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ruxolitinib cream side effects

Ruxolitinib Cream: Side Effects, Precautions, and Interactions

Ruxolitinib cream, also known as Opzelura, is a topical medication used to treat skin conditions like non-segmental vitiligo and mild to moderate atopic dermatitis (eczema). In this article, we will look at the possible side effects, precautions, and drug interactions. Understanding these aspects will help patients and professionals in making an informed decision about Ruxolitinib cream.


Ruxolitinib Cream Side Effects

Common Side Effects

Ruxolitinib cream, everyone does not experience the side effects, like any other medication will cause also side effects. The following are the side effects that are reported:

  • Application Site Reactions: The most frequent side effects of this application are redness, itching, and irritation. The consistent use of this cream reduces the typical reactions which move from mild to moderate.
  • Acne:  When this is applied to the skin some users get acne. However, this side effect can be managed with the proper skincare routines.
  • Headache: Most users report headaches often. These are typically transient and resolve on their own without the need for additional treatment.

These are all the common side effects of using this cream, and all these are inconvenient. But all these can be improved by managing with continued use of medication.

Serious Side Effects

While rare, ruxolitinib cream can cause more severe side effects. These require immediate medical attention and include:

  • Serious Infections: Ruxolitinib can raise the risk of major bacterial, viral, and fungal infections since it suppresses the immune system. It is important to keep an eye out for infection symptoms in patients, such as fever, chills, or a chronic sore throat.
  • Thrombocytopenia: Increased bleeding and bruises may result from thrombocytopenia, a significant reduction in platelet count. Patients should be kept an eye out for any odd bleeding or bruises, and they should notify their healthcare physician right once they do.
  • Anemia: Anemia can result from Roxolitinib’s ability to reduce red blood cell numbers. Anemia symptoms include pallor, exhaustion, and shortness of breath. It might be required to have routine blood tests to check for anemia while undergoing treatment.

These serious side effects are uncommon but require significant medical attention to manage effectively.

Long-term Side Effects

The long-term use of Ruxolitinib cream is still being studied, but potential concerns include:

  • Skin Atrophy: long-term use of this cream may reduce the thinness of the skin which is also a condition and known as skin atrophy. Because of this risk, it’s crucial to use the cream as prescribed and avoid covering large portions of the body with it.
  • Increased Risk of Skin Cancer: Long-term use may raise the risk of skin cancers due to its immunosuppressive effects. Patients should have routine skin exams to check for any changes or newly developing skin growth.

It is essential to discuss the potential long-term side effects with a healthcare provider to notice the benefits and risks of prolonged use.


Precautions When Using Ruxolitinib Cream

Who Should Avoid Ruxolitinib Cream?

Certain individuals should avoid using Ruxolitinib cream due to the potential for severe effects. These include:

  • Individuals with Active Infections: Due to ruxolitinib cream’s immunosuppressive qualities, which can worsen infections, patients with active, untreated illnesses shouldn’t take it.
  • Patients with Blood Disorders: before starting the treatment, patients with existing blood disorders such as anemia or thrombocytopenia, should be careful and consult their healthcare professional.
  • Pregnant and Breastfeeding Women: It is unknown if ruxolitinib cream is safe for use by expectant or breastfeeding women. It should only be applied if the possible advantages outweigh the possible risks to the developing fetus or infant. Women who are planning a baby, intend to get pregnant, or are currently pregnant should talk to their doctor about using ruxolitinib cream.

How to Use Ruxolitinib Cream Safely

To use ruxolitinib cream carefully and efficiently, patients should follow these guidelines:

  • Follow Dosage Instructions: Use ruxolitinib cream after approval of the doctor’s instructions. Applying it to broad parts of the body is not advised, nor should you use more or less than the prescribed amount.
  • Monitor for Side Effects: Patients should notice any side effects they experience and notify their healthcare practitioner of them, particularly any unusual bruises, persistent headaches, or indications of infection.
  • Avoid Broken Skin: Do not apply ruxolitinib cream to broken or infected skin to prevent further irritation or infection.

Understanding Ruxolitinib Cream: Is It a Steroid?

Ruxolitinib cream is not a steroid; it is a Janus kinase (JAK) inhibitor. Unlike steroids, which work by broadly suppressing inflammation, Ruxolitinib targets specific pathways in the immune system to reduce inflammation and abnormal immune responses associated with conditions like vitiligo and atopic dermatitis. This targeted approach helps to minimize some of the common side effects associated with long-term steroid use, such as skin thinning and systemic effects. However, it is still important to use Ruxolitinib cream under the guidance of a healthcare provider due to its potential side effects and interactions.


Drug Interactions with Ruxolitinib Cream

Potential Interactions

Ruxolitinib cream usually has few side effects, but there are a few considerations that should be kept in mind when using it alongside other medications and food. For example, it is advised that grapefruit and grapefruit juice should not be taken with ruxolitinib.

Additionally, taking CYP3A4 inhibitors such as clarithromycin, nelfinavir, and voriconazole possibly increases the blood level of ruxolitinib in your body. It is advisable to lower the dose of ruxolitinib if taking it along with these medicines. Likewise, Fluconazole is another medication that can affect ruxolitinib.

