What is tofacitinib?
Tofacitinib is an oral drug used to treat adults with moderately to severely active rheumatoid arthritis (RA). It belongs to a class of drugs known as targeted synthetic disease-modifying anti-rheumatic drugs (tsDMARDs).
How does it work?
Tofacitinib works by blocking a class of enzymes called Janus kinases in the body, which play an important role in joint inflammation, thereby leading to pain, swelling and stiffness in RA patients.
How should you take tofacitinib tablets?
Tofacitinib is available as 5 mg tablets that are to be taken twice per day with or without food. Your doctor may modify your dose based on your condition or any liver or kidney disorders. Tofacitinib may be used alone or in combination with methotrexate or other DMARDs. Tofacitinib should not be given in combination with another biologic drug or other potent immunosuppressants, such as azathioprine or cyclosporine.
Some patients may start to see improvement within a few weeks; however, it may take several months to experience complete benefits.
Take tofacitinib tablets exactly as per your doctor’s advice. Check with your doctor if you are not sure.
What do you need to know when you take tofacitinib tablets?
- Regular laboratory testing is necessary to monitor cholesterol or liver enzyme levels and blood cell counts while taking tofacitinib.
- During tofacitinib therapy, live vaccines must not be taken.
- Tofacitinib tablets are not recommended for use in children or adolescents under 18 years of age.
Do not take tofacitinib tablets in case of the following:
- If you are allergic to tofacitinib, or any of the other ingredients of this medicine
- If you have severe liver problems
- If you have severe kidney problems
- If you have heart problems
- If you had or have any type of cancer
- If you had or have any blood disorders, such as the development of blood clots in the lungs or veins, or have an increased risk for developing them
- If you have a serious or severe infection such as bloodstream infection or active tuberculosis
- If you suffer from any problem that affects your immune system (e.g. HIV/AIDS)
- If you are pregnant, think you may be pregnant, or are breastfeeding
What are the possible side effects of tofacitinib tablets?
- Tofacitinib can lower your immune system’s ability to fight infections. The most common side effects of tofacitinib are upper respiratory tract infections, headache, diarrhoea, infection and swelling of the nasal passages and the back of the throat (nasopharyngitis).
- Your doctor may tell you to perform a skin tuberculosis test and chest X-ray before starting on tofacitinib.
- Your doctor may also screen you for any hepatitis B and C infection prior to starting tofacitinib since this drug may increase the risk of reactivation of these infections.
- Some patients may have increased cholesterol levels; therefore, lab monitoring should be done periodically.
- Some patients may develop lymphoma and other malignancies when treated with tofacitinib.
- Rarely, tofacitinib has been associated with an injury to the intestines. Notify your doctor If you have a history or diverticulitis or develop stomach pain or rectal bleeding (blood in the stools) while taking tofacitinib.
- Tofacitinib may sometimes lead to the development of blood clots. Talk to your doctor if you have new onset of leg swelling or shortness of breath. Your doctor will evaluate your risk to develop blood clots in the lungs or veins and determine if tofacitinib is appropriate for you (if you already have or have had problems of developing blood clots in the lungs or veins, or have an increased risk for developing them, or if you are of older age > 50 years, or if you smoke, your doctor may decide that tofacitinib is not suitable for you).
What should you tell your doctor while on tofacitinib treatment?
- You should contact your doctor immediately if you develop symptoms of an infection, such as a fever or cough, or if you think you are having any side effects (such as abdominal pain, blood in the stools, or allergic reactions).
- Tell your doctor if you have any condition that increases your chances of infection (e.g. diabetes, HIV/AIDS, or a weak immune system) or if you have any kind of infection, are being treated for any infection, or if you have infections that keep coming back.
- Tell your doctor if you have any chronic lung disease, or if you have or had hepatitis B or hepatitis C, or had or have any type of cancer.
- Notify your doctor if you had a history of diverticulitis (a type of inflammation of the large intestine) or ulcers in the stomach or intestines.
- Inform your doctor if you are taking, have recently taken or might take any other medicines.
- Consult your doctor if you plan to have any surgery while taking tofacitinib or before receiving any vaccines.
- Be sure to let your doctor know If you are pregnant or breastfeeding, think you might be pregnant, or are planning to have a baby, consult your doctor for advice before taking this medicine.
- https://www.rheumatology.org/Portals/0/Files/Tofacitinib-Citrate-Xeljanz-Fact-Sheet.pdf Accessed on 18 March 2021
- Prescribing information. TOFAJAK Tablets. Last updated: December 2021