Abrocitinib
JAK inhibitors
JAK inhibitors
An oral JAK1 inhibitor for moderate to severe atopic dermatitis that has not responded to other treatments; it carries the JAK boxed warning.
Quick facts
- Group
- JAK inhibitors
- Target
- Janus kinase 1 (JAK1)
- Used for
- Moderate to severe atopic dermatitis
- Key effects
- Cold symptoms · Nausea and vomiting · Headache
- Monitor
- Latent tuberculosis test before starting
- ATC
- D11AH08
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows the human JAK1 kinase domain with abrocitinib (compound 25 of the discovery paper) in its ATP site.
Abrocitinib blocks Janus kinase 1 (JAK1). Many cytokines that drive atopic dermatitis and itch signal through JAK1; with it blocked, STAT proteins stay inactive and skin inflammation and itch fall.
- Drug enters immune and skin cells and blocks JAK1
- Eczema cytokines cannot switch on STAT proteins
- Less inflammation and itch signalling
- Eczema and itch improve
Indications
- Moderate to severe atopic dermatitis in adults and adolescents not controlled by other treatments Atopic dermatitis →
Adverse effects
Common
- Cold symptoms: stuffy nose, sneezing, sore throat
- Nausea and vomiting
- Headache, dizziness
- Acne
Contraindications
- Hypersensitivity to abrocitinib
- Antiplatelet therapy other than low-dose aspirin during the first three months
- Severe liver impairment
- Active serious infection
Key interactions
- Antiplatelet drugs (except low-dose aspirin)
- Contraindicated during the first three months because of low platelets.
- CYP2C19 inhibitors
- Higher abrocitinib levels.
- Other strong immunosuppressants
- Added infection risk; avoided.
- Live vaccines
- Avoided; vaccines are brought up to date before starting.
What is monitored
- Latent tuberculosis test before starting
- Blood counts (platelets, lymphocytes) and lipids
- Signs of infection, clots, heart attack or stroke
- Sudden vision changes
Administration and safety
- Tablets are swallowed whole.
- All antiplatelet drugs are reviewed before the first dose.
- Vaccines are brought up to date before starting.
Pregnancy and breastfeeding
Data are insufficient to know the risk in pregnancy; breastfeeding is avoided during treatment and for a day after.
Nursing care
- Check the medicine list for antiplatelet drugs and CYP2C19 inhibitors before starting.
- Teach to report fever, cough, chest pain, leg swelling or stroke signs.
- Ask about smoking, clots, heart disease and cancer history.
- Teach to report sudden vision changes and unusual bruising or bleeding.
Pharmacokinetics
- Absorption
- Oral tablet, swallowed whole
- Metabolism
- Liver, mainly by CYP2C19; inhibitors of CYP2C19 and poor metabolisers have higher levels
- Half-life
- About 5 to 6 hours for the drug and its main active metabolites
Test yourself
Think of the answer, then tap the question to see it.
Which kinase does abrocitinib block?
Janus kinase 1 (JAK1).
Which class of drugs is contraindicated in the first months of abrocitinib (except low-dose aspirin)?
Antiplatelet drugs, because abrocitinib can lower platelets.
Which enzyme mainly metabolises abrocitinib?
CYP2C19.
Connections
← Back to the class: JAK inhibitors
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Abrocitinib: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2023); RCSB PDB - 6BBU: Crystal Structure of JAK1 in complex with compound 25 (RCSB Protein Data Bank, 2018); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.