Abrocitinib

CIBINQO

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Pronunciation: a-broe-SYE-ti-nib (si-BINK-oe)

Abrocitinib ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Abrocitinib ballicule

Abrocitinib CIBINQO mascot mnemonic cartoon — Visual mnemonic: Abrocitinib mascot
**“Ape Bro, the Bingo City Nibbler”**

What it isSelective JAK1 inhibitor; refractory moderate to severe atopic dermatitis.

Why this oneFaster itch relief than dupilumab, and it is oral rather than injected.

What limits itJAK class warnings apply. CYP2C19 variation changes exposure; screen for tuberculosis and hepatitis B.

Abrocitinib molecular structure (skeletal formula) — Molecular structure: Abrocitinib

Abrocitinib prescription history

Animated chart of estimated U.S. prescriptions per year, Tyrosine kinase inhibitors (2001–2026). Abrocitinib enters in 2022 (estimated).

FDA-approved for

Refractory moderate-to-severe atopic dermatitis (2022)

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryN/A (post-2015 labeling)

Defining liabilitySerious infection, thrombosis and dose-dependent thrombocytopenia

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Serious infections (incl. TB), all-cause mortality, malignancy, MACE, and thrombosis (JAK-inhibitor class warnings).

FDA dosing	Population	Start	Target	Max
Atopic dermatitis, moderate-to-severe	Adults	100 mg QD	100 mg QD (lowest efficacious dose)	200 mg QD (only if inadequate response to 100 mg; discontinue if inadequate on 200 mg)
Atopic dermatitis, moderate-to-severe	Peds >=12 yr	100 mg QD	100 mg QD	200 mg QD (same escalation rule as adults)
Atopic dermatitis — CYP2C19 poor metabolizers (known/suspected)	All ages >=12 yr	50 mg QD	50 mg QD	100 mg QD (if inadequate response; discontinue if inadequate on 100 mg)

Renal Mild (eGFR 60-89): no adjustment. Moderate (30-59): 50 mg QD, may increase to 100 mg QD if inadequate response. Severe (15-29)/ESRD incl. renal replacement: not recommended

Hepatic Mild-moderate (Child-Pugh A/B): no adjustment. Severe (C): not recommended (avoid)

Instructions

Oral; with or without topical corticosteroids
Missed dose: take ASAP unless <12 h to next dose, then skip
Before initiation: TB evaluation, viral hepatitis screen, CBC (do not start if platelets <150k, ALC <500, ANC <1000, or Hb <8 g/dL); complete immunizations incl. herpes zoster
Taking a strong CYP2C19 inhibitor: reduce to 50 mg QD (may increase to 100 mg QD if inadequate response)
Discontinue for platelets <50k (follow CBC until >100k); hold for ALC <500, ANC <1000, or Hb <8 g/dL until recovered; CBC at baseline, 4 wk after start and 4 wk after dose increase
Discontinue if serious/opportunistic infection develops

Available strengths

tab 50, 100, 200 mg

Contraindications

Antiplatelet therapies (except aspirin <=81 mg/day) during the first 3 months of treatment

Cautions

Serious/opportunistic infections incl. TB, herpes zoster, pneumonia — avoid with active serious infection; monitor for TB during treatment
Higher all-cause mortality (incl. sudden CV death) with another JAK inhibitor vs TNF blockers in RA patients >=50 yr with CV risk
Malignancy incl. lymphoma and lung cancer (JAK class); current/past smokers at added risk
MACE (CV death, MI, stroke); discontinue if MI or stroke occurs
Thrombosis: DVT/PE and arterial thrombosis — avoid in patients at risk
Hypoglycemia in patients with diabetes on antidiabetic therapy
Laboratory abnormalities: thrombocytopenia, lymphopenia, neutropenia, anemia; lipid elevations
Avoid live vaccines before, during, and immediately after treatment

Adverse reactions

Nasopharyngitis
Nausea
Headache
Herpes simplex
Increased CPK
Dizziness
UTI
Fatigue
Acne
Vomiting
Herpes zoster (200 mg)
Thrombocytopenia (200 mg)

Pregnancy Insufficient human data; animal studies: dystocia and fetal skeletal variations at ~11x MRHD (rats). Pregnancy exposure registry 1-877-311-3770

Lactation Advise not to breastfeed during treatment and for 1 day after last dose (present in rat milk ~5x plasma)

Cost

Abrocitinib (CIBINQO)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	brand $/mo	CostPlus
50 mg	tab	30 qd		—	not offered
100 mg	tab	30 qd	—	$5,912.77	not offered
200 mg	tab	30 qd		—	not offered

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Self-check

Which infections should be screened before abrocitinib?
Tuberculosis and hepatitis B.
Which enzyme’s variation changes abrocitinib exposure?
CYP2C19.