Jakavi 20mg 

Jakavi 20mg belongs to the type of targeted therapy. It is an oral receptor tyrosine kinase inhibitor. It acts by inhibiting certain enzymes in the body which affect blood cell production.
Jakavi 20mg is prescription drug provided under supervision of doctors or pharmacists

INDICATION

Jakavi 20mg is indicated for the treatment in patients with intermediate and high-risk myelofibrosis.

DOSAGE

Myelofibrosis :

Kinase inhibitor uses for treatment of patients with intermediate or high-risk myelofibrosis, involving mainly myelofibrosis, post-PolycythemiaVera myelofibrosis and post-essential thrombocythemia myelofibrosis
Starting recommended doses for myelofibrosis
If Platelet count >200 x10^9/L the dose given is 20 mg PO BID
If Platelet count 100-200 x10^9/L the dose given is 15 mg PO BID
If Platelet count 50 to <100 x10^9/L the dose given is 5 mg PO BID
Titrate dose based on response; not to exceed 25 mg PO BID
Polycythemia Vera
The recommended dose is 10mg PO BID
Undergo CBC and platelet count prior starting and q2-4wk until doses are stabilized, and then as clinically used.

MECHANISM

Ruxolitinib is also knowns kinase inhibitor which is discriminating for the Janus analogue Kinases (JAK) 1 and 2. These kinases are required for the mediation of cytokine and growth factor signalling which in turn effect immune function and hematopoiesis.
The communicate process involves signal transducers and transcription activators (STAT) that modulate gene expression. Patients having myelofibrosis consist of abnormal JAK1 and JAK2 activity, Therefore Ruxolitinib function to regulate this.

PHARMACOKINETICS

Fast absorption and not affected by food maximum plasma level is 1.5 hours.
volume of distribution is 76.6 L plasma protein binding
Jakavi metabolized by CYP3A4
Jakavi eliminated via urine 74% and unchanged drug is <1% and through urine 22%,<1 % as unchanged drug

PRECAUTION

Treatment with Jakavi 20mg can resultedin thrombocytopenia, Anemia and neutropenia. Control thrombocytopenia by decreasing the dose or temporarily interfere with Jakavi 20mg. Platelet transfusions may be necessary.
Risk of infection occurs by delay initiate treatment with Jakavi 20mg until active severe infection have resolved. Tuberculosis infection has been reported in patients receiving Jakavi 20mg. Observe patients receiving Jakavi 20mg for signs and symptoms of active tuberculosis and manage promptly.
Progressive multifocal leukoencephalopathy (PML) has occurred with Jakavi 20mg treatment. If PML is suspected, stop Jakavi 20mg and evaluate
Non-melanoma skin cancers including basal cell, squamous cell, and Merkel cell carcinoma have occurred in patients treated with Jakavi 20mg. Perform periodic skin examinations.

DRUG INTERACTION

Concomitant use with fluconazole doses greater than 200mg daily may increase Ruxolitinib exposure leads to increase the risks of exposure related adverse reaction.
Interaction of Jakavi 20mg with strong CYP3A4 inhibitors will increases Ruxolitinib exposure.
Interaction of Jakavi 20mg with strong CYP3A4 inducers will decreases Ruxolitinib exposure.

CONTRAINDICATION

Hypersensitivity

MISSED DOSE

If dose is missed the have the dose immediately before next dose timing reaches or skip the missed dose and continue the regular schedule. Consult doctors regarding missed dose. Avoid taking double the dose.

SIDE EFFECTS

• Bruising
• Swelling
• Neutropenia
• Dizziness
• Increased cholesterol
• Shortness of breath
• Nasopharyngitis
• Anemia
• Thrombocytopenia
• Increased liver enzymes
• Diarrhea
• Headache
• Constipation
• Nausea & Vomiting
• Insomnia.