How does this medication work? What will it do for me?
Ruxolitinib belongs to the class of medications called Janus kinase (JAK) inhibitors. The topical form of ruxolitinib is used to treat nonsegmental vitiligo in individuals 12 years of age and older. It can also be used to treat mild to moderate atopic dermatitisin the same group of people, when other medications have not controlled the condition well enough.
Vitiligo is a skin condition where the skin loses its colour in patches. It is believed to be caused by the immune system (the body’s natural defenses) attacking the cells that produce skin pigments. This behaviour is called an auto-immune response. Atopic dermatitis is a skin condition often caused by an overactive immune system, resulting in dryness and inflammation.
Ruxolitinib works by blocking an enzyme called Janus kinase, a chemical in the body that starts the immune response. Ruxolitinib reduces this immune response and the inflammation that occurs with these conditions. Applying ruxolitinib on the skin reduces the chemicals produced by the immune system and allows the pigment-producing cells to produce normal skin colour. Reducing the chemicals produced by the immune system also reduces the redness, pain, and skin inflammation for people with atopic dermatitis.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each gram of white to off-white cream contains 15 mg of ruxolitinib, equivalent to 19.8 g of ruxolitinib phosphate. Nonmedicinal ingredients: cetyl alcohol, dimethicone 350, edetate disodium, glyceryl stearate SE, light mineral oil, medium chain triglycerides, methylparaben, phenoxyethanol, polyethylene glycol 200, polysorbate 20, propylene glycol, propylparaben, purified water, stearyl alcohol, propylparaben, purified water, stearyl alcohol, white petrolatum, and xanthan gum.
How should I use this medication?
Ruxolitinib topical cream should be applied to the areas affected by vitiligo or atopic dermatitis twice a day, morning and evening. Apply a thin layer to the affected area and gently rub it into the skin. There should be at least 8 hours between applications. Do not use more than 60 g per week or 100 g over 2 weeks.
Do not use this cream around the lips or in the eyes, mouth, or vagina. It is to be applied to the surface of the skin only.
The cream should not be used on more than 10% of the body surface area if you are using it to treat vitiligo. This is approximately 10 times the size of your hand, including the palm and fingers.
If you are using this medication to treat atopic dermatitis, do not apply it to more than 20% of your body surface area. This is approximately 20 times the size of your hand.
Wash your hands thoroughly with soap and water after each application, unless the hands are part of the area being treated.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor.
If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use this medication if you are allergic to ruxolitinib or any ingredients of the medication.
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- acne
- headache
- irritation at the application site (e.g., redness, rash, itching, peeling)
- removal of the dead skin (exfoliation)
- stinging
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- fever
- increased frequency of cold- or flu-like symptoms (e.g., stuffy or runny nose, headache, sore throat, fatigue)
- symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Anemia: Ruxolitinib may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible. Your doctor will do blood tests regularly to monitor the amounts of specific types of blood cells in your blood.
Bleeding: Ruxolitinib can reduce the number of platelet cells in the blood. Platelets help the blood to clot and if there aren't enough, you may bleed more easily. If you notice signs of unusual bruising or bleeding (e.g., blood in urine, cuts that won't stop bleeding, black stools, bleeding gums), contact your doctor.
Blood clots: Similar medications have been associated with an increased chance of blood clot formation, causing reduction of blood flow to organs or the extremities. Although this is generally considered a concern for using the oral form of ruxolitinib, enough medication may be absorbed through the skin to contribute to blood clots.
If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision, or difficulty speaking, contact your doctor immediately.
Heart disease: If you have a history of heart disease or risk factors for heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and whether any special monitoring is needed.
Infection: Ruxolitinib can cause a decrease in the number of white blood cells produced in the body. These cells are responsible for fighting off infections. If you experience more frequent symptoms of infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, listlessness, or a serious infection, contact your doctor as soon as possible. If you have a history of chronic infection or serious infections or you have other conditions that make you more likely to develop an infection, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and whether any special monitoring is needed.
Skin cancer: Non-melanoma skin cancer has been reported with the use of topical ruxolitinib. Protect your skin from exposure to the sun and check your skin regularly for changes. Let your doctor know if you notice any changes to your skin, including sores that don't heal, growths that change colour or are irregularly shaped.
Pregnancy: This medication should not be used during pregnancy. If you become pregnant while using this medication, contact your doctor immediately. People using topical ruxolitinib should use an effective method of birth control (e.g., birth control pill, condoms) during treatment and for at least 4 weeks after stopping use of this medication.
Breast-feeding: It is not known if ruxolitinib passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Breast-feeding should be avoided during treatment with topical ruxolitinib and for 4 weeks after stopping the medication.
Children: The safety and effectiveness of using this medication have not been established for children less than 12 years of age.
What other drugs could interact with this medication?
For a full list of interactions, use the Drug Interaction Checker available on the Drugs.com website.
If you are taking other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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