If you have any concerns regarding possible drug interactions with ruxolitinib cream or before starting any new medications, make sure to consult a doctor.

When to Consult a Doctor

Signs That Warrant Medical Attention

Patients using ruxolitinib cream should be aware of signs that permit instant medical attention, including:

If any of the following occur while using ruxolitinib cream, consult your doctor immediately:

  • Symptoms of infection; fever, chill, sore throat, and worsening skin redness or pain
  • Severe reaction at the site of application
  • Persistent headaches or dizziness
  • serious side effects such as chest pain unusual bleeding or bruising
  • no improvement after 8 weeks in case of eczema or 24 weeks in case of vitiligo

Regular Monitoring

Regular follow-ups with the healthcare provider are recommended for patients using ruxolitinib cream to monitor for severe effects, especially those about the immune system and blood counts. Frequent monitoring reduces the chance of major issues by ensuring that any negative effects are quickly detected and treated.


FAQs

What is the Warning on Ruxolitinib Cream?

Ruxolitinib comes with several warnings such as increased risk of infections, skin cancer, blood clots, severe allergic reactions, systematic immunosuppression, decrease in blood counts, and local skin reactions. In addition, it is advised to be cautious while using in pregnancy. In case of any side effects, patients are recommended to consult their doctors immediately.

What are the Side Effects of Ruxolitinib Cream for Vitiligo?

Some of the common side effects of vitiligo include redness, itching, swelling, pain, skin infections, acne, headache, and common cold symptoms such as sore throat, runny nose, inflammation of hair follicles, and severe allergic reactions. Most of the side effects in this case are mild to moderate but it is recommended to immediately contact doctors if someone experiences severe to persistent side effects.

What is the Most Common Side Effect of Opzelura?

The most common (ruxolitinib cream) side effect is irritation, itching, and redness at the application site. When the cream is used consistently, these reactions which are often mild to moderate tend to become better.

Does Opzelura Suppress the Immune System?

Yes, Opzelura’s role as a JAK inhibitor allows it to suppress the immune system. The immunosuppressive effect has the potential to raise the infection risk. Opzelura users should be kept an eye out for infection symptoms and take preventative measures to reduce their chance of coming into contact with infected materials.

Can I Use Ruxolitinib Cream with Other Eczema Treatments?

Combining ruxolitinib cream with other eczema treatments is possible, but it should be done so under a healthcare professional to prevent any possible interactions and overlapping negative effects. It is important to combine treatments carefully to guarantee both efficacy and safety.

What Should I Avoid While Using Ruxolitinib Cream?

Unless your doctor instructs you otherwise, stay away from powerful CYP3A4 inhibitors, biologics, and other JAK inhibitors. To further minimize irritation or infection, do not apply the lotion to damaged or infected skin.


Conclusion

Ruxolitinib cream is one of the useful treatments for certain skin conditions but it is important to be aware of its potential side effects and interactions. This article covered common and serious side effects, precautions that are necessary while using ruxolitinib cream, and drug interactions.

You can minimize potential risks and optimize the advantages of Ruxolitinib cream by being aware of these factors. Remember to consult with a doctor if you have any concerns regarding the use of ruxolitinib cream. Lastly, regular checkups help to ensure the efficacy of the treatment.


References:

  1. Kang, C. (2024). Ruxolitinib Cream 1.5%: A Review in Non-Segmental Vitiligo. Drugs84(5), 579–586. https://doi.org/10.1007/s40265-024-02027-2
  2. Ehsan, M., Aqeeb Ur Rehman, Muhammad Ayyan, Huzaifa Ahmad Cheema, Talha Zartash Ahmad, Mustafa, B., Shahid, A., Tarek Khedro, Ismail, H., & Nashwan, A. J. (2023). Efficacy and safety of topical ruxolitinib cream for the treatment of vitiligo: A systematic review and meta‐analysis of randomized controlled trials. Journal of Cosmetic Dermatology23(1), 350–353. https://doi.org/10.1111/jocd.15921
  3. Kenichi Umehara, Huth, F., Jin, Y., Schiller, H., Vassilios Aslanis, Heimbach, T., & He, H. (2019). Drug-drug interaction (DDI) assessments of ruxolitinib, a dual substrate of CYP3A4 and CYP2C9, using a verified physiologically based pharmacokinetic (PBPK) model to support regulatory submissions. Drug Metabolism and Personalized Therapy34(2). https://doi.org/10.1515/dmpt-2018-0042
  4. Papp, K., Szepietowski, J. C., Kircik, L., Toth, D., Eichenfield, L. F., Forman, S. B., Kuligowski, M. E., Kallender, H., Sun, K., Ren, H., & Simpson, E. L. (2023). Long-term safety and disease control with ruxolitinib cream in atopic dermatitis: Results from two phase 3 studies. Journal of the American Academy of Dermatology88(5), 1008–1016. https://doi.org/10.1016/j.jaad.2022.09.060

 

Post by:

Dermatologist Marcela J

 

 

 

 

 Dr.Marcella Jiovanni

Health and Beauty Expert

“Marcella Jiovanni actively promotes the importance of maintaining healthy skin, she envisions the future of dermatology as moving away from pure medical, pharmacological dermatology and flowing more toward a holistic approach to wellness and skincare.”