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Why is Litfulo prescribed?

Litfulo (Ritlecitinib) is a prescription medication used to treat severe alopecia areata in adults and adolescents aged 12 and older.

What does it do?

Litfulo works by targeting a protein called Janus kinase (JAK), helping to block the immune system’s attack on hair follicles. This reduces inflammation and supports hair regrowth.

How should I take it?

Take Litfulo once daily, with or without food. Swallow the capsules whole—do not split, crush, or chew them.

What if I missed a dose?

If you miss a dose of Litfulo, take it as soon as you remember. However, if it's less than 8 hours before your next scheduled dose, skip the missed dose and take your next dose at the regular time.

What are the special precautions before taking Litfulo?

Do not take Litfulo if you are allergic to ritlecitinib, Litfulo itself, or any of its inactive ingredients.

Before Starting Litfulo, Inform Your Healthcare Provider If You:

• Have ever smoked
• Are scheduled to receive a vaccine
• Have or had any type of cancer
• Have had shingles (herpes zoster), hepatitis B or C, or any liver disease
• Have heart conditions, including a history of stroke, heart attack, or blood clots
• Have conditions like chronic lung disease, diabetes, HIV, or a weakened immune system
• Have or had tuberculosis (TB), or have been in close contact with someone with TB
• Are being treated for an infection or have one that hasn’t resolved or keeps coming back (symptoms may include fever, chills, cough, skin sores, or painful urination)

Your healthcare provider will perform blood tests before and during treatment to check for:

• Low lymphocyte counts – These white blood cells help fight infections
• Low platelet counts – Important for blood clotting
• Elevated liver enzymes – May signal liver issues
• Increased creatine phosphokinase (CPK) – A muscle enzyme that may rise with treatment, sometimes severely

If any of these levels are abnormal (especially very low blood cell counts or high liver enzymes), your healthcare provider may pause or stop treatment as needed.

Does it have any side effects?

It is important to note that all drugs have corresponding side effects and adverse reactions. Additional information may be obtained when you ask your doctor or pharmacist.

Common side effects may include:
• Atopic dermatitis
• Fever
• Diarrhea
• Mouth ulcers
• Increased creatine phosphokinase (CPK) levels and decreased red blood cell counts
• Rash or hives (urticaria)
• Folliculitis (inflammation of hair follicles)

Serious side effects may include:

Litfulo carries serious risks, including infections, heart attack, stroke, cancer, blood clots, and increased rates of death and is not recommended for people with severe liver disease

• Cardiovascular Risks: People aged 50 or older with at least one heart risk factor (especially current or former smokers) may have a higher risk of heart attack, stroke, or death while taking Litfulo. Seek emergency medical help if you experience symptoms like chest pain, pressure, shortness of breath, or slurred speech.
• Blood Clots: Litfulo can increase the risk of blood clots in veins (such as deep vein thrombosis or pulmonary embolism) or eyes. The risk is higher in people over 50 with heart disease risk factors. Notify your doctor if you have a history of blood clots. Stop taking Litfulo and get urgent medical care if you experience sudden chest or back pain, leg swelling or pain, or vision changes.
• Cancer Risk: Litfulo may raise the risk of certain cancers, including lymphoma, skin cancer, and lung cancer, especially in current or past smokers. Follow your doctor’s advice on regular skin checks during treatment.
• Allergic Reactions: Severe allergic reactions, including anaphylaxis, can occur. Stop Litfulo and seek emergency help if you have symptoms like difficulty breathing, dizziness, hives, or swelling of the lips or throat.

These are not all possible side effects. Contact your doctor for advice on any side effects you experience.

Is it safe to take it with another drug?

Be sure to tell your doctor about all the medications you are taking, especially:

• CYP3A substrates such as Acetaminophen, Codeine, Erythromycin
• CYP3A inducers like Rifampicin
• CYP1A2 substrates, including caffeine, Propranolol, Clozapine, and Mexiletine

Litfulo should not be used together with other JAK inhibitors, cyclosporine, biologic immunomodulators, or other strong immunosuppressants.

This is not a complete list. Other medications—including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements—may also interact with Litfulo. Always consult your doctor about any medications you are taking.

How should I store it?
Store Litfulo at room temperature and keep it in its original packaging. The Litfulo bottle features a child-resistant cap and includes a canister with a drying agent (desiccant). Do not consume the desiccant.
What action should I take in case of overdose?
If you take more than the prescribed amount of Litfulo, go to the nearest emergency room immediately.
Is it safe for pregnant or breastfeeding women?

Pregnancy: Inform your doctor if you are pregnant or planning to become pregnant. It is unknown whether this medication could harm an unborn baby.

Breastfeeding: Let your doctor know if you are breastfeeding or plan to breastfeed. Breastfeeding is not recommended during treatment with Litfulo and for about 14 hours after your last dose.

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