Home Drug Guide Ritlecitinib Tosylate

Drug Guide

Generic Name

Ritlecitinib Tosylate

Brand Names Litfulo

Classification

Therapeutic: Immunosuppressant, Janus kinase (JAK) inhibitor

Pharmacological: Selective JAK3 and TEC family kinase inhibitor

FDA Approved Indications

  • Treatment of alopecia areata in adults

Mechanism of Action

Ritlecitinib selectively inhibits Janus kinase 3 (JAK3) and TEC family kinases, thereby modulating the immune response involved in alopecia areata by interfering with cytokine signaling pathways.

Dosage and Administration

Adult: Loading dose of 30 mg orally once daily for 24 weeks. Adjustments based on response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dose adjustments necessary, but monitor for adverse effects in elderly patients.

Renal Impairment: No specific dose adjustment needed.

Hepatic Impairment: Use with caution; no specific recommendations established.

Pharmacokinetics

Absorption: Rapid absorption with peak plasma concentrations achieved in approximately 1-2 hours.

Distribution: Extensively bound to plasma proteins.

Metabolism: Primarily metabolized in the liver via CYP3A4 and other pathways.

Excretion: Excreted mainly in feces with minimal renal excretion.

Half Life: Approximately 8 hours.

Contraindications

  • Known hypersensitivity to ritlecitinib or excipients.

Precautions

  • Use cautiously in patients with active infections, history of malignancies, or liver impairment. Monitor for infections, cytopenias, and lipid abnormalities during treatment. Not recommended during pregnancy or breastfeeding.

Adverse Reactions - Common

  • Upper respiratory tract infections (Frequent)
  • Headache (Frequent)
  • Nasopharyngitis (Frequent)

Adverse Reactions - Serious

  • Serious infections (e.g., pneumonia, herpes zoster) (Rare)
  • Liver enzyme elevations (Rare)
  • Blood dyscrasias (neutropenia, anemia, lymphopenia) (Rare)
  • Thrombosis (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors or inducers may affect ritlecitinib levels.
  • Other immunosuppressants may increase infection risk.

Drug-Food Interactions

  • No specific food interactions identified.

Drug-Herb Interactions

  • Avoid concomitant use with herbal products that impact immune function.

Nursing Implications

Assessment: Monitor for signs of infection, liver function tests, complete blood counts, lipid profile, and signs of thrombosis.

Diagnoses:

  • Risk for infection, Risk for bleeding, Risk for hepatotoxicity.

Implementation: Administer as prescribed, educate patient on infection prevention, monitor lab parameters regularly.

Evaluation: Assess efficacy of alopecia areata treatment, monitor for adverse effects, and adjust treatment accordingly.

Patient/Family Teaching

  • Report signs of infection promptly.
  • Maintain good hygiene and avoid sick contacts.
  • Inform about potential side effects and instruct on when to seek medical help.
  • Adherence to medication schedule is crucial.

Special Considerations

Black Box Warnings:

  • Serious infections leading to hospitalization or death, including opportunistic infections, herpes zoster, and tuberculosis.
  • Malignancies and serious bacterial, fungal, and viral infections.

Genetic Factors: No specific genetic markers required before initiation.

Lab Test Interference: May cause increase in liver enzymes and lipid levels, which should be monitored.

Overdose Management

Signs/Symptoms: Unusual bleeding, infection, or adverse drug reactions.

Treatment: Supportive care, discontinue medication, monitor symptoms, and provide appropriate medical management.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable until the expiration date on the packaging.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.