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tofacitinib

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Brand names: Xeljanz

JAK Inhibitor Rx

Xeljanz is a medicine that reduces inflammation in your body. It is used to treat conditions like arthritis and ulcerative colitis.

Drug Pricing (NADAC)

Brand Price

$93.73/unit

Generic Available

No

PF PRISM CV

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Xeljanz treats rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and ulcerative colitis in adults.

Common side effects

Upper respiratory tract infection (like a cold), Runny nose, Diarrhea

Key warnings

Xeljanz can increase your risk of serious infections, which could lead to hospitalization or death.

How It Works

Xeljanz is a JAK inhibitor. It works by blocking certain enzymes in your body. These enzymes cause inflammation, so blocking them helps to reduce swelling and pain.

How to Take It

Take Xeljanz exactly as your doctor tells you. For rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, the usual dose is 5 mg twice a day or 11 mg once a day. For ulcerative colitis, you may start at 10 mg twice a day or 22 mg once a day, then lower the dose. You can take Xeljanz with or without food.

Pregnancy & Breastfeeding

It is not known if Xeljanz will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. You should not breastfeed while taking Xeljanz.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store Xeljanz tablets and oral solution at room temperature, away from light and moisture.

Side Effects (from patient reports)

Based on 198,395 FDA adverse event reports.

The medicine is not working
43,542
Pain
25,737
Joint pain
19,670
Condition got worse
19,467
Rheumatoid arthritis
18,797
Tiredness
16,595
Using the medicine for something it's not approved for
14,815
Swollen joint
14,455
Headache
13,405
Rash
11,912

FDA Adverse Event Report Analysis

Detailed analysis of 181,998 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2008–2025.

Total Reports

181,998

Death-Related Reports

8,655

Hospitalization Reports

24,557

Top Indication

Rheumatoid Arthritis

Gender Distribution

Female 138,558 (80%)
Male 33,777 (20%)

Age Distribution

0–17 1,620
18–44 23,187
45–64 69,765
65–74 35,158
75+ 17,340

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 43,542
2 PAIN 25,737
3 ARTHRALGIA 19,670
4 CONDITION AGGRAVATED 19,467
5 RHEUMATOID ARTHRITIS 18,797
6 FATIGUE 16,595
7 OFF LABEL USE 14,815
8 JOINT SWELLING 14,455
9 HEADACHE 13,405
10 RASH 11,912
11 DRUG INTOLERANCE 11,718
12 MALAISE 10,489
13 PAIN IN EXTREMITY 10,277
14 ABDOMINAL DISCOMFORT 10,168
15 NAUSEA 9,949

Reactions in Death Reports

DEATH 3,491
OFF LABEL USE 2,002
JOINT SWELLING 1,969
RHEUMATOID ARTHRITIS 1,950
PAIN 1,933
RASH 1,899
INFUSION RELATED REACTION 1,889
FATIGUE 1,860
SYNOVITIS 1,848
SYSTEMIC LUPUS ERYTHEMATOSUS 1,844

Reactions in Hospitalization Reports

DRUG INEFFECTIVE 5,640
PAIN 5,294
RHEUMATOID ARTHRITIS 4,484
CONDITION AGGRAVATED 4,373
ARTHRALGIA 4,344
FATIGUE 4,196
OFF LABEL USE 4,018
RASH 3,865
JOINT SWELLING 3,732
ARTHROPATHY 3,429

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Xeljanz can increase your risk of serious infections, which could lead to hospitalization or death. It may also increase your risk of blood clots, cancer, and heart problems. Talk to your doctor about these risks before taking Xeljanz.

Known Drug Interactions

Table 7: Clinically Significant Interactions Affecting XELJANZ/XELJANZ XR When Concomitantly Used with Other Drugs Strong CYP3A4 Inhibitors (e.g., ketoconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Moderate CYP3A4 Inhibitors Concomitantly Used with Strong CYP2C19 Inhibitors (e.g., fluconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Admin...

Mechanism: Ketoconazole blocks the enzymes that break down tofacitinib, which can cause the drug to build up to high levels in your body.

What to do: Your doctor will likely reduce your dose of tofacitinib to prevent side effects from high drug levels.

Table 7: Clinically Significant Interactions Affecting XELJANZ/XELJANZ XR When Concomitantly Used with Other Drugs Strong CYP3A4 Inhibitors (e.g., ketoconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Moderate CYP3A4 Inhibitors Concomitantly Used with Strong CYP2C19 Inhibitors (e.g., fluconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Admin...

