Jakafi Dosage, forms & strengths
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Get started todayJakafi (ruxolitinib) is a prescription hematologic medication that is manufactured by Incyte Corporation. It belongs to a class of medicines called Janus Associated Kinase inhibitors (JAK inhibitors). It is approved by the U.S. Food and Drug Administration (FDA) to treat:
- intermediate or high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera myelofibrosis, and post-essential thrombocythemia myelofibrosis in adults.
- polycythemia vera in adults who did not respond or are intolerant to hydroxyurea.
- steroid-refractory acute graft-versus-host disease in adult and pediatric patients 12 years of age and older.
- chronic graft-versus-host disease (GVHD) in adult and pediatric patients 12 years of age and older that have failed other systemic therapies.
Jakafi dosage forms and strengths
Jakafi is available as an oral tablet with the following strengths:
- 5mg tablet
- 10mg tablet
- 15mg tablet
- 20mg tablet
- 25mg tablet
Jakafi dosage for adults
The starting dose of Jakafi to treat myelofibrosis in adults is based on your baseline platelet count:
- If it’s greater than 200 × 10^9/L, take 20mg by mouth twice daily.
- If it’s between 100 × 10^9/L to 200 × 10^9/L, take 15 mg by mouth twice daily.
- If it’s 50 × 10^9/L to less than 100 × 10^9/L take 5 mg by mouth twice daily.
Your healthcare provider will perform complete blood counts every 2 to 4 weeks until your doses are stabilized, and then as needed.
The recommended starting dose to treat polycythemia vera in adults is 10mg by mouth twice daily. A dose reduction should be considered based on hemoglobin and platelet counts.
The recommended starting dose to treat acute graft-versus-host disease in adults and children 12 years of age and older is 5mg by mouth twice daily. You may have your dose held or reduced based on your complete blood count (CBC) and bilirubin level.
The recommended starting dose to treat chronic graft-versus-host disease in adults and children 12 years of age and older is 10mg by mouth twice daily. You may have your dose held or reduced based on your complete blood count (CBC) and bilirubin level.
Jakafi adult and pediatric dosage chart
| Indication | Starting dosage | Standard dosage | Maximum dosage |
|---|---|---|---|
| Myelofibrosis in adults | 5mg to 20mg by mouth twice daily based on your baseline platelet count. | 5mg to 25mg by mouth twice daily based on your baseline platelet count. | 25mg by mouth twice daily. |
| Polycythemia vera in adults | 10mg by mouth twice daily. | 10mg to 25mg by mouth twice daily. | 25mg by mouth twice daily. |
| Acute GVHD (aGVHD) in adults and children over 12 years of age. | 5mg by mouth twice daily. | 5mg to 10mg by mouth twice daily. | 10mg by mouth twice daily. |
| Chronic GVHD (cGVHD) in adults and children over 12 years of age. | 10mg by mouth twice daily. | 10mg by mouth twice daily. | 10mg by mouth twice daily. |
Jakafi dosage restrictions
- Your Jakafi dose should be adjusted if you have moderate to severe renal impairment or if you have end-stage renal disease (ESRD) and are on dialysis.
- Jakafi should be avoided if you have ESRD and are not on dialysis.
- Your Jakafi dose should be modified if you have mild, moderate, or severe hepatic impairment. Your doctor should frequently monitor blood counts for toxicity and adjust your dose if indicated.
How to take Jakafi
- Read the Full Prescribing Information and Medication Guide that comes with this medication.
- Take Jakafi exactly as your doctor prescribes it for you. Do not change the dose or stop taking it without first discussing it with your doctor.
- Jakafi is typically taken by mouth with or without food. If you cannot swallow oral medications, you can take Jakafi through certain nasogastric (NG) tubes.
- If you miss a dose of Jakafi, skip the missed dose and take it at your regular time. Do not take an additional dose to make up for your missed dose.
- If you take too much Jakafi, call your doctor for medical advice or go to the nearest emergency room right away.
- While taking Jakafi, your doctor will perform regular blood tests. Your dose of Jakafi may be adjusted or your treatment may be stopped based on the blood test results.
- There is no data on the use of Jakafi during pregnancy so it is not known if there are any risks to the fetus.
- It is not known if Jakafi is found in breast milk or the effects it would have on a breastfed child. It was found in the milk of lactating rats during animal studies. Because of the potential for adverse events, you should discontinue breastfeeding while taking Jakafi and for 2 weeks after your final dose.
- Store Jakafi at room temperature between 68°F to 77°F (20°C to 25°C). Keep all medications, including Jakafi out of the reach of children.
Jakafi dosage FAQs
What are some side effects of Jakafi?
Some common adverse reactions to Jakafi may include:
Some common side effects of Jakafi may include:
- Low red blood cell count (anemia)
- Low white blood cell count (neutropenia)
- Low platelet count (thrombocytopenia)
- Bruising
- Dizziness
- Headache
- Fatigue
- Diarrhea
- Edema
- Elevation of cholesterol and triglyceride levels
Jakafi can rarely cause some serious side effects including:
- Severe bone marrow suppression
- Bacterial infections such as tuberculosis
- Viral infections such as hepatitis B and herpes zoster (shingles)
- Increased risk of cancer including non-melanoma skin cancer and lymphoma
- Increased risk of blood clots (thrombosis)
You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What are some drug interactions with Jakafi?
When Jakafi is taken with other medications, they can interact and change how they work. It can also increase the severity and frequency of certain side effects. Make sure your healthcare professional is aware of all the prescription and over-the-counter medications, vitamins, and herbal supplements you take. Some major drug interactions of Jakafi include:
- Fluconazole: Your Jakafi dosage should be reduced with fluconazole doses less than or equal to 200 mg. You should not take Jakafi if you are taking more than 200mg of fluconazole.
- Strong CYP3A4 Inhibitors: Your doctor should consider a dose modification if you take Jakafi with inhibitors such as clarithromycin, diltiazem, ketoconazole, and grapefruit juice.
- Strong CYP3A4 Inducers: Your dose may need to be increased if Jakafi is taken with inducers such as phenobarbital, phenytoin, rifampin, and St. John’s Wort.
Are there any contraindications or precautions with Jakafi?
You should not take this medication if you have had a serious allergic reaction to Jakafi or any of its inactive ingredients.
Following discontinuation or interruption of Jakafi treatment, myelofibrosis symptoms may worsen and return to pretreatment levels after 1 week. Your doctor should taper your dose of Jakafi to help reduce the potential risk of these complications.
How long does Jakafi stay in your system?
The half-life of Jakafi and its active metabolites is up to 6 hours so it will stay in your system for around 30 hours.
Is it safe to use Jakafi while pregnant or breastfeeding?
There have not been any studies that looked at the use of Jakafi during pregnancy so it is unknown if there is any risk of fetal harm.
There is also no data available to determine if Jakafi is found in breast milk or the effects it would have on a breastfed child. Because of the potential for serious complications, you should not breastfeed if you are taking Jakafi and for 2 weeks after the final dose.
Will lab monitoring be done when taking Jakafi?
Your doctor will monitor your blood counts and liver function before you start taking Jakafi and regularly during your treatment. They make a dose adjustment based on your platelet or absolute neutrophil count (ANC). Your doctor should also check your cholesterol levels every 8 to 12 weeks after you start Jakafi, and as needed.
