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Tuesday, August 6, 2019
Jakavi 10mg(Ruxolitinib)
Jakavi 10mg 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 10mg tablets is prescription drug provided under supervision of doctors or pharmacists
INDICATION
Jakavi 10mg 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 10mg tablets metabolized by CYP3A4 Jakavi 10mg tablets price in india eliminated via urine 74% and unchanged drug is <1% and through urine 22%,<1 % as unchanged drug
PRECAUTION
Treatment with Jakavi 10mg can resultedin thrombocytopenia, Anemia and neutropenia. Control thrombocytopenia by decreasing the dose or temporarily interfere with Jakavi 10mg tablets. Platelet transfusions may be necessary.
Risk of infection occurs by delay initiate treatment with Jakavi 10mg tablets price in india until active severe infection have resolved. Tuberculosis infection has been reported in patients receiving Jakavi 10mg. Observe patients receiving Jakavi 10mg tabletsfor signs and symptoms of active tuberculosis and manage promptly.
Progressive multifocal leukoencephalopathy (PML) has occurred with Jakavi 10mg treatment. If PML is suspected, stop Jakavi 10mg and evaluate
Non-melanoma skin cancers including basal cell, squamous cell, and Merkel cell carcinoma have occurred in patients treated with Jakavi 10mg. 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 10mg tabletswith strong CYP3A4 inhibitors will increases Ruxolitinib exposure.
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.