FDA-filed SPL labeling · retrieved through openFDA

Ruxolitinib

Ruxolitinib (Jakafi) is a targeted oral medication used to treat certain bone marrow disorders and graft-versus-host disease.

Brand names JakafiOpzeluraJakafi Xr
Drug classes Kinase Inhibitor
Rx Forms 3 Routes Oral · Topical
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveJul 20, 2026
AvailabilityRx
Earliest approval/marketing year 2011
FDA-listed product records 65
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 23, 2026
Other forms & routes:
Ruxolitinib at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Ruxolitinib is a powerful targeted therapy for serious blood disorders and graft-versus-host disease, but it comes with significant risks — including infections, blood count changes, heart events, blood clots, and certain cancers — that require close monitoring. Never stop it suddenly without your doctor's guidance, since symptoms can rebound quickly. Stay current with all follow-up blood tests and skin checks, and report any new symptoms to your care team promptly.

📖 Ruxolitinib: Patient Information Guide

A plain-language walkthrough of Ruxolitinib — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Ruxolitinib is used to treat several serious conditions involving the blood, bone marrow, or immune system:

  • Myelofibrosis (MF) — including primary MF, and MF that developed after polycythemia vera or essential thrombocythemia (intermediate or high-risk disease, in adults)
  • Polycythemia vera (PV) — in adults whose disease did not respond well to hydroxyurea, or who could not tolerate it
  • Acute graft-versus-host disease (aGVHD) — in adults and patients 12 and older whose condition did not respond to steroids
  • Chronic graft-versus-host disease (cGVHD) — in adults and patients 12 and older after one or two other systemic treatments have failed
⚙️How it works

Ruxolitinib targets a pair of enzymes called JAK1 and JAK2 (Janus kinases). Think of these as internal relay switches: they receive signals from outside the cell and pass them along to activate genes that control cell growth, blood production, and inflammation. In diseases like myelofibrosis and polycythemia vera, these switches are overactive — driving out-of-control cell production and chronic inflammation. By blocking JAK1 and JAK2, ruxolitinib turns down that overactive signal, helping to normalize blood cell production and reduce inflammation. In graft-versus-host disease, the same JAK signaling pathway drives the immune attack on the recipient's own tissue; blocking it helps calm that response.

💊How it's taken

Ruxolitinib is taken by mouth in tablet form. The standard version (Jakafi) is generally taken twice a day; the extended-release version (Jakafi XR) is taken once a day. Both can be taken with or without food — meals do not meaningfully affect how the drug is absorbed.

  • Your exact dose depends on your condition and, for myelofibrosis, your platelet count — doses are individualized and may be adjusted over time
  • Do not stop taking it suddenly without your doctor's guidance — abrupt discontinuation can cause your symptoms to flare
  • Follow your prescriber's instructions and the label on your prescription exactly
🤒Side effects — in detail

The most common side effects vary somewhat by condition, but overall include:

  • Thrombocytopenia (low platelet count) — increases bruising and bleeding risk
  • Anemia (low red blood cell count) — can cause fatigue and weakness
  • Neutropenia (low white blood cell count) — raises infection risk
  • Bruising more easily than usual
  • Dizziness
  • Headache
  • Diarrhea
  • Swelling (edema) — especially in GVHD patients

Serious reactions to watch for include signs of infection (fever, chills), chest pain or stroke symptoms, unusual skin changes, or signs of blood clots — call your doctor or get emergency help if any of these occur.

⚠️Warnings & precautions
  • Serious infections — including tuberculosis, fungal, viral (e.g., shingles), and bacterial infections. Screening before starting is essential; report any signs of infection immediately during treatment.
  • Blood count drops — low platelets, red cells, and white cells are common. Regular blood tests (CBC) every 2–4 weeks early on are required.
  • Stopping suddenly — abrupt discontinuation can cause rapid return or worsening of disease symptoms. Taper or resume only under medical supervision.
  • Cardiovascular events and mortality — in patients with heart disease risk factors, JAK inhibitors have been linked to higher rates of heart attack, stroke, and death.
  • Blood clots (thrombosis) — deep vein clots, pulmonary embolism, and other clotting events have been reported. Seek immediate care for sudden leg swelling, chest pain, or trouble breathing.
  • Cancer risk — lymphoma, non-melanoma skin cancer, and other malignancies have been reported. Periodic skin exams and monitoring for new symptoms are recommended, especially in current or former smokers.
  • Elevated cholesterol — lipid levels should be checked 8–12 weeks after starting therapy.
🔀What it interacts with

