Xeljanz/Xeljanx XR (tofacitinib)

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Xeljanz™/Xeljanx® XR (tofacitinib) is used to treat certain adults with moderately to severely active rheumatoid arthritis (RA). Xeljanz/Xeljanx XR can be taken alone or with some other drugs, including methotrexate.1

Before starting Xeljanz/Xeljanx XR, users must have tried at least 1 tumor necrosis factor (TNF) blocker. If it did not work or the user could not tolerate it, they can start using Xeljanz/Xeljanx XR. TNF blockers are a different type of drug that may be used to treat RA.1

Xeljanz/Xeljanx XR is also used to treat other conditions, including:1

What are the ingredients in Xeljanz/Xeljanz XR?

The active ingredient in Xeljanz/Xeljanx XR is tofacitinib.1

How does Xeljanz/Xeljanz XR work?

Xeljanz/Xeljanx XR is a type of drug called a Janus kinase (JAK) inhibitor. Kinase inhibitors are a very common type of medicine that treat many different conditions. They work by targeting certain kinases, which are a type of protein that cells use for many different functions.1

Xeljanz/Xeljanx XR works by targeting JAK. This kinase has a role in signaling the body’s inflammation response. By targeting JAK, Xeljanz/Xeljanx XR interrupts the signal. This can reduce inflammation caused by conditions like RA.1

What are the possible side effects?

The most common side effects of Xeljanz/Xeljanx XR include:1

  • Nasal congestion, sore throat, runny nose
  • Sinus infections
  • Headache
  • Diarrhea
  • High blood pressure (hypertension)

Xeljanz/Xeljanx XR has a boxed warning, the strictest warning from the US Food and Drug Administration. It has this warning because it may cause severe and life-threatening side effects, including increased risk of:1

  • Serious infections, including tuberculosis (TB)
  • Heart attack, stroke, or death, especially in people over 50 with RA who also have heart problems
  • Certain cancers, including lymphoma
  • Blood clots

Xeljanz/Xeljanx XR impacts the immune system. This can make you more likely to get infections. Call your doctor right away if you have any signs of infections while taking Xeljanz/Xeljanx XRq, such as:1

  • Fever or chills
  • Shortness of breath
  • Unusual tiredness
  • Cough
  • Muscle aches

These are not all the possible side effects of Xeljanz/Xeljanx XR. Talk to your doctor about what to expect when taking Xeljanz/Xeljanx XR. You also should call your doctor if you have any changes that concern you when taking Xeljanz/Xeljanx XR.

Other things to know

Your doctor should test you for TB before starting treatment with Xeljanz/Xeljanx XR. You should also be monitored for signs and symptoms of TB during treatment.1

You should not take Xeljanz/Xeljanx XR if you have any kind of infection unless your doctor tells you to.1

People taking Xeljanz/Xeljanx XR should not receive certain vaccines. Talk to your doctor before getting any vaccines.1

Before starting Xeljanz/Xeljanx XR, tell your doctor if you:1

  • Are being treated for an infection or have had an infection that does not go away or keeps coming back
  • Have diabetes, chronic lung disease, HIV, or a weak immune system
  • Have had a heart attack, other heart problems, or stroke
  • Have liver or kidney problems
  • Have TB or have been in close contact with someone with TB
  • Have or have had hepatitis B or C
  • Have unexplained stomach pain or have a history of diverticulitis or ulcers in your stomach or intestine
  • Are pregnant or plan to become pregnant

You should not breastfeed during treatment with Xeljanz/Xeljanx XR and for some time after the last dose. Talk to your doctor about your options for breastfeeding while taking Xeljanz/Xeljanx XR.1

Xeljanz/Xeljanx XR can interact with other drugs. Before beginning treatment for RA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.1

For more information, read the full prescribing information of Xeljanz/Xeljanx XR.

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