How to Take Xeljanz
Xeljanz (tofacitinib) is an oral tablet or extended-release tablet for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis, or polyarticular course juvenile idiopathic arthritis. Swallow whole with water, with or without food. Dose depends on condition, kidney/liver function, and formulation.[1]
Standard adult doses:
| Condition | Immediate-Release Dose | Extended-Release Dose |
|-----------|------------------------|-----------------------|
| Rheumatoid/psoriatic arthritis | 5 mg twice daily | 11 mg once daily |
| Ankylosing spondylitis | 5 mg twice daily | 11 mg once daily |
| Ulcerative colitis (induction) | 10 mg twice daily (8 weeks max) | Not approved |
| Ulcerative colitis (maintenance) | 5 mg twice daily | 11 mg once daily |
| Pediatric (≥40 kg, immediate-release only) | 5 mg twice daily | N/A |
Adjust for moderate/severe kidney impairment or moderate liver impairment: halve dose. Do not use in severe cases. Taper gradually when stopping for ulcerative colitis.[1][2]
What If I Miss a Dose?
Take as soon as possible within 6 hours of missed time. Skip if more than 6 hours late; resume next scheduled dose. Never double up.[1]
Common Side Effects Patients Report
Headache, diarrhea, high cholesterol, upper respiratory infections, anemia, fever, shingles, and increased infection risk (e.g., pneumonia, TB). Serious risks include blood clots, heart attack, stroke, cancers, and gastrointestinal tears—higher in those 50+ with heart risk factors. Get vaccinated before starting; avoid live vaccines during treatment.[1][2]
Drug Interactions to Watch
Avoid strong CYP3A4 inhibitors (e.g., ketoconazole—increase dose); strong inducers (e.g., rifampin—monitor). Use caution with biologics, other immunosuppressants, or CYP3A4 substrates. Inform doctor of all meds, including OTC.[1]
Who Should Not Use Xeljanz?
Active serious infection, TB, severe liver impairment. Pregnancy: avoid (risk of fetal harm); use contraception. Breastfeeding: not recommended. Long-term use linked to higher mortality/MACE in rheumatoid arthritis vs. TNF blockers.[1][2]
When Does Xeljanz Patent Expire?
Core patents expired in 2025; others extend to 2030. Multiple challenges ongoing from Teva, Sandoz, others for generics.[3]
[1]: Xeljanz Prescribing Information (Pfizer, 2023). https://labeling.pfizer.com/ShowLabeling.aspx?id=12700
[2]: FDA Medication Guide. https://www.fda.gov/media/115355/download
[3]: DrugPatentWatch.com. https://www.drugpatentwatch.com/p/tradename/XELJANZ