Xeljanz

Written by Dr. Brian Bressler on October 31, 2019

What is Xeljanz?

Xeljanz (tofacitinib) is a medication that reduces inflammation in large intestine by blocking an enzyme that is responsible for inflammation.

Xeljanz is used to treat ulcerative colitis. The goal of treatment is to reduce inflammation and allow the bowel to heal. This will improve symptoms and reduce complications including the need for steroids and/or surgery.

Xeljanz is often used when other drugs have not worked for you, or have caused bad side effects.

How is Xeljanz taken?

Xeljanz is an oral pill that is prescribed at a dose of 5mg and 10mg. During the induction phase, to help induce remission, the initial dose is 10mg taken twice a day, 12 hours apart.

After the induction phase, which can take up to four months, or when there’s been an improvement in your symptoms, your dose will be reduced to 5mg twice daily as decided by you and your physician.

This medication can be taken with or without food.

Important information

It is recommended that your immunizations are up to date prior to starting on therapy. Because of the increased incidence of shingles, please consider receiving Shingrix, a non-live vaccine against shingles. After starting on therapy, all live vaccines need to be avoided.

Please speak with your family doctor about getting regular skin examinations on a yearly basis.

Please inform your doctor if you are experiencing any muscle weakness or pain while on therapy.

Regular blood work monitoring should be done every 2-3 months while on treatment.

Xeljanz side effects

Common side effects of Xeljanz (tofacitinib):

  • Bladder pain
  • Bloody or cloudy urine
  • Blurred vision
  • Body aches
  • Cold symptoms such as sore throat, runny or stuffy nose.
  • Cough
  • Difficulty urinating
  • Difficulty breathing
  • Dizziness
  • Fever
  • Frequent urge to urinate
  • Headache
  • Loss of voice
  • Lower back pain
  • Nervousness
  • Sneezing
  • Tiredness

Additional details about the side effects of Xeljanz are:

  • Increased risk of infection: Because Xeljanz interacts with the immune system, it may increase your risk of various fungal, viral, and bacterial infections. In particular, it has been associated with an increased risk of shingles. This medication can reactivate tuberculosis (TB) if you’ve previously been exposed and it is latent in your body. A TB skin test is required prior to starting treatment. Please let the doctor know if you have any known exposure or prior history of TB.
  • Abnormal lab values: Prior to starting on therapy, you will be asked to complete some baseline blood work. Xeljanz can lower red and white blood counts. It can also cause an increase in liver enzymes and cholesterol levels. Therefore, it is important to go for ongoing blood work as a cessation or change in therapy may be indicated with specific lab findings. It is also recommended that you periodically check your blood pressure and heart rate while on treatment.
  • Lymphoma and non-melanoma skin cancer: Medications that manipulate the activity of the immune system may increase the risk of cancer. There may be an
  • increased risk of lymphoma or non-melanoma skin cancer with this therapy. Regular skin examinations are advisable.
  • Increased risk of thrombotic events: at the higher doses of Xeljanz, there may be an increased risk of developing a blood clot.

Your doctor will discuss the risks and benefits before you start on Xeljanz. Let your doctor or nurse know about any new symptoms you develop while on Xeljanz.

When will I start to feel better?

While some people may see an improvement in their symptoms within a few weeks, the full effects can take up to four months.

You should book a follow up appointment with your doctor to evaluate your response to treatment within the first two months of starting treatment.

How long do I have to take this medication?

Ulcerative colitis is a chronic condition that often requires ongoing therapy. This medication can induce and maintain remission. If it is effective, you will need to continue it to control inflammation and prevent flares.

Can I drink alcohol while on this medication?

Yes, alcohol can be consumed in moderation.

What happens when I want to get pregnant?

It is NOT safe to take this medication during pregnancy. There are very few studies looking at the use of Xeljanz during pregnancy but this medication may adversely affect the developing baby. For women, appropriate contraception is advised while on treatment. Please speak with your physician about your family planning.

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