Jakafi (ruxolitinib) is a prescription drug that’s used to treat graft-versus-host disease (GVHD) and certain cancers. Jakafi can interact with other medications and some supplements. For example, it can interact with dexamethasone (Hemady) and fluoxetine (Prozac).
Jakafi is used to treat:
- acute (short-term) and chronic (long-term) GVHD in certain adults and children
- myelofibrosis in certain adults
- polycythemia vera in certain adults
Jakafi comes as an oral tablet.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Jakafi’s possible interactions. And for more information about Jakafi, including details about its uses, see this article.
It should be safe to drink alcohol during your Jakafi treatment. There’s no known interaction between this drug and alcohol.
If you drink alcohol, talk with your doctor about how much may be safe to consume while taking Jakafi.
Before you start taking Jakafi, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. To learn whether Jakafi interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Jakafi?” section below.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Jakafi. Keep in mind that this table doesn’t include all drugs that may interact with Jakafi. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| certain antifungals | • fluconazole (Diflucan) • ketoconazole • itraconazole (Sporanox) | can increase the risk of side effects from Jakafi* |
| certain antibiotics | • clarithromycin • erythromycin (Eryc, Ery-Tab, others) • rifampin (Rifadin, Rimactane) | can make Jakafi less effective, or increase the risk of side effects from Jakafi |
| certain calcium channel blockers | • diltiazem (Cardizem, Tiazac, others) • verapamil (Verelan, Verelan PM) | can increase the risk of side effects from Jakafi |
| certain seizure drugs | • carbamazepine (Carbatrol, Epitol, Tegretol, others) • phenytoin (Dilantin, Phenytek) • phenobarbital (Sezaby) | can make Jakafi less effective |
| dexamethasone (Hemady) | — | can make Jakafi less effective |
| fluoxetine (Prozac) | — | can increase the risk of side effects from Jakafi |
* To learn more about Jakafi’s side effects, see this article.
Learn more about certain drug interactions that can occur with Jakafi.
Interaction with certain calcium channel blockers
Jakafi may interact with certain calcium channel blockers (CCBs). These drugs are used to treat high blood pressureand certain heart conditions.
CCBs that interact with Jakafi include diltiazem (Cardizem, Tiazac, others) and verapamil (Verelan, Verelan PM).
What could happen
Taking Jakafi with certain CCBs could increase your risk of side effects from Jakafi. This is because certain CCBs slow the activity of the enzyme (a kind of protein) that breaks down Jakafi in your body. This could raise the level of Jakafi in your system, which can increase your risk of side effects from the drug.
To learn more about Jakafi’s side effects, see this article.
What you can do
Before starting Jakafi treatment, tell your doctor if you take a CCB. They can determine whether this drug interacts with Jakafi and whether it’s safe to take them together.
Interaction with dexamethasone
Jakafi may interact with dexamethasone (Hemady). This is a corticosteroid drug that’s used to ease swelling associated with inflammation.
What could happen
Taking Jakafi with dexamethasone could make Jakafi less effective. This is because dexamethasone speeds up the activity of the enzyme that breaks down Jakafi in your body. This could lower the level of Jakafi in your system, making the drug less effective.
What you can do
Before you take Jakafi, tell your doctor if you take dexamethasone. They can determine whether it’s safe to take these medications together.
Interaction with fluoxetine
Jakafi may interact with fluoxetine (Prozac). This drug is an antidepressant that’s used to treat depression and other mental health conditions.
What could happen
Taking Jakafi with fluoxetine could raise your risk of side effects from Jakafi.
Fluoxetine slows the activity of the enzyme that breaks down Jakafi in your body. As a result, fluoxetine could raise the level of Jakafi in your body, which can increase your risk of side effects from the drug.
What you can do
Before starting Jakafi treatment, tell your doctor if you take fluoxetine. They can determine whether you can take these drugs together.
Jakafi may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below doesn’t include all other possible interactions with Jakafi.
Does Jakafi interact with supplements?
Before you start taking Jakafi, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Jakafi interactions with herbs
It may not be safe to take Jakafi with the herbal supplement St. John’s wort. This herb is used to ease symptoms of depression and other conditions.
Taking Jakafi with St. John’s wort could cause your body to break down Jakafi too quickly. This can lower the level of Jakafi in your body, which may make Jakafi less effective.
Before taking any herbal supplements with Jakafi, be sure to talk with your doctor or pharmacist.
Jakafi and vitamins
There are currently no reports of Jakafi interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Jakafi.
Does Jakafi interact with food?
Jakafi may interact with grapefruit or grapefruit juice. Taking the drug with grapefruit products could prevent your body from breaking down Jakafi properly. This can raise the level of Jakafi in your body, which may increase your risk of side effects from Jakafi. (For details about Jakafi’s side effects, see this article.)
If you consume grapefruit, talk with your doctor before taking Jakafi.
Does Jakafi interact with vaccines?
It may not be safe to receive COVID-19 vaccines (Comirnaty, Spikevax) or cholera vaccines (Vaxchora) while taking Jakafi.
This is because Jakafi may lower the activity of your immune system. These vaccines work by helping the immune system recognize COVID-19 and cholera. Getting these vaccines while taking Jakafi could make the vaccines less effective at protecting against infection.
Before taking Jakafi, ask your doctor to review your vaccine history. If you need a vaccine for COVID-19 or cholera, they may give you the vaccine before you start Jakafi treatment. Your doctor can also tell you whether other vaccines are safe to receive while you’re taking Jakafi.
Does Jakafi interact with lab tests?
There are currently no reports of Jakafi interacting with lab tests. If you have questions about getting certain lab tests during your Jakafi treatment, talk with your doctor.
Does Jakafi interact with cannabis or CBD?There are currently no reports of Jakafi interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Jakafi.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Jakafi. Before taking Jakafi, talk with your doctor about your health history. They’ll determine whether Jakafi is right for you.
Health conditions or other factors that might interact with Jakafi include:
Factors that raise the risk of heart-related side effects. Taking Jakafi may lead to heart-related side effects, including heart attack. Certain factors may raise your risk of these side effects. Examples include smoking, high blood pressure, high cholesterol, and type 2 diabetes.
If you have any of these factors, talk with your doctor before taking Jakafi. They can determine whether it’s safe for you to take the drug.
Tuberculosis (TB) or hepatitis B. Before starting Jakafi treatment, tell your doctor if you’ve ever had TB or hepatitis B. Jakafi may cause the TB bacterium or hepatitis B virus (HBV) to become active and cause symptoms.
If you’ve ever had TB or hepatitis B, your doctor can determine whether Jakafi is the right treatment option for you. If you do take Jakafi, your doctor will watch for symptoms of TB and hepatitis B during your treatment. They’ll let you know what you should do if either infection becomes active.
Kidney problems. Before taking Jakafi, tell your doctor if you have a kidney problem such as kidney failure. They may prescribe a lower dose of Jakafi for you. (To learn about Jakafi’s dosage, see this article.)
Liver problems. Before taking Jakafi, tell your doctor if you have a liver problem such as liver failure. They may prescribe a lower dose of Jakafi than usual.
Pregnancy. It’s not known whether Jakafi is safe to take while pregnant. If you’re pregnant or planning a pregnancy, talk with your doctor. They can tell you about the risks and benefits of taking Jakafi during pregnancy.
Breastfeeding. It’s not known whether it’s safe to take Jakafi while breastfeeding. It isn’t known if the drug passes into breast milk or causes side effects in a child who is breastfed. To be safe, your doctor may advise you to avoid breastfeeding during your Jakafi treatment and for at least 2 weeks after your last dose.
If you’re breastfeeding or planning to breastfeed, talk with your doctor before starting Jakafi treatment.
Allergic reaction. If you’ve had an allergic reaction to Jakafi or any of its ingredients, your doctor will likely not prescribe Jakafi. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Jakafi. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Jakafi treatment.
It’s also important to understand Jakafi’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Jakafi exactly as prescribed can also help prevent interactions.
If you still have questions about Jakafi and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Should I tell you if I start taking another medication during my Jakafi treatment?
- Do other drugs that treat my condition have similar interactions?
- Does my dosage of Jakafi affect my risk of interactions?
To learn more about Jakafi, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