Ruxolitinib is processed by liver enzymes (mainly CYP3A4), so drugs that affect those enzymes can change how much ruxolitinib is in your bloodstream:

  • Fluconazole (antifungal) — raises ruxolitinib blood levels significantly; avoid higher doses of fluconazole, and your ruxolitinib dose may need to be reduced even with lower doses
  • Strong CYP3A4 inhibitors (e.g., certain antifungals, some antibiotics, some HIV medications) — increase ruxolitinib exposure and the risk of side effects; dose reduction is usually needed (except in GVHD patients, per your doctor's guidance)
  • Strong CYP3A4 inducers (e.g., certain anti-seizure drugs, rifampin for tuberculosis) — lower ruxolitinib levels, potentially making it less effective; close monitoring and possible dose adjustment is needed

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Active infections: Do not start ruxolitinib until any serious infection has fully resolved
  • Past infections: Tell your doctor about any history of tuberculosis, herpes, hepatitis B, or recurring infections — screening is required before starting
  • Kidney impairment: A lower starting dose or avoiding use may be needed — discuss with your doctor
  • Liver impairment: Dose reduction may be required — your doctor will assess this
  • Pregnancy: Animal studies showed developmental harm at high doses. There are no human studies. Discuss risks and benefits carefully with your doctor if you are pregnant or planning to become pregnant
  • Breastfeeding: Do not breastfeed while taking ruxolitinib — it is unknown whether it passes into breast milk, but the potential risk to an infant means breastfeeding should be avoided
  • Smokers (current or former): Face an additional increased risk of malignancy — be sure your doctor knows your smoking history
  • Patients 12 and older: Approved for GVHD in this age group; dosing should be guided by the prescriber
🚑If you take too much

There is no specific antidote if too much ruxolitinib is taken. Taking more than prescribed can worsen bone marrow suppression — meaning dangerously low counts of red blood cells, white blood cells, and platelets. If an overdose is suspected, supportive medical treatment should be provided; hemodialysis (kidney dialysis) is not expected to help remove the drug from the body.

📡Pharmacodynamics — effects in the body

After dosing, ruxolitinib reaches its peak effect on JAK-STAT signaling (a key cell communication pathway) within about 2 hours, with the effect returning close to baseline by 10 hours. This means the drug is actively working against its target for several hours after each dose. At recommended doses, ruxolitinib does not cause any clinically meaningful changes to heart rhythm (specifically, it does not prolong the QT interval — an electrical measurement of the heart).

🔬Pharmacokinetics — how your body processes it

Ruxolitinib is very well absorbed when taken by mouth — at least 95% of a dose enters the bloodstream, and food does not meaningfully affect this. The standard tablet reaches peak blood levels in about 1–2 hours; the extended-release version peaks around 3 hours. The drug reaches a stable level in the blood (steady state) within about 3 days of regular dosing. It is broken down mainly by the liver enzyme CYP3A4, and most of the drug is excreted in the urine. The half-life (how long it takes the body to clear half the drug) is approximately 3 hours for the standard form, though the combined effect of the drug and its active metabolites lasts roughly 5–6 hours.

📦How to store it

Store JAKAFI/JAKAFI XR at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F) . Dispense in a tight container. Protect from light.

