Jakafi Dosage

Generic name: ruxolitinib
Drug class: Multikinase inhibitors

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  TAB: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg

Myelofibrosis, intermediate or high-risk

[baseline Plt >200,000]

Dose: 5-25 mg PO bid; Start: 20 mg PO bid x4wk, then may incr. dose by 10 mg/day no more frequently than q2wk to max 25 mg PO bid; Info: see pkg insert for dose adjustments based on Plt response; D/C after 6mo if no spleen size reduction or sx improvement; consider tapering dose by 10 mg/day qwk to D/C unless thrombocytopenia

[baseline Plt 100,000-200,000]

Dose: 5-25 mg PO bid; Start: 15 mg PO bid x4wk, then may incr. dose by 10 mg/day no more frequently than q2wk to max 25 mg PO bid; Info: see pkg insert for dose adjustments based on Plt reponse; D/C after 6mo if no spleen size reduction or sx improvement; consider tapering dose by 10 mg/day qwk to D/C unless thrombocytopenia

[baseline Plt 50,000-99,000]

Dose: 5-10 mg PO bid; Start: 5 mg PO bid x4wk, then may incr. dose by 5 mg/day no more frequently than q2wk to max 10 mg PO bid; Info: see pkg insert for dose adjustments based on Plt response; D/C after 6mo if no spleen size reduction or sx improvement; consider tapering dose by 10 mg/day qwk to D/C unless thrombocytopenia

Polycythemia vera

[10-25 mg PO bid]

Start: 10 mg PO bid x4wk, then may incr. dose by 10 mg/day no more frequently than q2wk to max 25 mg PO bid; Info: for hydroxyurea-refractory or intolerant dz; see pkg insert for dose adjustments based on Hgb and/or Plt response; D/C after 6mo if no spleen size reduction or sx improvement; consider tapering dose by 10 mg/day qwk to D/C unless thrombocytopenia

GVHD, acute

[5-10 mg PO bid]

Start: 5 mg PO bid for at least 3 days, then may incr. dose to 10 mg PO bid; Info: for steroid-refractory dz; see pkg insert for dose adjustments based on bilirubin, ANC, or Plt response; consider tapering dose by 50% q8wk after 6mo in responding pts no longer on corticosteroids

GVHD, chronic

[10 mg PO bid]

Info: for pts who have failed 1-2 prior tx; see pkg insert for dose adjustments based on bilirubin, ANC, or Plt response; consider tapering dose by 50% q8wk after 6mo in responding pts no longer on corticosteroids

Renal dosing

[myelofibrosis]

CrCl 15-59: start 10 mg bid if baseline Plt 100,000-150,000, start 5 mg qd if baseline Plt 50,000-99,000 or avoid use if baseline Plt <50,000; CrCl <15: avoid use

HD: start 20 mg after dialysis if baseline Plt >200,000 or start 15 mg after dialysis if baseline Plt 100,000-200,000; admin. subsequent doses after dialysis on dialysis days; PD: not defined

[polycythemia vera]

CrCl 15-59: start 5 mg bid; CrCl <15: avoid use

HD: start 10 mg after dialysis; admin. subsequent doses after dialysis on dialysis days; PD: not defined

[GVHD, acute]

CrCl 15-59: start 5 mg qd; CrCl <15: avoid use

HD: start 5 mg after dialysis; admin. subsequent doses after dialysis on dialysis days; PD: not defined

[GVHD, chronic]

CrCl 15-59: start 5 mg bid; CrCl <15: avoid use

HD: start 10 mg after dialysis; admin. subsequent doses after dialysis on dialysis days; PD: not defined

Hepatic dosing

[myelofibrosis]

hepatic impairment: start 10 mg bid if baseline Plt 100,000-150,000, start 5 mg qd if baseline Plt 50,000-99,000 or avoid use if baseline Plt <50,000

[polycythemia vera]

hepatic impairment: start 5 mg bid

[GVHD, acute]

Stage 4 liver acute GVHD: start 5 mg qd

[GVHD, chronic]

Score 3 liver chronic GVHD: caution advised

Recommended Peds Dosing

Dosage forms:  TAB: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg

GVHD, acute

[12 yo and older]

Dose: 5-10 mg PO bid; Start: 5 mg PO bid for at least 3 days, then may incr. dose to 10 mg PO bid; Info: for steroid-refractory dz; see pkg insert for dose adjustments based on bilirubin, ANC, or Plt response; consider tapering dose by 50% q8wk after 6mo in responding pts no longer on corticosteroids

GVHD, chronic

[12 yo and older]

Dose: 10 mg PO bid; Info: for pts who have failed 1-2 prior tx; see pkg insert for dose adjustments based on bilirubin, ANC, or Plt response; consider tapering dose by 50% q8wk after 6mo in responding pts no longer on corticosteroids

Renal dosing

[GVHD, acute]

CrCl 15-59: start 5 mg qd; CrCl <15: avoid use

HD: start 5 mg after dialysis; admin. subsequent doses after dialysis on dialysis days; PD: not defined

[GVHD, chronic]

CrCl 15-59: start 5 mg bid; CrCl <15: avoid use

HD: start 10 mg after dialysis; admin. subsequent doses after dialysis on dialysis days; PD: not defined

Hepatic dosing

[GVHD, acute]

Stage 4 liver acute GVHD: start 5 mg qd

[GVHD, chronic]

Score 3 liver chronic GVHD: caution advised

SRC: NLM .