Not to be initiated in patients w/ ANC <1 x 109
cells/L, ALC <0.5 x 109
cells/L or Hb levels <8 g/dL; active, serious infection including localised infections. Interrupt treatment if patient develops serious or opportunistic infection. Increased risk of malignancy; CV disorders, HTN, hyperlipidaemia; hepatic transaminases elevation; high risk for DVT & pulmonary embolism. Screen patients for TB, viral hepatitis & monitoring for reactivation prior to initiation. Perform periodic skin exam in patients at increased risk of skin cancer. Closely monitor for development of signs & symptoms of infection. Not recommended in combination w/ other potent immunosuppressants eg, azathioprine, ciclosporin, tacrolimus, biologic DMARDs or other Janus kinase (JAK) inhibitors. Not recommended in concomitant use w/ live, attenuated vaccines. Not to be used in severe hepatic impairment (Child-Pugh C). Severe renal impairment, end-stage renal disease. Women of childbearing potential should use effective contraception during & 4 wk after last dose. Not to be used during pregnancy & lactation. Childn & adolescents 0-18 yr. Elderly ≥75 yr.