Drug Interactions between ruxolitinib topical and voclosporin

Food may delay and reduce the absorption of voclosporin, which may lead to lower blood levels of the medication and possibly reduced effectiveness. Voclosporin should be taken on an empty stomach at least 1 hour before or 2 hours after food. This will make it easier for your body to absorb the medication. Also, while taking voclosporin, you should avoid grapefruits and grapefruit juice. Grapefruit can raise the blood levels of voclosporin in your body and lead to increased adverse effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. Also, if you are taking voclosporin you should avoid potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your doctor. Taking voclosporin together with these salt substitutes or supplements may cause high levels of potassium in your blood. High levels of potassium can cause weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs. Call your doctor at once if you have any of these symptoms. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Smoking during treatment with topical ruxolitinib may increase the risk of major adverse cardiovascular events (MACE) and the risk of developing malignancies, including lymphomas. During clinical trials, patients who were current or past smokers and received oral Janus Kinase (JAK) inhibitors to treat inflammatory conditions had an additional increased risk of overall malignancies. Additionally, oral JAK inhibitors reportedly increase patients' risk of MACE, including cardiovascular death, myocardial infarction, and stroke, particularly in patients who are current or past smokers or patients with other cardiovascular risk factors.

MANAGEMENT: The potential risks and benefits of topical ruxolitinib should be carefully weighed prior to initiating therapy, particularly in patients with cardiovascular risk factors, as well as those with a history of malignancy, those who develop a malignancy while on treatment, and/or patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur. The manufacturer recommends discontinuing topical ruxolitinib in patients who have experienced a myocardial infarction or stroke.