Care During Chemotherapy and Beyond
(rux oh LI ti nib)
Trade name: Jakafi™
Ruxolitinib is the generic for the trade drug Jakafi™. In some cases,
health care professionals may use the trade name Jakafi™ when referring to the generic
drug name ruxolitinib.
Drug type: Ruxolitinib is a targeted therapy. It is an oral receptor
tyrosine kinase inhibitor - (For more detail, see "How this drug works," below.)
What Ruxolitinib Is Used For:
- For the treatment of intermediate and high risk myelofibrosis.
- For the treatment of acute graft-versus-host (GVHD) not responsive steroids, in adults and pediatric patients 12 years of older.
Note: If a drug has been approved for one use, physicians may elect to use this
same drug for other problems if they believe it may be helpful.
How Ruxolitinib Is Given:
- Ruxolitinib is a pill, taken by mouth, with or without food.
- Take ruxolitinib exactly as prescribed, even if you are feeling better.
- Swallow ruxolitinib tablets whole. Do not chew, crush or break.
- Those who have feeding tubes may also use the tablet. Mix each tablet with 40 mL
of water. Stir for 10 minutes. Give within 6 hours of mixing. Flush the feeding
tube with water before and after this drug is given.
- Do not change your dose or stop ruxolitinib unless your health care provider tells
- If a dose is missed, return to the usual dosing schedule. Do not
take an additional dose.
- Do not take extra doses of ruxolitinib. Call your health care provider right away
if you take too much.
- Avoid grapefruit, grapefruit juice, and supplements that contain grapefruit extract
while taking ruxolitinib. Grapefruit products may increase the amount of ruxolitinib.
- The amount of ruxolitinib that you will receive depends on many factors, your general
health or other health problems, and the type of cancer or condition being treated.
Important things to remember about the side effects of ruxolitinib:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for patients
These side effects are less common side effects (occurring in about 10-29%) of patients
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your health
care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Fever of 100.4° F (38°C or higher, chills)
- Signs of a very bad reaction (wheezing, chest tightness, fever, itching, bad cough,
blue or grey skin color, seizures, or swelling or the face, lips, tongue or throat)
Always inform your health care provider if you experience any unusual symptoms.
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
- Diarrhea (4-6 episodes in a 24-hour period)
- Nausea (interferes with ability to eat and unrelieved with prescribed medication)
- Vomiting (vomiting more than 4-5 times in a 24 hour period)
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst,
dry mouth, dark and decrease amount of urine, or dizziness
- Skin or the whites of your eyes turn yellow
- Urine turns dark or brown (tea color)
- Decreased appetite
- Pain on the right side of your stomach
- Bleed or bruise more easily than normal
- Signs of infection (very bad sore throat, ear or sinus pain, cough, more sputum
or change in color of sputum, pain with passing urine, mouth sores, wound that will
not heal or anal itching or pain)
- Headache, back pain or joint pain
- Skin changes (rash, acne, itching, blisters, peeling, redness or swelling)
Always inform your health care provider if you experience any unusual symptoms.
- Ruxolitinib may interact with many types of medications. Before starting ruxolitinib treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking ruxolitinib.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category C (use in pregnancy only when benefit
to the mother outweighs risk to the fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking ruxolitinib.
Barrier methods of contraception, such as condoms, are recommended during treatment.
Discuss with your doctor when you may safely become pregnant or conceive a child
- Do not breast feed while taking this medication.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your healthcare provider.
- Wash your hands often. Do not touch your eyes or the inside of your nose unless
you have just washed your hands and have not touched anything else in the meantime.
- Ask your doctor or nurse before scheduling dental appointments or procedures.
- Use an electric razor to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- If you should experience nausea, take anti-nausea medications as prescribed by your
doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that are
effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you are taking
ruxolitinib. Testing may include blood work that checks blood counts and liver functions.
How Ruxolitinib Works:
Targeted therapy is the result of about 100 years of research dedicated to understanding
the differences between cancer cells and normal cells. To date, cancer treatment
has focused primarily on killing rapidly dividing cells because one feature of cancer
cells is that they divide rapidly. Unfortunately, some of our normal cells divide
rapidly too, causing multiple side effects.
Targeted therapy is about identifying other features of cancer cells. Scientists
look for specific differences in the cancer cells and the normal cells. This information
is used to create a targeted therapy to attack the cancer cells without damaging
the normal cells, thus leading to fewer side effects. Each type of targeted therapy
works a little bit differently but all interfere with the ability of the cancer
cell to grow, divide, repair and/or communicate with other cells.
There are different types of targeted therapies, defined in three broad categories.
Some targeted therapies focus on the internal components and function of the cancer
cell. The targeted therapies use small molecules that can get into the cell and
disrupt the function of the cells, causing them to die. There are several types
of targeted therapy that focus on the inner parts of the cells. Other targeted therapies
target receptors that are on the outside of the cell. Therapies that target receptors
are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the
blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.
Ruxolitinib is a targeted therapy that targets and binds to the tyrosine kinase
receptors and inhibits Janus Associated Kinases (JAK1 and JAK2) which mediate the
signaling of a number of cytokines and growth factors that are important for hematopoiesis
and immune function. By binding to these receptors, ruxolitinib blocks important
pathways that promote cell division. Myelofibrosis (MF) is a myeloproliferative
neoplasm (MPN) known to be associated with dysregulated JAK1 and JAK2 signaling.
Patients with MF who either carry the JAK2 V617 mutation or does not have the JAK2
V617F mutation may both respond to ruxolitinib.
Research continues to identify which cancers may be best treated with targeted therapies
and to identify additional targets for more types of cancer.
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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