Ruxolitinib

Ruxolitinib, as an innovative JAK inhibitor, has shown significant efficacy in the treatment of myelofibrosis and other diseases.

1. Drug name

1. Generic name: Ruxolitinib (Ruxolitinib)

2. Trade name: Jakafi ™

2. Indications

It is used to treat patients with intermediate and high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera myelofibrosis and post-essential thrombocythemia myelofibrosis.

3. Specifications and properties

5mg tablets.

IV. Main ingredients

1. Active ingredient: Ruxolitinib phosphate.

2. Excipients: Microcrystalline cellulose, lactose monohydrate, magnesium stearate, colloidal silica, hydroxypropyl cellulose, etc.

5. Usage and dosage

1. Initial dose of : adjusted according to platelet count:

Platelet>200×10⁹/L: 20mg twice daily.

Platelets 100-200×10⁹/L: 15mg twice daily.

2. Dose adjustment :

Monitor blood routine every 2-4 weeks, and adjust the dose according to the degree of thrombocytopenia (if platelets are <50×10⁹/L, pause).

When the effect is insufficient, the dose can be increased by 5 mg every 2 weeks, up to a maximum of 25 mg twice a day.

3. Course of treatment : If there is no spleen shrinkage or symptom improvement within 6 months, the drug needs to be discontinued.

6. Medication precautions

1. Diet : Can be taken with food or on an empty stomach.

2. Missed dose of : Skip the missed dose and take the next dose at the originally planned time.

3. Vomiting : If you vomit after taking the medicine, there is no need to take another dose.

4. Nasogastric tube administration : Dissolve the tablets in 40mL of water and stir for 10 minutes, administer the drug through the nasogastric tube within 6 hours, and then flush the tube with 75mL of water.

7. Medication for special groups

1. Renal insufficiency :

Moderate or severe (CrCl15-59mL/min): initial dose 10mg twice daily.

It is contraindicated in patients with end-stage renal disease (CrCl<15mL/min) and who do not require dialysis.

2. Hepatic insufficiency :

Any degree of hepatic insufficiency and platelets 100-150×10⁹/L: The initial dose is 10 mg twice a day.

Disabled if platelets <100×10⁹/L.

3. Pregnant women and lactating women : During pregnancy, use it only when the benefits outweigh the risks; during lactation, you need to stop taking the drug or stop breastfeeding.

8. Adverse reactions

1. Common hematological reactions : Thrombocytopenia (69.7%), anemia (96.1%), neutropenia (18.7%).

2. Non-hematological reactions : Bruising (23.2%), dizziness (18.1%), headache (14.8%), weight gain (7.1%).

3. Infection risk : Be wary of opportunistic infections such as herpes zoster.

9. Contraindications

There are no clear contraindications, but patients with severe liver and kidney dysfunction and platelets <100×10⁹/L should avoid using it.

10. Drug interactions

1. Strong CYP3A4 inhibitor (such as ketoconazole): The dose needs to be reduced to 10 mg twice a day.

2. Strong CYP3A4 inducer (such as rifampicin): It may reduce the efficacy, and the efficacy needs to be monitored.

11. Storage method

Save at room temperature (20°C-25°C) and avoid moisture and light.