Antimalaria Medication and Jakavi

[Ticotopia]

Hello dear all,

Things are going well with my husband who has myelofibrosis. Jakavi has been a live changer and he responds very well to it. We are ready to go on an adventure!!!. We are leaving for Kenya in a few weeks to visit friends and of course visit Masai Mara and Ol Pejeta. My husband cannot take a yellow fever vacine due to his condition. We are planning to DET ourselves day and night and us all precautions. My question is in regards to Malaria pills. I tried to find information to see if the malaria medications interact with the Jakavi and which medication best to take. It seems that it is safe but thought maybe I put that out here to see if anybody has any information or experience with it. We are purposly are going during the dry seasno which is less prone to malaria and choose areas with high altitude but we want to be as cautious as possible. We tried to consult witht he doctors here but could not find a definite answer. What she said "We are keeping you feeling as good as possible for as long as possible so that you can live and enjoy live" which I thought was very true. Saludos.

[EPguy]

I assume you refer to hydroxychloroquine . I 'm on Rux and also a candidate for hydroxychloroquine to treat Sjogren's autoimmune. I have not taken it so far but my Rheumatologist has not been concerned about this combo.

In this old trial for Rux for Covid they have this note:

" Note: recent or concurrent treatment with hydroxychloroquine or chloroquine is allowable"

classic.clinicaltrials.gov/...

So at least these guys were ok with it with Rux. This pill was once in the news for treating Covid by itself, but it seems to have been well studied and didn't work out for that.

--

If you both are feeling well enough to take that sort of trip you're most fortunate and I wish you well.

[Ticotopia in reply to EPguy]

Thank you very much. Yes I think what they will give us here to take is hydroxychloroquine. We do feel fortunate but of course a bit nervous as well... :). All the best to you!

[hunter5582]

Here is the information from ePocrates.

Monitor/Modify Tx ruxolitinib + hydroxychloroquine

monitor CBC: combo may incr. risk of myelosuppression (additive effects)

Additional Considerations hydroxychloroquine in Plaquenil

monitor ECG in combo w/ other drugs that prolong QT interval after hydroxychloroquine D/C due to long half-life (32-50 days); combo may incr. risk of QT prolongation, cardiac arrhythmias

Of interest, are these warnings from Drugs.com. Suggest no grapefruit juice.

hydroxychloroquine food Applies to: Plaquenil (hydroxychloroquine)

You may want to limit your consumption of grapefruit or grapefruit juice during treatment with hydroxychloroquine. Grapefruit juice can significantly increase the blood levels and effects of hydroxychloroquine, which may result in an irregular heart rate or other conduction disturbances. Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with hydroxychloroquine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ruxolitinib food Applies to: Jakafi (ruxolitinib)

Do not consume grapefruit or grapefruit juice during treatment with ruxolitinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of ruxolitinib. This may increase the risk of side effects that affect your bone marrow function, resulting in low numbers of different types of blood cells. You may be more likely to develop anemia, bleeding problems, or infections. Contact your doctor if you experience potential signs and symptoms of these conditions such as paleness, fatigue, dizziness, fainting, unusual bleeding or bruising, fever, chills, sore throat, body aches, or other flu-like symptoms. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Hope you all enjoy your trip.

[EPguy in reply to hunter5582]

The Rux bottle actually has a paper tail on it explicitly saying in bold no grapefruit. An unusually strong notice. I do miss that fruit. I use to climb trees in a parking lot and get ~40lbs of it. (might still as my hubby eats them too)

[Ticotopia in reply to hunter5582]

Thank you, Hunter. You are truly amazing. Definitely no grapefruit Since it also interacts with bloopressure medication no grapefruit has crossed the doorstep in years.

[Wyebird]

Hi we always do the questionnaire on line. I’m on peg and Simvistatin. I have to have Malarone. You can book an appointment with boots the chemist but give yourself plenty of time for an appointment as they are usually booked a few weeks in advance.

As for the Mara we go every year. We stay at Governors camp. You will love it.

[Ticotopia in reply to Wyebird]

Thank you. Yes it has been a livelong dream to go there. We are super excited but a bit nervous of course. Appreciate the advice and the link to check interaction of meds. I did not know that such thing exists.

[Wyebird in reply to Ticotopia]

Haha I didn’t either. Have a wonderful time. Do nt ignore the birds. Do take good binoculars. Our guide introduced us to the birds. Make sure you get to see a ‘lilac breasted roller bird ‘

[Wyebird]

I just found this on internet

White background blue and black text

[EPguy]

Hope your trip was great. Did you take the HCQ? (hydroxychloroquine )

I have update on my experience as I did try it since these posts. After two weeks of low dose treatment I got increased tinnitus. It may be permanent. It is a known but rare side effect of HCQ, esp rare so early in treatment. No way to know if it's a Rux interaction but I stopped the HCQ at the 1st sign of it.

[Ticotopia in reply to EPguy]

Hi there. The trip was absolutely amazing. We are so glad that we took it. We stayed in mountainous regions and not one pesky mosquito in sight. My husband took the malaria pills as instructed and had no immediate issues. However immediately after we came back he had his blood exam and is platelets had dropped dangerously low. From 190 to under 50. The doctor thought that the Jakafi HCQ combo caused it. As we had not been bitten by mosquitoes he immediately stopped taking remaining antimalarials and platelets are back in range.I think one really has to weigh the risk. Hope that all is good with you. All the best!

[EPguy in reply to Ticotopia]

That's so fun to go places. I can no longer after my severe vaccine/IFN reactions. (HCQ reaction I note here is a minor issue so far)

While we had different HCQ reactions, it does point to the Rux/HCQ combo being of concern. HCQ is supposed to be one of the lowest risk immune suppressants with the two not listed anywhere I can find as having interactions.