Is ruxolitinib (Jakafi) safe to use postoperatively?

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Last updated: April 26, 2025View editorial policy

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From the Guidelines

Ruxolitinib should be used with caution after surgery, with careful monitoring of hematologic parameters, as it may increase the risk of bleeding, infection, and delayed wound healing. The management of ruxolitinib after surgery is crucial to minimize its potential adverse effects, such as thrombocytopenia, anemia, and neutropenia, which can be managed by dose reduction or interruption, as well as blood transfusions and dose modifications 1. When considering the use of ruxolitinib after surgery, it is essential to weigh the benefits of the medication against the potential risks, particularly in patients with a history of bleeding or thrombocytopenia.

Some key considerations for the use of ruxolitinib after surgery include:

  • Monitoring CBCs every 2 to 4 weeks until doses are stabilized, and then as clinically indicated, to quickly identify any potential hematologic toxicities 1
  • Managing thrombocytopenia, anemia, and neutropenia through dose reduction or interruption, as well as blood transfusions and dose modifications, as necessary 1
  • Considering the potential for increased infection risk and interactions with certain anesthetics or post-surgical medications when using ruxolitinib after surgery
  • Developing a personalized plan for managing ruxolitinib after surgery, in consultation with both the surgeon and the specialist who prescribed the medication.

The decision to restart ruxolitinib after surgery should be based on the individual patient's circumstances, surgical procedure, and healing progress, with careful consideration of the potential benefits and risks of the medication. The goal is to balance the need for effective management of the underlying condition with the need to minimize the risks associated with ruxolitinib use after surgery.

From the Research

Ruxolitinib Safety After Surgery

  • The safety of ruxolitinib after surgery is not directly addressed in the provided studies 2, 3, 4, 5, 6.
  • However, the studies discuss the potential risks and side effects of ruxolitinib, including increased risk of infections 3, 5, myelosuppression 4, and viral reactivations 4, 5.
  • Ruxolitinib has been shown to be effective in treating myelofibrosis and polycythemia vera, but its use requires careful monitoring and management of potential side effects 2, 4, 6.
  • In the context of surgery, patients taking ruxolitinib may be at increased risk of bleeding or infection due to its immunosuppressive effects 3, 5.
  • It is essential to weigh the benefits and risks of ruxolitinib treatment in patients undergoing surgery, and to closely monitor their condition and adjust treatment as needed 2, 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Ruxolitinib.

Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer, 2018

Research

A journey through infectious risk associated with ruxolitinib.

British journal of haematology, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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