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Home > MPN Myelofibrosis - ruxolitinib

MPN Myelofibrosis - ruxolitinib

Treatment Overview

Cycle 1 (and all further cycles) - 28 days

Cycle length:
28

ruxolitinib: Starting doses and continuing treatment doses are dependent on the patients platelet count and renal function. Clinicians must consult prescribing information at all times for dosing.

Cycle details

Cycle 1 (and all further cycles) - 28 days

Medication Dose Route Days Max Duration
ruxolitinib 20 mg Twice daily oral administration 1 to 28

ruxolitinib: Starting doses and continuing treatment doses are dependent on the patients platelet count and renal function. Clinicians must consult prescribing information at all times for dosing.

Full details

Cycle 1 (and all further cycles) - 28 days

Day: 1

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 2

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 3

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 4

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 5

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 6

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 7

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 8

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 9

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 10

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 11

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 12

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 13

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 14

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 15

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 16

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 17

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 18

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 19

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 20

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 21

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 22

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 23

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 24

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 25

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 26

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 27

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Day: 28

Medication Dose Route Max duration Details
ruxolitinib 20 mg Twice daily oral administration
Instructions:

Do not stop taking this medication without consulting with your doctor.

Additional details:

Additional details

Section 1: Dosing

ruxolitinib: Starting doses and continuing treatment doses are dependent on the patients platelet count and renal function. Clinicians must consult prescribing information at all times for dosing.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Emetogenicity: Minimal to low

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Talpaz, M., R. Paquette, L. Afrin, et al. 2013. "Interim analysis of safety and efficacy of ruxolitinib in patients with myelofibrosis and low platelet counts." J Hematol Oncol 6(1):81. , PMID: 24283202

Tefferi, A., M. Nicolosi, M. Mudireddy, et al. 2018. "Driver mutations and prognosis in primary myelofibrosis: Mayo-Careggi MPN alliance study of 1,095 patients." Am J Hematol 93(3):348-355. , PMID: 29164670

Tefferi, A. and A. Pardanani. 2011. "Serious adverse events during ruxolitinib treatment discontinuation in patients with myelofibrosis." Mayo Clin Proc 86(12):1188-1191. , PMID: 22034658

Harrison, C., J. J. Kiladjian, H. K. Al-Ali, et al. 2012. "JAK inhibition with ruxolitinib versus best available therapy for myelofibrosis." N Engl J Med 366(9):787-798. , PMID: 22375970

Ho, P. J., P. Marlton, C. Tam, et al. 2015. "Practical management of myelofibrosis with ruxolitinib." Intern Med J 45(12):1221-1230. , PMID: 26648193

Cervantes, F., A. M. Vannucchi, J. J. Kiladjian, et al. 2013. "Three-year efficacy, safety, and survival findings from COMFORT-II, a phase 3 study comparing ruxolitinib with best available therapy for myelofibrosis." Blood 122(25):4047-4053. , PMID: 24174625

Geyer, H. L. and R. A. Mesa. 2014. "Therapy for myeloproliferative neoplasms: when, which agent, and how?" Blood 124(24):3529-3537. , PMID: 25472969

Harrison, C. N., A. M. Vannucchi, J. J. Kiladjian, et al. 2016. "Long-term findings from COMFORT-II, a phase 3 study of ruxolitinib vs best available therapy for myelofibrosis." Leukemia 30(8):1701-1707. , PMID: 27211272

Verstovsek, S., R. A. Mesa, J. Gotlib, et al. 2012. "A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis." N Engl J Med 366(9):799-807. , PMID: 22375971

Verstovsek, S., R. A. Mesa, J. Gotlib, et al. 2017. "Long-term treatment with ruxolitinib for patients with myelofibrosis: 5-year update from the randomized, double-blind, placebo-controlled, phase 3 COMFORT-I trial." J Hematol Oncol 10(1):55. , PMID: 28228106

Mead, A. J., D. Milojkovic, S. Knapper, et al. 2015. "Response to ruxolitinib in patients with intermediate-1-, intermediate-2-, and high-risk myelofibrosis: results of the UK ROBUST Trial." Br J Haematol 170(1):29-39. , PMID: 25824940

Guglielmelli, P., F. Biamonte, G. Rotunno, et al. 2014. "Impact of mutational status on outcomes in myelofibrosis patients treated with ruxolitinib in the COMFORT-II study." Blood 123(14):2157-2160. , PMID: 24458439

Patel, K. P., K. J. Newberry, R. Luthra, et al. 2015. "Correlation of mutation profile and response in patients with myelofibrosis treated with ruxolitinib." Blood 126(6):790-797. , PMID: 26124496

Bjorn, M. E., M. O. Holmstrom and H. C. Hasselbalch. 2016. "Ruxolitinib is manageable in patients with myelofibrosis and severe thrombocytopenia: a report on 12 Danish patients." Leuk Lymphoma 57(1):125-128. , PMID: 25936872

Grunwald, M. R. and J. L. Spivak. 2016. "Ruxolitinib Enhances Platelet Production in Patients With Thrombocytopenic Myelofibrosis." J Clin Oncol 34(5):e38-40. , PMID: 24958831

Novartis New Zealand Limited Jakavitab New Zealand Medicine Datasheet 7 July 2021 https://www.medsafe.govt.nz/profs/datasheet/j/jakavitab.pdf (Accessed 29 March 2022)

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.