Drug Interaction Report

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration of topical ruxolitinib with other Janus Kinase (JAK) inhibitors, biologic immunomodulators, or other potent immunosuppressants (e.g., cyclosporine, azathioprine) may potentiate the risk of infections as well as lymphoma and other malignancies. Serious and sometimes fatal infections including bacterial, mycobacterial (e.g., tuberculosis), fungal, viral including viral reactivation, and other opportunistic infections have been reported in patients who have received oral ruxolitinib, including oral ruxolitinib for inflammatory conditions.

MANAGEMENT: The safety and efficacy of topical ruxolitinib in combination with immunosuppressive agents has not been evaluated. It is recommended that the concomitant use of topical ruxolitinib with other Janus Kinase (JAK) inhibitors, biologic immunomodulators, or other potent immunosuppressants (e.g., cyclosporine, azathioprine) should be avoided. Patients receiving topical ruxolitinib should be closely monitored for the development of signs and symptoms of infection during and after treatment, including the possible development of tuberculosis in patients who tested negative for latent tuberculosis infection prior to initiating therapy. If a patient develops a serious infection, ruxolitinib topical therapy should be interrupted until the infection is controlled.

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.

Grapefruit and grapefruit juice can increase the levels of cycloSPORINE in your body and should generally not be consumed during treatment. High blood levels of cycloSPORINE can lead to increased risk of serious side effects on kidney, liver, and nervous system functions. If you regularly consume grapefruits or grapefruit juice, you should be monitored for side effects and/or changes in cycloSPORINE levels. However, do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. You should also take cycloSPORINE on a consistent schedule with regard to time of day and relation to meals. Let your doctor know if you experience fever, rash, nausea, vomiting, abdominal pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes), decreased urination, excessive thirst, swelling, weight gain, dizziness, fatigue, weakness, headache, blurred vision, numbness/burning/tingling in the hand and feet, tremors, or convulsions, as they may be symptoms caused by excessive effects of cycloSPORINE.