Deuruxolitinib phosphate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
Deuruxolitinib phosphate: clinical details
Prescribing considerations
- Confirm severe alopecia areata in an adult and assess treatment alternatives.
- Determine CYP2C9 genotype before initiation. Poor metabolisers are contraindicated; local test access and interpretation must be resolved.
- Assess infection, tuberculosis, viral-hepatitis, malignancy, cardiovascular and thrombosis risks.
- Use only where no suitable alternative exists in older patients or those with cardiovascular or malignancy risk factors.
- Avoid active serious infection; do not use in active tuberculosis or active hepatitis B or C.
- Not recommended in severe renal impairment, end-stage renal disease or severe hepatic impairment.
- Complete necessary immunisations, including herpes-zoster vaccination where appropriate, before treatment.
Contraindications and cautions
- CYP2C9 poor-metaboliser status
- Concomitant moderate or strong CYP2C9 inhibitor
- Pregnancy
- Breastfeeding
- Hypersensitivity to deuruxolitinib or an excipient
Monitoring
- Full blood count before treatment and periodically thereafter
- Lipid profile at baseline and periodically
- Signs of serious or opportunistic infection, including tuberculosis
- Hepatitis B reactivation where relevant
- Thrombotic, cardiovascular and new abdominal symptoms
- Periodic skin examination in people at increased skin-cancer risk
Clinical pharmacology
An oral JAK inhibitor with greater in-vitro potency against JAK1, JAK2 and TYK2 than JAK3. It is metabolised mainly by CYP2C9 and secondarily by CYP3A4, making genotype and interacting medicines clinically important.
Formulation and product differences
- The product is a lactose-containing, purple, round film-coated tablet supplied in a moisture-protective bottle with a silica-gel desiccant.
- The tablet contains carmine and must remain in its original package to protect it from moisture.
Deuruxolitinib phosphate preparations and strengths
Tablet
Route: Oral
Strengths: 8 mg
Deuruxolitinib phosphate interactions
A full review of prescription, non-prescription and herbal products is required before treatment.
Moderate or strong CYP2C9 inhibitors, including amiodarone, fluconazole and miconazole
Concomitant use is contraindicated because it can increase deuruxolitinib exposure and the risk of serious reactions such as thrombosis.
Strong CYP3A or moderate-to-strong CYP2C9 inducers, including carbamazepine, phenytoin, rifampicin, enzalutamide and St John's wort
Avoid concomitant use because reduced exposure may reduce effectiveness.
Other JAK inhibitors, biologic immunomodulators, ciclosporin or other potent immunosuppressants
Combination is not recommended.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.