Filgotinib
Indications
Filgotinib is used to treat adults with moderate to severe active rheumatoid arthritis who have not responded well to, or cannot take, one or more disease-modifying anti-rheumatic drugs (DMARDs). It may be used alone or with Methotrexate. It is also used for moderate to severe active ulcerative colitis (long-term inflammation of the large bowel) when other treatments have not worked well enough.
How It Works
Filgotinib is a Janus kinase (JAK) inhibitor that acts mainly on JAK1. JAK enzymes pass signals from inflammatory messengers (cytokines) into immune cells. By blocking JAK1, Filgotinib reduces these signals and calms the overactive immune response that causes joint pain, swelling and stiffness, or bowel inflammation.
Dosage and Administration
Filgotinib tablets are taken by mouth once daily, with or without food, at the dose prescribed by your specialist. A lower dose is used for people aged 75 or over and for those with moderate to severe kidney problems. Swallow the tablet whole. Blood tests are done before starting and during treatment, and your doctor may pause treatment if results are abnormal or if you develop a serious infection.
Interactions
- Live vaccines such as yellow fever, oral polio, BCG or live shingles vaccine: avoid during treatment and shortly before starting; ask your doctor which vaccines you need first.
- Strong immunosuppressants such as Azathioprine, Ciclosporin, Tacrolimus or biological medicines: not recommended together because of high infection risk.
- Other JAK inhibitors: do not combine.
Contraindications
- Allergy to Filgotinib.
- Active tuberculosis or other serious active infections.
- Pregnancy.
Side Effects
Common side effects include nausea, dizziness, upper respiratory and urinary infections, and shingles. Blood tests may show low white blood cells or raised cholesterol. JAK inhibitors have been linked with serious infections, blood clots, heart attacks and strokes, and some cancers, especially in people over 65, current or past long-term smokers, and those with other heart or cancer risks.
Get urgent medical help if you have fever, chills, cough or other signs of a serious infection; a painful blistering skin rash; pain or swelling in a leg, sudden chest pain or breathlessness; weakness on one side of the body or difficulty speaking; or signs of a severe allergic reaction.
Pregnancy and Lactation
Filgotinib must not be used during pregnancy. Women who could become pregnant should use effective contraception during treatment and for at least 1 week after the last dose. Do not breastfeed during treatment. In men, it may reduce sperm production; discuss family plans with your doctor.
Precautions and Warnings
- You will be checked for tuberculosis and hepatitis B and C before starting.
- Blood counts, liver tests and cholesterol are monitored regularly.
- In people aged 65 or over, smokers and those with heart, clot or cancer risks, it should be used only when no suitable alternative exists.
- Have regular skin checks; report any new skin lumps or sores.
Overdose
An overdose may increase side effects. Seek medical help; you will be monitored for signs of infection and blood changes.
Therapeutic Class
Immunosuppressant, Janus kinase (JAK1-preferential) inhibitor, targeted synthetic DMARD.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Filgotinib