📄 Written from Ruxolitinib’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

141

Supplements & herbs that interact with Ruxolitinib

141 supplements and herbal products have documented interactions with Ruxolitinib in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 3
  • Moderate · 96
  • Minor · 42
Every supplement checked against Ruxolitinib — ranked by severity The full interaction hub: 3 major · 96 moderate · 42 minor · every one linked to its full report. Check Ruxolitinib against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Ruxolitinib — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is ruxolitinib treating in my body?
Ruxolitinib targets overactive enzymes called JAK1 and JAK2 that are driving your condition — whether that's abnormal bone marrow cell growth in myelofibrosis or polycythemia vera, or an out-of-control immune attack in graft-versus-host disease. By blocking these enzymes, it helps calm the abnormal signals causing your symptoms. It's not a cure, but it's designed to control the disease and improve how you feel.
Can I stop taking it if I feel better or if the side effects bother me?
Please don't stop suddenly without talking to your doctor first. If you stop ruxolitinib abruptly, your disease symptoms can come back quickly and sometimes more severely. If a side effect is bothering you, your doctor may be able to adjust the dose or help manage the issue — but stopping cold turkey on your own can create a serious rebound. Always check in before making changes.
What signs of infection should I watch for while I'm on this medication?
Because ruxolitinib lowers your immune defenses, even infections that might seem minor can become serious. Watch for fever, chills, night sweats, unusual cough, shortness of breath, painful skin sores, or just feeling much worse than usual. Shingles (a painful blistering rash), fungal infections, and tuberculosis are among the specific infections that have been reported. If anything like this comes up, call your doctor right away — don't wait it out.
I take fluconazole sometimes for yeast infections. Is that a problem?
It can be, yes — that's an important one to flag. Fluconazole raises the level of ruxolitinib in your bloodstream, which increases the risk of side effects. Your doctor may need to lower your ruxolitinib dose while you're taking fluconazole, or recommend an alternative antifungal. Make sure every member of your care team — including your pharmacist — knows all the medications you're taking.
Is it safe to take ruxolitinib if I'm pregnant or trying to get pregnant?
This needs a careful conversation with your doctor. There are no human studies, but animal studies did show some developmental harm at high doses. Given the serious nature of the conditions ruxolitinib treats, your doctor will need to weigh the risks versus the benefits for your specific situation. Breastfeeding is also not recommended while on this medication, since the potential risk to a nursing infant hasn't been ruled out.
I'm a former smoker. Does that change anything about my risk on this drug?
It does, and it's worth knowing. People who currently smoke or have smoked in the past are at an additional increased risk of certain cancers — including lymphoma — when taking JAK inhibitors like ruxolitinib. Make sure your doctor knows your smoking history so they can factor it into your monitoring plan. Regular skin exams and staying alert to new lumps, swollen lymph nodes, or unexplained weight loss are especially important for you.
Is Ruxolitinib available over the counter?
Ruxolitinib is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Ruxolitinib first available?
Ruxolitinib has been available in the United States since at least 2011, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Ruxolitinib?
Ruxolitinib is supplied by 17 manufacturers listed in the FDA NDC Directory, including Incyte Corporation, Patheon Manufacturing Services LLC, Catalent Pharma Solutions, LLC.

💬 Answers drafted from Ruxolitinib’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Ruxolitinib comes

Ruxolitinib is available in 3 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
Brands Jakafi
Available strengths 5 strengths
30 FDA-listed product records

Extended-release tablet

By mouth
Brands Jakafi Xr
Available strengths 5 strengths
10 FDA-listed product records

Topical cream, ointment or gel

On the skin
Brands Opzelura
Available strengths 1 strength
4 FDA-listed product records

📊 Ruxolitinib across the U.S. market

How Ruxolitinib appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

3
Dose forms
17
Manufacturers
3
Brand names
65
FDA-listed product records
2011
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (21) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Incyte Corporation52%
Patheon Manufacturing Services LLC8%
Catalent Pharma Solutions, LLC8%
American Pacific Corporation5%
MSN Laboratories Private Limited5%
Chunghwa Chemical Synthesis & Biotech Co., Ltd.3%
Other makers20%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Ruxolitinib is used

A general measure of how commonly Ruxolitinib is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Ruxolitinib is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

84,308
Medicaid prescriptions filled (Q1–Q4 2025)
$287.9M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Ruxolitinib prescribed? Of the 1,596 medications we measure, Ruxolitinib ranks #534 by Medicaid prescriptions — more than 67% of them.

