❓ 1. What is Tofacitinib?
Tofacitinib is an oral Janus kinase (JAK) inhibitor used to treat autoimmune and inflammatory conditions. It works by interfering with signaling pathways involved in the body’s immune response, helping to reduce inflammation and prevent joint damage.
💊 2. What conditions is Tofacitinib used to treat?
Tofacitinib is approved for the treatment of:
- Rheumatoid Arthritis (RA) – moderate to severe
- Psoriatic Arthritis (PsA)
- Ulcerative Colitis (UC)
- Ankylosing Spondylitis (AS) (in some regions)
- Juvenile Idiopathic Arthritis (JIA) (in select populations)
It is usually prescribed when patients have not responded adequately to other DMARDs (Disease-Modifying Anti-Rheumatic Drugs).
⚙️ 3. How does Tofacitinib work?
Tofacitinib blocks the activity of Janus kinase enzymes (JAK1 and JAK3), which are involved in the immune system’s inflammatory response. By inhibiting these enzymes, the drug reduces the activity of immune cells that drive inflammation and damage in autoimmune diseases.
🕒 4. How is it taken?
- Orally – as a tablet (most common form)
- Dosage depends on the condition:
- RA/PsA: Usually 5 mg twice daily or 11 mg once daily (extended-release)
- UC: Induction may start with 10 mg twice daily, then maintenance with 5 mg BID or 11 mg once daily
Always follow your doctor’s instructions exactly, as dosing can vary.
🔄 5. How quickly does it work?
- Some patients notice improvements within a few weeks.
- For others, it may take up to 8–12 weeks to see full benefits.
- In ulcerative colitis, symptom relief may start as early as 3 days, but full induction usually takes 8 weeks.
⚠️ 6. What are the common side effects?
Common side effects include:
- Headache
- Diarrhea or upset stomach
- Nasopharyngitis (cold-like symptoms)
- Elevated cholesterol levels
- High blood pressure
Less common but serious risks:
- Increased risk of infections (especially shingles, TB, pneumonia)
- Blood clots
- Liver enzyme elevations
- Increased risk of certain cancers (e.g. lymphoma, lung cancer – rare but noted in long-term studies)
- Gastrointestinal perforation (very rare)
🛡 7. Are there any precautions or contraindications?
Yes. Tofacitinib may not be suitable for:
- People with active infections
- History of blood clots, cardiovascular disease, or cancer
- Severe liver disease
- Pregnant or breastfeeding women (use only if clearly needed)
You will likely undergo blood tests (CBC, liver function, lipids) before and during treatment.
💉 8. Can it be taken with other medications?
- Can be combined with methotrexate or used alone in RA and PsA.
- Should not be combined with other biologics or potent immunosuppressants like azathioprine or cyclosporine due to increased risk of infection.
- Let your doctor know about all medications, especially blood thinners, antifungals, and immunosuppressants.
💬 9. What monitoring is required during treatment?
Regular tests are crucial:
- CBC (Complete Blood Count) – for infection risk
- Liver enzymes – to detect liver stress
- Lipid panel – cholesterol may increase
- TB and hepatitis screening before starting
🦠 10. What about infections and vaccines?
- Avoid live vaccines (e.g., MMR, yellow fever)
- Inactive vaccines (flu, COVID-19, shingles [Shingrix]) are safe and recommended
- You may be more prone to infections – report fever, cough, or unexplained symptoms promptly
🚺 11. Can I take Tofacitinib if I’m pregnant or breastfeeding?
- Tofacitinib is not recommended during pregnancy or breastfeeding
- Women of childbearing age should use effective contraception during treatment and for at least 4–6 weeks after stopping the medication
🧍 12. What lifestyle measures should I follow while on Tofacitinib?
- Maintain a healthy weight – reduces cardiovascular risk
- Avoid smoking – increases clot and cancer risk
- Limit alcohol – to reduce liver strain
- Stay active – helps manage joint health and fatigue
📌 13. What if I miss a dose?
- If you miss a dose, take it as soon as you remember unless it’s almost time for your next dose
- Do not double up on doses
📦 14. Is there a generic version available?
- In some countries, generic tofacitinib is available.
- The brand name is Xeljanz® (by Pfizer)
🧾 15. What are the costs and access options?
- Can be expensive without insurance or subsidies
- In India the price of 60 tablets of Tofacitinib can cost between Rs.1700 to Rs.3500 between different manufacturers
- Many countries offer financial assistance or patient access programs
- Check with your healthcare provider, insurer, or a pharmacist for support options
🧠 Final Thoughts:
Tofacitinib can be highly effective for people with autoimmune diseases who haven’t responded to other treatments — but it requires careful monitoring and awareness of potential risks.
Always consult your healthcare provider before starting, stopping, or changing your dose of Tofacitinib.
