Risk of serious infections; viral reactivation, including herpes virus reactivation. Not recommended to use live, attenuated vaccines during or immediately prior to therapy. Bring patients up to date w/ all immunisations, including prophylactic zoster vaccinations, prior to treatment initiation. Increased risk of malignancies, including lymphoma. Periodic skin examination is recommended for patients at increased risk for skin cancer (eg, non-melanoma skin cancer). Do not initiate or temporarily interrupt treatment in patients w/ absolute neutrophil count <1 x 109
cells/L, absolute lymphocyte count <0.5 x 109
cells/L or Hb <8 g/dL. Increased risk for CV disorders. Increased lipid parameters, including total, LDL & HDL cholesterol. Increased incidence of liver enzyme elevation. Patients at high risk for DVT/pulmonary embolism. Not recommended to combine w/ other potent immunosuppressants (eg, azathioprine, ciclosporin, tacrolimus, & biologic DMARDs or other Janus kinase inhibitors). Patients w/ severe renal impairment; end stage renal disease. Women of childbearing potential should use effective contraception during treatment & for 4 wk following final dose. Should not be used during breast-feeding. Elderly ≥75 yr. Childn & adolescent <18 yr.