Ojjaara: A New Oral Therapy to Treat Rare Blood Cancer

Ojjaara is an oral prescription medicine used to treat certain forms of myelofibrosis (a type of bone marrow cancer) in adults with anemia. 

Ojjaara Introduction and Uses

Ojjaara is a brand-name product. It contains the active ingredient momelotinib, which belongs to the Janus kinase (JAK) inhibitor drug class. No generic versions of this medication are currently available. 

Ojjaara is not chemotherapy, but rather a targeted therapy that lowers the activity of the immune system for cancer treatment. 

In 2023, the US FDA approved this medication to treat certain forms of myelofibrosis in adults with anemia. Myelofibrosis is a rare cancer that causes scar tissue to form in the bone marrow. As a result, the bone marrow fails to produce enough healthy blood cells, resulting in:

• Shortness of breath and tiredness
• Easy bruising or bleeding 
• Recurrent infections 

Your liver or spleen may also become enlarged. 

Ojjaara Mechanism of Action 

Ojjaara is a janus kinase (JAK) inhibitor. Cells inside the bone marrow contain proteins (JAK) that become overactive when you have myelofibrosis. Ojjaara blocks the action of these proteins. In addition, Ojjaara blocks another protein in the liver cells, leading to an increased level of healthy red blood cells. 

Ojjaara Dosage

Ojjaara comes as 100 mg, 150 mg, and 200 mg tablets that are taken by mouth. 

The recommended dosage is 200 mg orally once daily. Your healthcare provider may prescribe a lower dose, 150 mg orally once daily, if you have severe liver problems.   

Before and during treatment with this medication, your healthcare provider will monitor your blood counts and liver function. Moreover, you will be asked to take tests to see if you have active hepatitis B before starting this medication. 

Treatment with Ojjaara is long-term and will likely continue as long as it is safe and effective for you. However, if you experience severe side effects or the medication stops working, your healthcare provider may ask you to stop it temporarily or permanently. 

Ojjaara Side Effects

Common side effects

• Low platelet count
• Bleeding
• Bacterial infection
• Tiredness
• Dizziness
• Diarrhea
• Nausea
• Pain in the back, leg, or arm 
• Rash 
• Itching 
• Blurry vision 

Talk to your healthcare provider or pharmacist if any side effect worsens or don’t get better with time. 

Severe side effects

Call your healthcare provider immediately or seek emergency care if you have signs and symptoms of:

• Infections, such as fever, chills, cough, difficulty breathing, diarrhea, vomiting, pain, or a burning sensation when passing urine
• Low platelet counts, such as unexplained bleeding or bruising, or tarry stools
• Liver problems, such as yellow skin or eyes, or pain in the upper right region of your stomach 
• Severe skin reactions, such as flu-like symptoms, severe rashes, skin peeling, blistering of the lips, eyes, or mouth

Heart attack or stroke

Though not specifically reported in people taking Ojjaara, heart attack and stroke have been reported in individuals taking a different JAK inhibitor. The risk may be higher among current or past smokers. Seek emergency care if you experience any signs or symptoms of a heart attack or stroke, such as: 

• Discomfort in your chest
• Severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw
• Pain or discomfort in your arms, back, neck, jaw, or stomach
• Shortness of breath with or without chest discomfort
• Nausea or vomiting
• Lightheadedness
• Weakness in one part or on one side of your body
• Slurred speech

Blood clots

Blood clots in the arms or legs (deep vein thrombosis or DVT) or in the arteries or lungs (pulmonary embolism or PE) have occurred in people taking JAK inhibitors like Ojjaara. Go to the emergency room immediately if you are experiencing:

• Swelling, pain, or tenderness in one or both legs
• Sudden, unexplained chest pain
• Difficulty breathing

New cancers

Taking JAK inhibitors may increase the risk of getting new cancers. The risk may be higher among current or past smokers. Talk to your healthcare provider about the risk of new cancers while taking this medication. 

Use in Pregnancy 

Animal studies suggest this medication may harm your unborn baby. Avoid getting pregnant during treatment and for seven days after the final dose. Inform your healthcare provider immediately if you become pregnant during treatment. 

Use in Lactation

Animal studies suggest Ojjaara can get into breastmilk, which can be passed on to your baby. Avoid breastfeeding during treatment and for 7 days after the final dose. 

Before Taking Ojjaara

Before taking your first dose, inform your healthcare provider if you:

• Have an infection
• Have or have had hepatitis B
• Have or have had liver issues
• Have had a heart attack, or have had other heart problems, or a stroke
• Have or have had a blood clot
• Smoke or were a smoker in the past
• Have or have had any other cancers
• Are pregnant or plan to become pregnant

Missed Dose and Overdose

Skip the missed dose and continue your recommended dosing schedule. Never take a double dose to make up for the missed one. 

If you think you have overdosed on Ojjaara, contact the Poison Help line (1-800-222-1222) or seek medical help by going to an emergency room immediately. 

Proper Use, Storage, and Disposal

• Before using this medication, read the instructions on the prescription label carefully. Take your doses exactly as directed. 
• If you have any questions, talk to your doctor or pharmacist. 
• Swallow the entire tablet; avoid crushing, chewing, or breaking it. 
• You may take this medication with or without food.
• Never stop taking this or any medicine without talking to your healthcare provider.
• Store this medication at temperatures between 20°C and 25°C (68°F and 77°F). Storage between 15°C and 30°C (59°F and 86°F) may be allowed for a brief period.
• Store Ojjaara in the original bottle, which contains a desiccant packet that protects the tablets from moisture. Never discard desiccant.
• Replace the cap tightly each time after you take the recommended tablets.
• Dispose of unused or expired medicines following the local requirements. Click HERE to learn how to dispose of unneeded or expired drugs. 

Ojjaara Cost

Cost can vary depending on your insurance plan, location, and pharmacy. Ask your insurance provider if your plan covers this medication or if you need prior authorization. 

GSK (GlaxoSmithKline), the manufacturer of Ojjaara, may provide reimbursement support and financial assistance if you are eligible. 
Contact us if you are interested in exploring financial and copay assistance for Ojjaara.