What is Xeljanz Uses, warnings & interactions
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Xeljanz (tofacitinib) is a biologic medication that is manufactured by Pfizer Inc. It was approved in 2012 by the U.S. Food and Drug Administration (FDA) to treat certain types of arthritis, including rheumatoid arthritis and psoriatic arthritis. Xeljanz is typically used by people who have failed 1 or more biological drugs such as tumor necrosis factor (TNF) blockers.
It is available as Xeljanz tablet, Xeljzan XR tablet, and Xeljanz Oral Solution. The oral solution is used to treat juvenile idiopathic arthritis in patients 2 years and older that weigh at least 10kg (22lbs) to less than 40kg (88lbs).
If your doctor has prescribed Xeljanz to you, you may want to know more about what it is and how it works. Here we’ll explain what Xeljanz is used for, how it works, its side effects, and more.
What is Xeljanz used for?
Xeljanz is a Janus kinase (JAK) inhibitor that is indicated to treat adults who have failed or did not tolerate at least 1 TNF blocker with:
- Moderate to severe active rheumatoid arthritis.
- Active psoriatic arthritis. Xeljanz should be taken along with a nonbiologic disease-modifying antirheumatic drug (DMARD) such as methotrexate or leflunomide.
- Ankylosing spondylitis.
- Active ulcerative colitis.
It is also used to treat polyarticular course juvenile idiopathic arthritis in pediatric patients aged 2 years and older who have failed or did not tolerate at least 1 TNF blocker. Xeljanz tablets and oral solution should not be used along with biologic DMARDs or potent immunosuppressants such as azathioprine and cyclosporine.
How does Xeljanz work?
Xeljanz is a Janus kinase (JAK) inhibitor that alters the function of your immune system to reduce inflammation. It works by blocking the activity of Janus kinase enzymes. JAK enzymes play a role in the inflammation that causes symptoms and complications of these inflammatory conditions.
What are the most commonly prescribed doses of Xeljanz?
- 5mg tablet
- 10mg tablet
- 11 mg extended-release tablet
- 22mg extended-release tablet
- 1 mg/ml oral solution
Before taking Xeljanz
Before beginning Xeljanz treatment, tell your doctor if you have any of the following medical conditions:
- Active infection
- Current or past smoker
- History of cancer
- History of heart disease or previous heart attack or stroke
- History of blood clots
- Liver problems
- Kidney problems
- Previous or scheduled vaccination
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Xeljanz
- Read the Full Prescribing Information including the Black Boxed Warning, Instructions for Use, and Medication Guide that comes with this medication.
- Take Xeljanz exactly as your prescriber tells you to. Do not change your dose or stop taking this medication without talking to them first.
- Xeljanz tablets and Xeljanz Oral Solution are typically taken twice a day with or without food. Xeljanz XR tablets are typically taken once a day with or without food.
- Swallow Xeljanz XR tablets whole and do not crush, split, or chew them. The empty shell of a Xeljanz XR tablet may show up in your stool. This is normal and there is no medicine left in the shell of the tablet.
- If you think you have taken too much Xeljanz, call your doctor or go to the nearest emergency room right away.
You should not use Xeljanz if you are allergic to tofacitinib or any other ingredients in this product.
- You should avoid the use of Xeljanz if you currently have a serious infection.
- Increased risk of infections, including serious infections such as tuberculosis, have occurred with the use of Xeljanz. You should be tested for latent tuberculosis before starting this medication and monitored for active tuberculosis during treatment.
- Increased risk of cancer, including lymphoma and skin cancer have occurred with the use of Xeljanz.
- The hepatitis B or C virus may become active when you use Xeljanz if you are a carrier of the virus.
- Caution should be used in patients that are at an increased risk of GI perforations (holes). Nonsteroidal anti-inflammatory drugs (NSAIDs) and oral steroids might raise your risk of GI problems.
- Your doctor may recommend blood tests and lab monitoring to check for changes in your white blood cells, red blood cells, liver enzymes, and cholesterol.
- If you take Xeljanz, you should not receive a live vaccine. You can however receive a non-live vaccine.
Xeljanz drug interactions
When Xeljanz is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. Discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:
- Moderate to strong CYP3A4 inhibitors such as ketoconazole or fluconazole
- Strong CYP3A4 Inducers such as rifampin
- Immunosuppressive medications such as azathioprine, tacrolimus, or cyclosporine
Xeljanz side effects
Some common side effects of Xeljanz in clinical trials include:
- Upper respiratory tract infection
- Common cold symptoms
- Hypertension (high blood pressure)
- Increased cholesterol levels
- Fungal infection
- Herpes zoster (shingles)
- Stomach pain
Sometimes, Xeljanz can cause more serious side effects, including:
- Severe allergic reactions (hives, angioedema, and shortness of breath)
- Serious infection
- Liver impairment or increased liver enzymes
- GI problems including diverticulitis
Contact your doctor for medical advice about any adverse effects you experience while taking Xeljanz. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your healthcare professional can prescribe other medications for your medical condition if Xeljanz is not right for you. These other treatment options will vary by different factors such as side effects and costs. Some FDA-approved alternatives to Xeljanz include:
Can you take Xeljanz while you are pregnant or breastfeeding?
There are no well-controlled studies on the use of Xeljanz during pregnancy. Miscarriages and birth defects were reported in clinical development programs associated with Xeljanz. There is a pregnancy exposure registry that monitors outcomes for Xeljanz use in women during pregnancy. Please call the toll-free number 1-877-311-8972 for more information.
You should not breastfeed during Xeljanz treatment and for at least 18 hours after your last dose of Xeljanz. You should wait at least 36 hours after your last dose of Xeljanz XR.
You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
Is Humira the same as Xeljanz?
Xeljanz is an oral medication that works differently than injectable Humira to reduce inflammation.
Xeljanz blocks the actions of JAK proteins while Humira blocks the activity of tumor necrosis factor (TNF). Xeljanz is taken once or twice daily by mouth while Humira is an injection you typically take every other week. A study in 2017 showed that patients taking Xeljanz along with methotrexate had as much symptom relief as patients taking Humira.
How long does it take Xeljanz to work?
Some people saw a reduction in symptoms in as little as 2 weeks while it took others up to 3 months or longer.
What is the cost of Xeljanz?
The average cost of #60, 10mg Xeljanz tablets is over $5000.
Is there a generic for Xeljanz?
Currently, there is no generic Xeljanz available on the market. However, you can still save on brand-name drugs like Xeljanz through NiceRx if eligible for assistance.
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.