Pacritinib

FDA label

Read the full label on DailyMed ↗

Renal Avoid if eGFR <30 mL/min

Hepatic Mild–moderate (Child-Pugh A/B): no adjustment; severe (Child-Pugh C): 100 mg BID, may increase to 200 mg BID after 12 weeks if ineffective and no safety concerns

Instructions

• Swallow capsules whole — do not open, break, or chew; with or without food
• Taper or discontinue prior kinase inhibitors per their labels before starting
• Baseline CBC (with differential and platelets), coagulation testing (PT, PTT, TT, INR), and ECG before starting; monitor as clinically indicated
• Hold 7 days before elective surgery/invasive procedures (hemorrhage risk); restart only after hemostasis assured
• Toxicity dose reductions: 200 mg BID → 100 mg BID → 100 mg QD; discontinue if 100 mg QD not tolerated
• Missed dose: skip; do not take extra capsules

Contraindications

• Concomitant strong CYP3A4 inhibitors or inducers

Cautions

• Hemorrhage — serious (11–13%) and fatal (2%) bleeds; avoid with active bleeding; hold 7 days pre-procedure
• Diarrhea (~48%) — control pre-existing diarrhea first; manage with antidiarrheals, fluids, dose modification; postmarketing severe diarrhea with AKI
• Worsening thrombocytopenia — dose reduce/interrupt
• QT prolongation — avoid if baseline QTc >480 ms; hold for QTc >500 ms or >60 ms rise; correct hypokalemia before and during
• JAK-inhibitor class risks: MACE (esp. smokers/CV risk), thrombosis (DVT/PE/arterial), secondary malignancies (lymphoma)
• Infection — delay start until active serious infections resolve
• Symptom exacerbation after interruption/discontinuation

Adverse reactions

• ≥20%: diarrhea, thrombocytopenia, nausea, anemia, peripheral edema

Pregnancy No human data; animal embryonic/fetal loss and maternal toxicity at exposures below the human dose; advise of potential fetal risk

Lactation Breastfeeding not recommended during treatment and for 2 weeks after the last dose