Tofacitinib, sold under the brand Xeljanz and others, belongs to a class of medications called Janus Kinase Inhibitors. Tofacitinib was approved by the FDA in 2018 for the treatment of Ulcerative Colitis, an Inflammatory Bowel Disease (IBD) that affects the colon and rectum. It is used for treating adults with moderate to severe ulcerative colitis often when one or more anti-TNF medicines are not working. Studies have shown that Tofacitinib is effective in inducing remission (controlled symptoms) for people with ulcerative colitis
Janus kinase inhibitors work by blocking the enzyme Janus kinase, which is involved in inflammation. Tofacitinib is used in other conditions associated with inflammation, such as Rheumatoid Arthritis and Psoriatic Arthritis.
Tofacitinib is taken by mouth with or without food. The time for Tofacitinib to take effect varies person-to-person. While some people have a relatively rapid response within one week, for others it may take up to 8 weeks.
Common side effects are:
- Diarrhea
- Upset stomach
- Vomiting
- Headache
- Nose or throat irritation
- Signs of common cold
Tofacitinib and vaccines
Talk with your doctor before getting any vaccines. Tofacitinib may lower the body’s resistance to infection, so you may end up getting an infection with the vaccine.
Avoid being near anyone who has received a live virus vaccine, as there is a possibility that they could pass the virus on to you. Examples of live vaccines include influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, measles, mumps, and rubella.
Tofacitinib and pregnancy
Currently, there is no sufficient data using pregnant women to determine the effects of tofacitinib on a fetus. Discuss the risk and benefits of the medication with your doctor if you are planning for pregnancy.
Tofacitinib may cause fertility problems in females, which may affect the ability to have children. Talk to your doctor if this is important for you.
Tofacitinib and breastfeeding
Breast-feeding is not recommended while taking this drug. Also, avoid breastfeeding after you stop this drug until there are no traces of this drug left in your body. Talk with your doctor regarding breastfeeding while on this medication.
Interactions with other medications and food
Tofacitinib is known to interact with Adalimumab, Azathioprine, Atezolizumab, Bleomycin, Corticotropin, Clarithromycin, Certolizumab, Golimumab, Hydrocortisone, Infliximab, Interferons, Methotrexate, Mercaptopurine, Rifampin, and Tacrolimus. This is not a complete list of drug interactions. Check with your doctor if you are planning to take any medications while taking Tofacitinib.
Be sure to talk with your doctor if you drink grapefruit juice or eat grapefruit often.
Tests or check-ups done before starting Tofacitinib
- Skin test to check for tuberculosis
- Hepatitis test
- Immunity to chicken pox or shingles if you haven’t had them. You may be given a vaccine to protect from catching them.
Tests or check-ups done while taking Tofacitinib
Blood Counts
Tofacitinib may cause bone marrow suppression, leading to low white and red blood cells and platelets. Blood counts may be checked periodically by your doctor while on this medication.
Lipid Profile
High cholesterol levels can occur with this medication. Your doctor may periodically check your cholesterol levels. Be sure to eat a heart-healthy diet while on this medication.
Liver Function Test
Even though it is rare, Tofacitinib may cause liver problems. Your doctor may periodically assess your liver function.
Check with your doctor if you experience dark urine, tiredness, lack of hunger, upset stomach or stomach pain, light-colored stools, vomiting, or yellow skin or eyes.
Skin Examination
Tofacitinib is associated with an increased risk of skin cancer. Your doctor may conduct regular skin exams.
Avoid sun, sunlamps, and tanning beds. Always wear sunscreen, clothing, and eyewear that provides sun protection.
Things to know or do while taking Tofacitinib
- Inform all your health care providers that you take this drug, including your dentist and pharmacist.
- Since you may be more prone to infections while on this medication, wash your hands often and stay away from people with infections, colds or the flu. Check with your doctor if you experience fever, chills, flu-like signs, bad sore throat, ear or sinus pain, mouth sores, cough, excess phlegm or change in the color of phlegm, pain when passing urine, or a wound that will not heal.
- Lymphoma, cancer of infection-fighting cells, happens rarely with this medication. Because of this, it is important to regularly test your blood during the time you are taking Tofacitinib. Talk with your doctor if you experience unusual bleeding, bruising, weakness, swollen lymph nodes in the neck, underarms, or groin, raised bumps with pus on the skin, weight loss, or red, scaly patches.
- Tofacitinib can lower the number of platelets that are necessary for proper blood clotting. Be careful when using a regular toothbrush, dental floss or toothpick. Check with your medical doctor before having any dental work done.
- Be careful not to cut yourself when using sharp objects. Avoid contact sports or other situations where bruising or injury might occur.
- Check with your doctor right away if you have unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
- The liquid form of the medication may contain sugar, aspartame and/or alcohol. Talk to your doctor if you have (birth defect that causes an amino acid called phenylalanine to build up in the body)
- Blood clots, though rare, have occurred with this medication, especially in people 50 years of age or older. Check with your doctor immediately if you have sudden shortness of breath, chest pain, or else pain, redness, swelling, or tenderness in your arms or legs.
- This drug may affect certain lab tests. Again, tell all your lab workers and health care providers when you are taking this drug.
No medication comes without any side effects. If your doctor has prescribed this medication, they will have weighed your benefits and risks, and chosen this medication when the benefits outweigh the risks. Keep all appointments with your doctor, so your doctor can closely monitor you and check for side effects.
