Understanding Tofacitinib: Medication Profile, Uses, and Important Information

Names of Medication

The medication of focus in this article is known as Tofacitinib, but it’s more commonly recognized in the United States by its brand name: Xeljanz (Tofacitinib).

Pharmacologic category

Tofacitinib falls under the category of medications known as Janus kinase (JAK) inhibitors. Other medications within this category include Baricitinib (Olumiant) and Upadacitinib (Rinvoq).

Dosing

Tofacitinib is used in the treatment of various conditions in adults. Here is a breakdown of the diseases, including the respective dose, frequency, and length of treatment:

Rheumatoid Arthritis

The standard dose for treating Rheumatoid Arthritis is 5 mg of Tofacitinib taken orally twice a day.

Psoriatic Arthritis

For Psoriatic Arthritis, the standard therapeutic dose is also 5 mg taken orally twice a day.

Ulcerative Colitis

For Ulcerative Colitis, the initial dose is 10 mg taken orally twice a day for the first 8 weeks. This is followed by a maintenance dose of 5 mg taken orally twice a day.
Remember, these dosing instructions are general guidelines. Your healthcare provider may prescribe a different dose depending on your condition and overall health. Never adjust your medication dosage without first consulting your healthcare provider.

Dosage Forms and Strengths

Tofacitinib is available in the following dosage forms and strengths:
Tablets: 5 mg and 10 mg
Extended-release tablets: 11 mg and 22 mg

Administration Instructions

Tofacitinib can be taken with or without food. Swallow the tablet whole with water. Do not crush, split, or chew it. If you’re prescribed the extended-release tablet, make sure to take it at the same time each day.

Adverse Reactions and Side Effects

Like all medications, Tofacitinib can cause side effects. The following are some of the common and more serious side effects associated with this medication:

Common Side Effects

1. Diarrhea: This may occur in up to 10% of patients. This is because Tofacitinib affects the immune system, which can sometimes affect the gastrointestinal tract.
Upper respiratory tract infections (occurring in more than 10% of patients): As Tofacitinib suppresses the immune system, it may make you more susceptible to infections.
Headache (frequency not reported): This is a common side effect of many medications and may be due to the body adjusting to the new medication.

More Serious Side Effects

1. Serious infections (frequency not reported): Because Tofacitinib affects your immune system, you’re at a higher risk of developing serious infections. These could include tuberculosis, bacterial, invasive fungal, viral, and other infections due to opportunistic pathogens.
Malignancies (frequency not reported): Long-term use of Tofacitinib may increase the risk of certain types of cancer including lymphoma and other malignancies, particularly of the skin. This could be due to the medication’s immune-suppressing effects.

Contraindications to Taking Tofacitinib

A contraindication is a specific situation in which a drug should not be used, because it may be harmful to the person. Here are some contraindications to taking Tofacitinib:

Severe Liver Disease

Tofacitinib is contraindicated in patients with severe liver disease as the drug is metabolized in the liver. If a patient’s liver isn’t functioning well, the drug may not be broken down properly, which could lead to an increased risk of side effects.

Active Serious Infections

Tofacitinib suppresses the immune system, which may cause an existing infection to become worse. Therefore, people with active serious infections should avoid this drug.

Allergy to Tofacitinib

People who have had an allergic reaction to Tofacitinib or any of its components should not take this medication.

Drug to Drug Interactions

There are several medications known to interact significantly with Tofacitinib. Here are a few:
Ketoconazole (Nizoral): An antifungal medication, can increase the levels of Tofacitinib in the body, increasing the risk of side effects.
Rifampin (Rifadin): An antibiotic used to treat tuberculosis, can decrease the levels of Tofacitinib in the body, making it less effective.
Warfarin (Coumadin): A blood thinner, may have its effects altered when taken with Tofacitinib.
Always discuss any medications you are taking, including over-the-counter drugs, with your healthcare provider to avoid potential interactions.

Tofacitinib in Pregnancy

Tofacitinib should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown harm to the fetus, but there are no adequate and well-controlled studies in pregnant women.

Tofacitinib while Breastfeeding

It is unknown whether Tofacitinib is excreted in human breast milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Estimated Cost of Medication

The estimated cost of a 30-day supply of Tofacitinib 5mg without insurance, using a GoodRx coupon, is approximately $3,000. Remember, this is only an estimate and the actual price can vary depending on the pharmacy and location.

Brief Legal Disclaimer

This article is for informational purposes only and is not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.
Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.