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Jakafi (ruxolitinib) Disease Interactions

There are 9 disease interactions with Jakafi (ruxolitinib):

Moderate

Multikinase Inhibitors (Includes Jakafi) ↔ Lung Toxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Interstitial Pneumonitis, Pulmonary Impairment

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures. Immediately withhold treatment in patients diagnosed with ILD/pneumonitis and permanently discontinue therapy if no other potential causes of ILD/pneumonitis have been identified.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Cytopenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Anemia, Neutropenia, Thrombocytopenia

The use of ruxolitinib can cause thrombocytopenia, anemia, and neutropenia. It is recommended to manage thrombocytopenia by reducing the dose, temporarily interrupting treatment with ruxolitinib, or as clinically appropriate. Perform a pre-treatment complete blood count (CBC) and monitor CBCs every 2 to 4 weeks until doses are stabilized, and then as clinically indicated. Close monitoring is recommended.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Hepatic Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

A dose reduction of ruxolitinib is recommended for patients with hepatic impairment, particularly those patients with myelofibrosis with a platelet count between 50 X 109/L and 150 X 109/L. Close monitoring is recommended.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Hepatitis B

Moderate Potential Hazard, Moderate plausibility

Applies to: Infectious Hepatitis

Hepatitis B viral load (HBV-DNA titer) increases, with or without associated elevations in alanine aminotransferase and aspartate aminotransferase, have been reported in patients with chronic HBV infections taking ruxolitinib. The effect of ruxolitinib on viral replication in patients with chronic HBV infection is unknown. Care and close monitoring is recommended and patients with chronic HBV infection should be treated and monitored according to clinical guidelines.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Infections

Moderate Potential Hazard, Moderate plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

Serious bacterial, mycobacterial, fungal and viral infections have been reported in patients receiving ruxolitinib. It is recommended to delay starting therapy with ruxolitinib until serious active infections have resolved. Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment. Treatment should be interrupted if a patient develops a serious infection, an opportunistic infection, or sepsis and appropriate therapy should be instituted according to clinical guidelines. Prompt management of signs and symptoms of infection is advisable.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Lipid Elevations

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperlipidemia

The use of ruxolitinib may increase total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides. It is recommended to assess lipid parameters approximately 8-12 weeks following initiation of therapy and to monitor and treat per clinical guidelines for the management of hyperlipidemia. Care should be exercised when using this agent in patients with lipids disorders.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Pml

Moderate Potential Hazard, Moderate plausibility

Applies to: Immunodeficiency

The use of ruxolitinib may increase the risk of progressive multifocal leukoencephalopathy (PML). Healthcare professionals should monitor patients for any new sign or symptom suggestive of PML. Withhold therapy dosing immediately and perform an appropriate diagnostic evaluation at the first sign or symptom suggestive of PML.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Renal Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

A dose reduction of ruxolitinib is recommended for patients with moderate or severe renal impairment, particularly those patients with myelofibrosis with a platelet count between 50 X 10^9/L and 150 X 10^9/L; and in patients presenting with end stage renal disease on dialysis. Ruxolitinib is not removed by dialysis; however, the removal of some active metabolites by dialysis cannot be ruled out.

Moderate

Ruxolitinib (Includes Jakafi) ↔ Tuberculosis

Moderate Potential Hazard, Moderate plausibility

Applies to: Tuberculosis -- Active, Tuberculosis -- Latent

Before initiating ruxolitinib, patients should be screened for latent or active tuberculosis infection. Prior to initiating therapy with ruxolitinib patients should be evaluated for tuberculosis risk factors, and those at higher risk should be tested for latent infection. Patients should be closely monitored for any signs and symptoms of tuberculosis, including those patients who tested negative for latent tuberculosis infection before initiating therapy. Patients with latent tuberculosis should be treated with standard therapy before initiation of treatment and should be closely screened for whether initiating anti-tuberculosis therapy is appropriate.

Jakafi (ruxolitinib) drug Interactions

There are 391 drug interactions with Jakafi (ruxolitinib)

Jakafi (ruxolitinib) alcohol/food Interactions

There are 2 alcohol/food interactions with Jakafi (ruxolitinib)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2017 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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