Mechanism: Using these two drugs together can overly weaken your immune system, making it harder for your body to fight off infections.

What to do: This combination is generally not recommended, and you should talk to your doctor about safer alternatives.

Table 7: Clinically Significant Interactions Affecting XELJANZ/XELJANZ XR When Concomitantly Used with Other Drugs Strong CYP3A4 Inhibitors (e.g., ketoconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Moderate CYP3A4 Inhibitors Concomitantly Used with Strong CYP2C19 Inhibitors (e.g., fluconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Admin...

Mechanism: Rifampin causes your body to process tofacitinib much faster than normal, which can lower the amount of medicine in your blood.

What to do: Your doctor may need to monitor your condition closely as tofacitinib may be less effective during this time.

) Tofacitinib: Coadministration of fluconazole (400 mg on Day 1 and 200 mg once daily for 6 days [Days 2 to 7]) and tofacitinib (30 mg single dose on Day 5) in healthy subjects resulted in increased mean tofacitinib AUC and C max values of approximately 79% (90% CI: 64% to 96%) and 27% (90% CI: 12% to 44%), respectively, compared to administration of tofacitinib alone. (See CLINICAL PHARMACOLOGY: Drug Interaction Studies .) Tofacitinib: Systemic exposure to tofacitinib is increased when tofacitinib is coadministered with fluconazole. Reduce the dose of tofacitinib when given concomitantly w...

Mechanism: Fluconazole increases the amount of tofacitinib in your system by slowing its metabolism. This can lead to a higher risk of side effects from the tofacitinib.

What to do: Your doctor should reduce your dose of tofacitinib when it is taken at the same time as fluconazole. Follow your healthcare provider's instructions for the specific dosage change.

Janus kinase (JAK) inhibitors tofacitinib ↑ tofacitinib Dosage adjustment of tofacitinib is recommended. Refer to the tofacitinib product label for more information.

Mechanism: This medicine blocks the enzymes that usually break down tofacitinib, causing more of it to stay in your body.

What to do: Your doctor will likely need to change your dose of tofacitinib while you are on this treatment.

Common Questions

Can I take Xeljanz with other medicines?
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
How long does it take for Xeljanz to work?
It may take several weeks or months for you to feel the full effects of Xeljanz.
What should I do if I get an infection while taking Xeljanz?
Tell your doctor right away if you get any signs of infection, such as fever, cough, or sore throat.
Can Xeljanz cause cancer?
Xeljanz may increase your risk of certain types of cancer. Talk to your doctor about this risk.
Can Xeljanz cause blood clots?
Xeljanz may increase your risk of blood clots. Seek immediate medical attention if you experience symptoms such as chest pain, shortness of breath, or swelling in your leg.
Will Xeljanz cure my condition?
Xeljanz helps manage your condition, but it is not a cure.
Can I get vaccines while taking Xeljanz?
Avoid live vaccines while taking Xeljanz.
What tests will I need while taking Xeljanz?
Your doctor will do blood tests to monitor your blood cell counts, liver function, and cholesterol levels.
Can I drink alcohol while taking Xeljanz?
Talk to your doctor about drinking alcohol while taking Xeljanz.
What if Xeljanz does not seem to be working?
Talk to your doctor if you do not feel any improvement while taking Xeljanz.
What are the common side effects of tofacitinib?
The most commonly reported side effects of tofacitinib include Upper respiratory tract infection (like a cold), Runny nose, Diarrhea, Headache, Increased cholesterol levels. Based on 198,395 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does tofacitinib interact with other medications?
Yes, tofacitinib has 5 known drug interactions. Notable interactions include ketoconazole, cyclosporine, rifampin. Always inform your doctor about all medications you are taking.
What drug class is tofacitinib?
tofacitinib belongs to the JAK Inhibitor drug class. It requires a prescription (Rx). Xeljanz treats rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and ulcerative colitis in adults.
Is tofacitinib safe during pregnancy?
It is not known if Xeljanz will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for tofacitinib

The FDA label for tofacitinib (sold under brand names such as Xeljanz) classifies it as a prescription-only medication in the JAK Inhibitor class. Xeljanz treats rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and ulcerative colitis in adults. Official labeling lists 8 commonly reported side effects, including Upper respiratory tract infection (like a cold), Runny nose, Diarrhea.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 198,395 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: January 30, 2026

All federal data sources used on this page