Ruxolitinib (topical application route)


    Description

    Ruxolitinib topical is used to treat mild to moderate atopic dermatitis (eczema) in non-immunocompromised patients whose condition is not well controlled with other topical treatments or when these treatments are not recommended.

    Ruxolitinib topical is also used to treat a skin disease called nonsegmental vitiligo.

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Cream

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of ruxolitinib topical in children younger than 12 years of age. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ruxolitinib topical in the elderly.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Anemia (low number of red blood cells) or
    • Diabetes or
    • Heart or blood vessel disease or
    • Hepatitis B, history of or
    • Hepatitis C, history of or
    • Herpes zoster (shingles), history of or
    • High cholesterol or fats in the blood
    • HIV infection or
    • Lung disease, chronic or
    • Neutropenia (low number of white blood cells) or
    • Skin cancer, history of or
    • Thrombocytopenia (low number of platelets) or
    • Tuberculosis, or history of or
    • Weakened immune system—Use with caution. May make these conditions worse.
    • Liver disease (eg, hepatitis B or C), active or
    • Serious infections, active—Use is not recommended in patients with these conditions.
    • Smoker, current or past—May increase risk for serious side effects.

    Proper Use

    It is very important that you use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

    This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

    This medicine is for use on the skin only. Do not get it in your eyes, nose, mouth, or vagina. If it does get on these areas, rinse it off right away with water.

    To use the cream:

    • Wash your hands with soap and water before and after using this medicine.
    • Apply a thin layer of this medicine to the affected area of the skin. Rub it in gently.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For topical dosage form (cream):
      • For mild to moderate atopic dermatitis and nonsegmental vitiligo:
        • Adults and children 12 years of age and older—Apply to the affected area of the skin 2 times a day. Do not use more than 1 tube (60 grams) per week or 1 tube (100 grams) of this medicine per 2 weeks.
        • Children younger than 12 years of age—Use and dose must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

    Storage

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.


    Precautions

    It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for any unwanted effects.

    This medicine should not be used together with azathioprine or cyclosporine.

    If your condition does not improve within 8 weeks for atopic dermatitis or 24 weeks for nonsegmental vitiligo, or if it become worse, check with your doctor.

    This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections (eg, herpes, tuberculosis, hepatitis B or C, fungal infection) more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.

    This medicine may increase your risk of cancer (eg, lymphoma, non-melanoma skin cancer). Tell your doctor right away if you have black, tarry stools, general feeling of illness, swollen glands, weight loss, yellow skin and eyes, persistent non-healing sore, reddish patch or irritated area, shiny bump, pink growth, or white, yellow or waxy scar-like area on the skin.

    This medicine may increase your risk of serious heart or blood vessel problems, including heart attack or stroke, especially in patients with rheumatoid arthritis who are 50 years of age and older and with a heart or blood vessel disease. Call your doctor right away if you have chest pain or discomfort, confusion, difficulty in speaking, double vision, headache, inability to move arms, legs, or facial muscles, nausea, pain or discomfort in the arms, jaw, back, or neck, sweating, trouble breathing, or vomiting.

    This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

    This medicine may increase your risk of developing blood clots (eg, arterial thrombosis, deep vein thrombosis, pulmonary embolism), especially in patients with rheumatoid arthritis who are 50 years of age and older and with a heart or blood vessel disease. Check with your doctor right away if you have anxiety, chest pain, cough, dizziness, lightheadedness, or fainting, fast heartbeat, pain, redness, or swelling in the arm or leg, pains in the chest, groin, or legs, especially calves of the legs, severe headaches, sudden loss of coordination, sudden onset of slurred speech, sudden vision changes, or trouble breathing.

    This medicine may increase the level of cholesterol and fat in your blood. Talk to your doctor if you have concerns.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    Less common

    • Black, tarry stools
    • bladder pain
    • bloody or cloudy urine
    • chest pain
    • chills
    • cough
    • difficult, burning, or painful urination
    • fever
    • frequent urge to urinate
    • lower back or side pain
    • sore throat
    • sores, ulcers, or white spots on the lips or in the mouth
    • swollen glands
    • trouble breathing
    • unusual bleeding or bruising
    • unusual tiredness or weakness

    Rare

    • Painful blisters on the trunk of the body
    • pale skin

    Incidence not known

    • Anxiety
    • bleeding gums
    • blood in the urine or stools
    • chest discomfort
    • coughing or spitting up blood
    • dizziness or lightheadedness
    • fainting
    • general feeling of illness
    • muscle aches
    • nausea
    • night sweats
    • pain, redness, or swelling in the arm or leg
    • pain or discomfort in the arms, jaw, back, or neck
    • pains in the chest, groin, or legs, especially calves of the legs
    • persistent non-healing sore
    • pink growth
    • pinpoint red spots on the skin
    • reddish patch or irritated area
    • severe headaches of sudden onset
    • shiny bump
    • sudden loss of coordination
    • sudden onset of slurred speech
    • sudden vision changes
    • sweating
    • vomiting
    • weight loss
    • white, yellow or waxy scar-like area
    • yellow skin and eyes

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Blemishes, itching, flushing, redness at the application site

    Less common

    • Burning, itching, and pain in the hairy areas, pus at the root of hair
    • change in hearing
    • chest tightness
    • cough producing mucus
    • diarrhea
    • earache
    • ear drainage
    • headache
    • hives, itching, skin rash
    • stuffy or runny nose

    Rare

    • Burning, dry, or itching eyes
    • discharge, excessive tearing
    • itching ears
    • redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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