Where Ruxolitinib ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Ruxolitinib product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 15 mg/mL topical cream is the most-dispensed Ruxolitinib product — about 90% of these Medicaid prescriptions.

ruxolitinib 15 MG/ML Topical Cream Most dispensed

76,226 Medicaid prescriptions (Q1–Q4 2025) 90% of Ruxolitinib prescriptions shown $157.7M gross reimbursement (before rebates) ≈ $2,069 per prescription (gross)

Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2570752

ruxolitinib 10 MG Oral Tablet

3,611 Medicaid prescriptions (Q1–Q4 2025) 4% of Ruxolitinib prescriptions shown $57.8M gross reimbursement (before rebates) ≈ $16,000 per prescription (gross)

Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1193331

ruxolitinib 5 MG Oral Tablet

2,992 Medicaid prescriptions (Q1–Q4 2025) 4% of Ruxolitinib prescriptions shown $47.6M gross reimbursement (before rebates) ≈ $15,900 per prescription (gross)

Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1193339

ruxolitinib 20 MG Oral Tablet

765 Medicaid prescriptions (Q1–Q4 2025) <1% of Ruxolitinib prescriptions shown $13.3M gross reimbursement (before rebates) ≈ $17,345 per prescription (gross)

Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1193347

ruxolitinib 15 MG Oral Tablet

660 Medicaid prescriptions (Q1–Q4 2025) <1% of Ruxolitinib prescriptions shown $10.9M gross reimbursement (before rebates) ≈ $16,564 per prescription (gross)

Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1193343

ruxolitinib 25 MG Oral Tablet

54 Medicaid prescriptions (Q1–Q4 2025) <1% of Ruxolitinib prescriptions shown $659,811 gross reimbursement (before rebates) ≈ $12,219 per prescription (gross)

Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1193351

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Ruxolitinib, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 6 of 20 listed Ruxolitinib NDCs with Medicaid activity.

🔍 Compare Ruxolitinib products

A representative set of FDA-listed product records for Ruxolitinib — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 65 of 65 products — FDA National Drug Code Directory. See every product, package size and price: browse all 65 Ruxolitinib NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Ruxolitinib RxCUI 1193326 3 dose forms · 11 strengths
  1. Dose form (SCDF) Oral Tablet RxCUI 1193330 In current FDA listings
    Clinical drug / strength (SCD) 5 MG RxCUI 1193339 10 MG RxCUI 1193331 15 MG RxCUI 1193343 20 MG RxCUI 1193347 25 MG RxCUI 1193351
  2. Dose form (SCDF) Topical Cream RxCUI 2570751 In current FDA listings
    Clinical drug / strength (SCD) 15 MG/ML RxCUI 2570752

Look up RxCUI 1193326 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Jakafi Opzelura Jakafi Xr

🏭 Manufacturers & labelers

Incyte Corporation 34 Patheon Manufacturing Services LLC 5 Catalent Pharma Solutions, LLC 5 American Pacific Corporation 3 MSN Laboratories Private Limited 3 Chunghwa Chemical Synthesis & Biotech Co., Ltd. 2 Granules India Limited 2 Zhejiang Ausun Pharmaceutical Co., Ltd. 2 Finorga 1 Chongqing Huapont Pharmaceutical Co., Ltd 1 Melody Healthcare Pvt. Ltd. 1 AX Pharmaceutical Corp 1 Natco Pharma Limited 1 Alivus Life Sciences Limited 1 Siegfried Evionnaz SA 1 Sterling Spa 1 Valary Lab Private Limited 1

RxNorm drug class

Ruxolitinib belongs to the Kinase Inhibitor class.

Pharmacologic class Kinase Inhibitor, Janus Kinase Inhibitor
Drug family (ATC) Agents for dermatitis, excluding corticosteroids, Janus-associated kinase (JAK) inhibitors
How it works Janus Kinase Inhibitors

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Jul 20, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Ruxolitinib.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Ruxolitinib after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
1
NDC products indexed
65
Distinct labelers/manufacturers represented
17
Linked representative label
Incyte Corporation
Linked label effective
Jul 20, 2026
Composite sections available
21
Linked SPL Set ID
f1c82580-87ae-11e0-bc84-0002a5d5c51b
Linked SPL Document ID
1c261eb0-f426-47a1-8281-62282d207644
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Incyte Corporation is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.