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How it is administered
Ruxolitinib is taken by mouth as a tablet. The tablets come in various strengths, including 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg. The medication is usually taken twice daily, with or without food. For patients who cannot swallow tablets, ruxolitinib can be suspended in water and administered through a nasogastric tube.
The starting dose for polycythemia vera is typically 10 mg twice daily, but your doctor will adjust the dose based on your blood counts and how you respond to treatment.
How it works
Ruxolitinib is a type of medicine called a kinase inhibitor. It works by blocking specific enzymes known as Janus Associated Kinases (JAK1 and JAK2). These enzymes are involved in sending signals that help control the production and growth of blood cells and immune system activity.
In polycythemia vera and other related blood cancers, these JAK enzymes can become overactive, leading to the production of too many blood cells and causing symptoms like an enlarged spleen and increased risk of blood clots. By blocking JAK1 and JAK2, ruxolitinib helps to reduce the number of abnormal blood cells, decrease spleen size, and control symptoms such as itching, night sweats, and tiredness. It also helps lower the risk of complications associated with polycythemia vera.
Common side effects
- Thrombocytopenia (low platelet count)
- Anemia (low red blood cell count)
- Neutropenia (low white blood cell count)
- Bruising
- Dizziness
- Headache
- Diarrhea
- Muscle spasms
- Constipation
- Weight gain
- High cholesterol
- High blood pressure
- Infections (including herpes zoster)
Most side effects are related to changes in blood counts, so regular monitoring is important during treatment.
Who Should take it
Ruxolitinib is indicated for adults with polycythemia vera who have had an inadequate response to or are intolerant of hydroxyurea. It is also used in adults with intermediate or high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera myelofibrosis, and post-essential thrombocythemia myelofibrosis.
If you have polycythemia vera and your blood counts are not well controlled with hydroxyurea, or you cannot tolerate hydroxyurea due to side effects, your doctor may recommend ruxolitinib. It is also used in certain cases of graft-versus-host disease after stem cell transplant.
Who should not take it
There are no absolute contraindications listed for ruxolitinib, but it should not be used in people who are allergic to it or any of its ingredients. Caution is needed in people with very low blood counts (anemia, thrombocytopenia, or neutropenia), active serious infections, or severe liver or kidney impairment.
Before starting ruxolitinib, your doctor will check your blood counts and screen for infections like tuberculosis and hepatitis. If you are pregnant, planning to become pregnant, or breastfeeding, discuss this with your doctor, as ruxolitinib may not be safe in these situations.
Commonly used with
Ruxolitinib is often used alone for polycythemia vera, but in some cases, it may be used alongside other supportive treatments such as low-dose aspirin or phlebotomy (blood removal) to help control blood counts and reduce the risk of blood clots.
In other blood cancers or after stem cell transplant, it may be used with other medications to manage symptoms or complications.
Commonly tested with
In clinical studies, ruxolitinib has been compared to best available therapy, which may include hydroxyurea, interferon, anagrelide, or observation. It has also been tested in combination with corticosteroids and other immunosuppressive drugs in the setting of graft-versus-host disease.
Your doctor will monitor your response to ruxolitinib with regular blood tests and may adjust your treatment based on these results.
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