Ruxolitinib (JAKAVI)

Myelofibrosis and polycythemia vera

Myelofibrosis‍

• Platelet Count Greater than 200,000/mm3: 20mg orally twice daily continuously
• Platelet Count 100,000 – 200,000/mm3: 15mg orally twice daily continuously
• Platelet Count 75,000 to less than 100,000/mm3: 10mg orally twice daily continuously
• Platelet Count 50,000 to less than 75,000/mm3: 5mg orally twice daily continuously

Polycythemia vera

• Platelet Count Greater than 200,000/mm3: 10mg orally twice daily continuously
• Platelet Count 100,000 – 200,000/mm3: 10mg orally twice daily continuously
• Platelet Count 75,000 to less than 100,000/mm3: 5mg orally twice daily continuously
• Platelet Count 50,000 to less than 75,000/mm3: 5mg orally twice daily continuously

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Available as 5 mg, 10 mg, 15 mg, and 20 mg tablets. Tablets contain lactose. A nasogastric solution can be prepared for patients unable to swallow them and who need NG administration, please discuss with your pharmacy team. Store at room temperature.

Janus Associated Kinase (JAK) Inhibitor

Take with or without food

If a dose is missed, patients should be instructed not to take the missed dose but to resume with the next scheduled dose.

Common: Anemia, Thrombocytopenia, Bruising.

Less Common: Neutropenia, Decreased heart rate/ PR prolongation, QTc prolongation, Herpes zoster, Lipid abnormalities.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential (2 - 4 weeks until doses are stabilized, and then as clinically indicated), liver and renal function tests, ECG, pulse rate and blood pressure.

If clinically indicated: liver and renal function, ECG, heart rate and blood pressure, lipids (total cholesterol, LDL, triglycerides).

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Ensure patient does not stop ruxolitinib abruptly. Tapering of ruxolitinib is required.

BC Cancer. BC Cancer Drug Manual. Ruxolitinib.  Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Ruxolitinib_monograph.pdf. Updated June 1, 2022. Accessed February 2, 2024.

Lexicomp. Ruxolitinib Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/7155640?cesid=1je0oPMLW9W&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Druxolitinib%26t%3Dname%26acs%3Dtrue%26acq%3Druxolitinib. Updated January 24, 2024. Accessed February 2, 2024.

Cancer Care Ontario. Ruxolitinib Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/44291. Updated February 2023. Accessed January 22, 2024.

Novartis Pharmaceuticals Canada Inc. JAKAVI® Product Monograph. Dorval, Quebec. Updated September 22, 2015.