Cibinqo

Increased risk of serious infections (eg, TB, bacterial, viral, invasive fungal, or other opportunistic pathogens). Avoid in active, serious, or localized infections. Consider the risks/benefits in chronic, recurrent, or history of serious or opportunistic infections. Travel to, or residence in, areas with endemic TB or mycoses. Conditions that predispose to infection. Test/treat latent TB infection prior to and per applicable guidelines during therapy. Monitor closely if new infection, active TB (even if initial latent test is negative), reactivation of herpes virus or hepatitis occurs; interrupt treatment if serious or opportunistic infection. Screen for viral hepatitis before starting therapy. RA patients age ≥50yrs with ≥1 CV risk factor treated with another JAK inhibitor: increased rate of all-cause mortality (including sudden CV death), MACE (CV death, MI, stroke), or thrombosis. Discontinue in those with previous MI or stroke, or with symptoms of thrombosis. Avoid in those with increased risk for thrombosis. Increased rate of malignancies (esp. lymphomas, lung cancers). Consider benefits/risks prior to or continuing therapy (esp. smokers, with other CV risk factors, or with a known malignancy). Perform periodic skin exam in those with skin cancer risk. Update immunizations based on current guidelines prior to initiation. Do not initiate therapy if platelets <150,000/mm³, lymphocytes <500/mm³, ANC <1000/mm³, or hemoglobin <8g/dL. Monitor CBCs at baseline, 4 weeks after initiation, and 4 weeks after dose increase. Monitor lipids 4 weeks following initiation and manage hyperlipidemia. Severe hepatic or renal impairment (eGFR 15–29mL/min), ESRD (eGFR <15mL/min): not recommended. CYP2C19 poor metabolizers. Elderly. Pregnancy. Nursing mothers: not recommended (during and for 1 day after the last dose).