JAK2 inhibitor
Fedratinib (Specialist drug)
Brand names: Inrebic
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC; usually 400mg OD
Route: PO
Frequency: OD
Clinical pearls
- Myelofibrosis (intermediate-2/high risk) intolerant or refractory to ruxolitinib
- Mandatory thiamine measurement before each cycle
Contraindications
- Pregnancy
- Severe renal/hepatic impairment
Side effects
- Anaemia
- Thrombocytopenia
- GI upset
- Hepatotoxicity
- Wernicke's encephalopathy (CHECK thiamine before/during)
- Increased infection risk
Interactions
- Strong CYP3A4 inhibitors/inducers
- Drugs causing thiamine deficiency
Monitoring
- FBC
- LFTs
- Thiamine
- Pancreatic enzymes
Reference: BNF; NICE TA756; SmPC; https://bnf.nice.org.uk/drugs/fedratinib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
Pathways
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO