Drug Interaction Report

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may increase plasma concentrations (Cmax) and systemic exposure (AUC) of topical ruxolitinib, which is primarily metabolized by the isoenzyme. Following administration of ketoconazole (200 mg twice daily for four days), a potent CYP450 3A4 inhibitor, healthy subjects then received a single dose of ruxolitinib (10 mg orally). The Cmax and AUC of ruxolitinib increased 33% and 91% respectively, compared to healthy subjects receiving the oral ruxolitinib dose alone. Increased exposure to ruxolitinib may increase the risk of adverse events. However, clinical data for topical ruxolitinib are not available.

MANAGEMENT: Concomitant use of topical ruxolitinib with potent inhibitors of CYP450 3A4 should generally be avoided. It may be advisable to monitor patients for the development of adverse effects. Consultation with individual package labeling, as well as relevant institutional protocols, may be advisable for further guidance.

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.