Ruxolitinib Cream

Overview

Ruxolitinib cream is a prescription-only medicine. It is a topical Janus kinase (JAK) inhibitor. It blocks two enzymes, JAK1 and JAK2, in the skin. These enzymes carry the signal that causes the immune attack on melanocytes, the cells that give skin its colour. When the cream decreases this signal, the pigment cells can recover and the pale patches can become darker. The active ingredient is ruxolitinib phosphate, at a strength of 15 mg of ruxolitinib per gram of cream. You can read more about the condition on our vitiligo page.

Ruxolitinib is also made as a tablet (brand names Jakavi and Jakafi) to treat blood conditions such as myelofibrosis. The tablet and the cream are different medicines. You cannot use one in place of the other. This page is about the cream only.

Global Name

• Generic Name: Ruxolitinib (as ruxolitinib phosphate)
• Brand Names: Lumirix in Hong Kong and Mainland China; Opzelura in the United States, Europe and Canada.

Usage

What is Ruxolitinib Cream used for?

Ruxolitinib cream is used to treat non-segmental vitiligo. This is a long-term condition in which the immune system destroys pigment cells. It causes pale patches on both sides of the body. The Hong Kong registration is for adults and adolescents from 12 years.

In the United States and Europe, the cream is also approved for mild to moderate atopic dermatitis (eczema). This use is not part of the Hong Kong registration.

Other treatments for vitiligo

Ruxolitinib cream is one of many treatments for vitiligo. The correct treatment depends on the type of vitiligo, where the patches are, how quickly they spread, and your general health. Other treatments include:

• Corticosteroid creams and ointments.
• Calcineurin inhibitor creams and ointments, such as tacrolimus and pimecrolimus.
• Phototherapy (light therapy), such as narrowband UVB or excimer light.
• Short courses of oral corticosteroids, for vitiligo that spreads quickly.
• Skin grafting procedures, for vitiligo that is stable.
• Cosmetic camouflage and sun protection.

Your dermatologist can tell you which treatments are suitable for you.

How do you use Ruxolitinib Cream?

Ruxolitinib cream is available in one strength:

• Cream, 15 mg of ruxolitinib per gram (1.5%).
• Supplied in Hong Kong as a 100 g tube.

The dose is the same for adults and for adolescents from 12 years. General instructions:

• Apply a thin layer two times each day to the pale areas, with a minimum of 8 hours between applications.
• Do not treat more than 10% of the body surface. This is approximately ten times the area of one palm with the five fingers.
• Do not use more than two 100 g tubes in one month.
• Do not wash the treated skin for a minimum of 2 hours after you apply the cream.

Colour returns slowly. A doctor usually continues treatment for a minimum of 6 months. A satisfactory result can take more than 12 months.

Do not use ruxolitinib cream if you:

• Had an allergic reaction to ruxolitinib or to any other ingredient in the cream.
• Are less than 12 years old, because there is no safety data for this group.

Speak to your doctor before you use the cream if you:

• Have end-stage kidney disease.
• Have an active serious infection, such as tuberculosis. Your doctor must treat the infection first.
• Have a weak immune system. For example, you have another autoimmune disease, you take oral corticosteroids or other immunosuppressants, or you get treatment for cancer.
• Have an increased risk of blood clots, such as deep vein thrombosis (DVT), pulmonary embolism (PE) or arterial thrombosis.
• Are pregnant, plan to become pregnant or are breastfeeding. There is little safety data in pregnancy. In studies in rats, the medicine went into breast milk.

Interactions and Contraindications of Ruxolitinib Cream

A small quantity of the medicine goes through the skin into the blood. Tell your doctor about all the medicines you take. Do not use the cream at the same time as another JAK inhibitor or a strong immunosuppressant, unless your doctor tells you to. Speak to your doctor before you have a live vaccine during treatment. Tell your doctor if you had tuberculosis, shingles, or hepatitis B or C.

Ruxolitinib Cream Side Effects

Common side effects occur on the treated skin and are usually mild. They include acne, itching and redness where you apply the cream. Other common side effects are cold-like symptoms, headache, urinary tract infection and fever.

Ruxolitinib is a JAK inhibitor. Studies of JAK inhibitors taken by mouth showed an increased risk of serious infection, blood clots, heart problems, some cancers and low blood cell counts. Regulators list these as warnings for all medicines in this class, including the cream. Do not treat more skin than your doctor tells you to. If you treat a larger area, more of the medicine can go into the blood. Get medical help immediately if you have a fever, chills, a cough that does not stop, pain or swelling in a leg, chest pain or shortness of breath.

Ruxolitinib Cream Pharmacist Tips and Storage

Keep the tube at room temperature, away from direct sunlight, heat and moisture. Do not freeze it. Read the carton for the correct storage temperature. Keep the tube out of the reach and sight of children. Do not use the cream after the expiry date on the tube.

Wash and dry your hands before you open the tube. Apply a thin layer and rub it in gently. Apply it only to the pale patches, not to the healthy skin around them. Wash your hands after you apply the cream, unless you treat your hands. Use the cream on the skin only. Do not put it in your eyes, mouth or vagina, and do not apply it to your lips. Do not put an airtight dressing on treated skin, unless your doctor tells you to. Protect treated skin from strong sun. Do not share the tube with other persons, also if they have the same condition.

Availability of Ruxolitinib Cream

Where is Ruxolitinib Cream available in Hong Kong?

Ruxolitinib cream is a Prescription Only Medicine. It is registered in Hong Kong as Lumirix Cream 15 mg/g, registration number HK-68437 (registered November 2024). It is classified as a Part 1, Schedule 1 and Schedule 3 poison. You must have a prescription from a registered doctor, and a pharmacist must supply the medicine.

You can get the cream from registered pharmacies that show the “Rx” logo, and from the dispensaries of hospitals, clinics and dermatology centres. Shops that are not registered pharmacies cannot sell it. A dermatologist usually starts the treatment, because the diagnosis of non-segmental vitiligo and the selection of the area to treat need a specialist assessment.

FAQs

How long does Ruxolitinib Cream take to work?

Colour returns slowly. Treatment usually continues for a minimum of 6 months before your doctor examines the result. A satisfactory result can take more than 12 months.

Does Ruxolitinib Cream cure vitiligo?

No. The cream can bring colour back to treated patches, but it does not remove the cause of the condition. The colour can fade again after you stop.

Is Ruxolitinib Cream a steroid?

No. It is a JAK inhibitor, which is a different class of medicine.

Can I use it on my whole body?

No. Do not treat more than 10% of your body surface at one time. This is approximately ten times the area of one palm with the five fingers. If you treat a larger area, more of the medicine can go into your blood.

What should I do if I forget a dose?

Apply the cream when you remember, unless your next application is soon. In that case, do not apply the missed dose, and continue with your usual times. Do not apply extra cream to make up for a missed dose.

What happens if I stop using the cream?

The new colour can fade in the months after you stop. Speak to your doctor before you stop, and tell your doctor if the pale patches return.

Can children use Ruxolitinib Cream?

Adolescents from 12 years can use it at the adult dose. There is no safety data for children less than 12 years old with vitiligo. Thus, the cream is not approved for this age group. Speak to a paediatric dermatologist about the treatments for a younger child.