blood cancers, it is typically taken by mouth, with or without food, as directed by your doctor. The dose depends on your condition, blood counts, and other factors. Tablets should be swallowed whole with water.
For patients unable to swallow tablets, ruxolitinib can be administered through a nasogastric tube by suspending a tablet in water. The topical cream formulation is not used for blood cancers.
How it works
Ruxolitinib is a type of medicine called a Janus kinase (JAK) inhibitor. It works by blocking the activity of JAK1 and JAK2 enzymes, which are important in the signaling pathways that help blood cells grow and function. In certain blood cancers, such as myelofibrosis and polycythemia vera, these pathways become overactive, leading to abnormal blood cell growth and symptoms like enlarged spleen, fatigue, and other complications.
By inhibiting JAK1 and JAK2, ruxolitinib helps to reduce the abnormal growth of blood cells, decrease inflammation, and control symptoms. In patients with graft-versus-host disease (GVHD), ruxolitinib can reduce the immune response that causes tissue damage. Its action helps improve quality of life by reducing spleen size and controlling disease-related symptoms.
Common side effects
- Thrombocytopenia (low platelets)
- Anemia (low red blood cells)
- Neutropenia (low white blood cells)
- Bruising
- Dizziness
- Headache
- Diarrhea
- Infections (including bacterial, viral, and fungal)
- Weight gain
- High cholesterol or triglycerides
- Increased risk of skin cancers (non-melanoma)
In patients with GVHD, infections and edema (swelling) are also common. Always report any new or worsening symptoms to your healthcare provider.
Who Should take it
Ruxolitinib is used in adults (and some children 12 years and older) for:
- Intermediate or high-risk myelofibrosis (including primary myelofibrosis, post-polycythemia vera myelofibrosis, and post-essential thrombocythemia myelofibrosis)
- Polycythemia vera when other treatments like hydroxyurea are not effective or tolerated
- Steroid-refractory acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) after failure of other systemic therapies
Your doctor will determine if ruxolitinib is appropriate for you based on your diagnosis, previous treatments, and overall health.
Who should not take it
There are no absolute contraindications listed for ruxolitinib, but it should not be started if you have an active, serious infection. Caution is needed if you have a history of low blood counts (anemia, thrombocytopenia, or neutropenia), liver or kidney problems, or a history of certain infections (such as tuberculosis, hepatitis B or C, or herpes zoster).
Ruxolitinib should be used with caution in patients with a history of cardiovascular disease, blood clots, or certain cancers. It is not recommended during pregnancy or breastfeeding. Always discuss your full medical history with your doctor before starting ruxolitinib.
Commonly used with
Ruxolitinib may be used alongside other supportive treatments such as blood transfusions, antibiotics, or other medications to manage symptoms or side effects. In graft-versus-host disease, it may be used after or in combination with corticosteroids and other immunosuppressive drugs.
It is important to tell your doctor about all medications you are taking, as ruxolitinib can interact with drugs that affect the liver enzyme CYP3A4 (such as ketoconazole, fluconazole, or rifampin).
Commonly tested with
Ruxolitinib has been tested in combination with other therapies for blood cancers, such as hydroxyurea (for polycythemia vera), corticosteroids (for GVHD), and other immunosuppressants. In clinical trials, it has also been compared to best available therapy, which may include a range of medications depending on the specific blood cancer.
Your doctor will monitor your blood counts and other lab tests regularly while you are on ruxolitinib to ensure it is safe and effective for you.