what are Precautions of Xeljanz (tofacitinib) before using

 See also Warning section.

Before taking tofacitinib, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this Xeljanz , tell your doctor or pharmacist your medical history, especially of: liver disease (such as hepatitis B or C), kidney disease, blood/bone marrow disorders (such as anemia, low lymphocyte/neutrophil count), past/recent/current infections (such as tuberculosis, herpes zoster, HIV infection), cancer, other stomach/intestinal disorders (such as ulcers, diverticulitis), lung disease, heart disease (such as previous heart attack), blood clots, stroke.

Tofacitinib can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.

Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

Liquid products may contain sugar and/or aspartame. Liquid products may also contain alcohol. Caution is advised if you have diabetes, liver disease, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be at greater risk for infections while using this drug.

During pregnancy, this Xeljnz should be used only when clearly needed. Discuss the risks and benefits with your doctor. Tell your doctor if you are planning pregnancy or become pregnant.

It is unknown if this medication passes into breast milk. However, because of the possible risk to the infant, breast-feeding while using this drug and for at least 18 hours after the last dose is not recommended. Consult your doctor before breast-feeding.

Consult your pharmacist or physician.

Xeljanz (tofacitinib)

Effects on other treatments and vaccination Xelanz (Tofacitinib)

You’ll probably be taking methotrexate as well as tofacitinib. However, some drugs may interact with tofacitinib, so check with your doctor before starting any new medicines, especially if you’re taking medicines to treat bacterial or fungal infections. And remember to mention you’re on tofacitinib tab if you’re treated by anyone other than your usual rheumatology team.

You may be more likely to develop a serious infection if you’re taking tofacitinib alongside steroid treatments or other drugs that affect the immune system.

You can carry on taking painkillers and NSAIDs, if needed, unless your doctor advises otherwise.

You shouldn’t take over-the-counter or herbal medicines without discussing it first with your rheumatology team.

Vaccinations

It’s best to discuss vaccinations with your doctor and, if possible, to have any vaccinations you may need before starting tofacitinib.

It’s generally recommended that people on to Xelanz (Tofacitinib) facitinib avoid live vaccines. These include measles, mumps and rubella (MMR), tuberculosis (BCG) and yellow fever.

The Zostavax shingles vaccine is a live vaccine and isn’t recommended for people who are on tofacitinib. However, a non-live shingles vaccine (Shingrix) is available so you may be able to have this instead.

Pneumococcal vaccines, which help to protect against pneumonia, and yearly flu vaccines – except the nasal flu vaccine – are fine and are usually recommended.

Xelanz (Tofacitinib)

 

Possible risk and side effects Xeljanz(Tofacitinib)

Like any medicine, tofacitinib can cause side effects. The most common ones, headaches and diarrheic, aren’t usually serious and should soon pass. Feeling sick is fairly common when taking tofacitinib but may settle with time.

Because tofacitinib affects your immune system, it can make you more likely to pick up infections. These aren’t usually serious and include throat, nose and chest infections, cold sores, urinary tract infections and stomach upsets. Some people may have more serious infections including shingles and skin infections, known as cellulitis.

Xeljanz(Tofacitinib) tablet

Tell your doctor or rheumatology nurse straight away if you develop any signs of infection such as a sore throat or persistent cough, fever or chills, or any other new symptoms that concern you. If any of these symptoms are severe, you should stop taking tofacitinib and see your doctor straight away.

You should also see your doctor if you develop chickenpox or shingles or come into contact with someone who has chickenpox or shingles. These may be more severe if you’re on tofacitinib. You may need treatment, and you may need to stop taking tofacitinib xeljanz until you’re better.

Some people who take tofacitinib may have a reduced white blood cell count, raised cholesterol or raised levels of liver enzymes. These problems are usually mild but your rheumatology team will arrange regular blood checks while you are taking tofacitinib as a precaution.

It’s possible that tofacitinib may increase the risk of blood clots in the legs, called deep vein thrombosis. These can sometimes move to the lungs, which is called pulmonary embolism. The risk is likely to be greater if you’ve had either of these before. You should seek urgent medical care if you develop swelling of the legs or breathlessness.

It’s possible that there may be a slightly increased risk of some cancers in people taking XELJANZ (Tofacitinib) though research so far hasn’t confirmed this. If you’ve had previous cancers, this may affect whether tofacitinib is offered to you as a treatment.

Tofacitinib can sometimes cause stomach or bowel problems. These are more common in people who also take non-steroidal anti-inflammatory drugs (NSAIDs) or steroids. You should also tell your doctor straight away if you notice any signs of stomach or abdominal problems, such as pain, change in bowel habits or blood in your poo.

Rarely, tofacitinib can cause an allergic reaction with sudden swelling, a rash or breathlessness. If you develop these symptoms, or any other severe symptoms while taking tofacitinib, you should seek medical advice straight away.

Tips to reduce your risk of infection

• Try to avoid close contact with people you know have an infection.
• Wash your hands regularly and carry around a small bottle of antibacterial hand gel.
• Keep your mouth clean by brushing your teeth regularly.
• Stop smoking if you’re a smoker.
• Make sure your food is stored and prepared properly.
• Try to keep your house clean and hygienic, especially the kitchen, bathrooms and toilets.

Is Tofacitinib(Xelanz) suitable for me?

 Tofacitinib can be prescribed by a consultant rheumatologist for adults with rheumatoid arthritis or psoriatic arthritis. It can be used alone or with methotrexate.

Tofacitinib won’t be started if:

• your arthritis isn’t active
• you haven’t tried other treatments appropriate for your condition first.

Your doctor may decide not to prescribe this treatment if you’re pregnant, planning to try for a baby, or breastfeeding, or if you are over 65. They may also not prescribe it if you have or have had:

• an active infection
• repeated or serious previous infections
• shingles
• disease of the lungs, liver or kidneys
• heart problems, high blood pressure, high cholesterol or blood clots (deep vein thrombosis or pulmonary embolism)
• cancer.

Tofacitinib contains lactose, so you should tell your rheumatology team if you’re lactose intolerant.

You’ll have blood tests before treatment starts to assess your condition and whether the drug is suitable for you.

Your rheumatology team will also monitor you through blood tests once you start treatment. If your red or white blood cell count gets too low, your treatment may be stopped until it improves.

Your doctor will need to check if you’ve previously been exposed to tuberculosis (TB). Even if you don’t have symptoms, the bacteria that cause TB may still be present in the body and you may need a course of treatment for this before starting tofacitinib.

If you’ve previously had hepatitis you may need regular checks for this as Tofacitinib may increase the risk of the hepatitis coming back.

You may have to be monitored for other conditions as well, for example if you have liver problems, high cholesterol, or if you are at risk of heart or lung conditions. Tofacitinib raises cholesterol levels in some people.

Tofacitinib(Xelanz) 

What is tofacitinib (Xeljanz) and how is it used?

Tofacitinib, also known as Xeljanz, is a type of drug known as a Janus kinase (JAK) inhibitor. It works by blocking the action of Janus kinase enzymes, which are involved in the inflammation that causes the symptoms of rheumatoid arthritis and psoriatic arthritis.

Tofacitinib is a long-term treatment. Most people who benefit from this treatment will notice an improvement the first 12 weeks of starting treatment

XELJANZ(Tofacitinib) Tablet

How to used Xeljanz (Tofacitinib)

Read the Medication Guide provided by your pharmacist before you start taking tofacitinib and each time you get a refill. If you are using the liquid form of this medication, also read the Instructions for Use. If you have any questions, ask your doctor or pharmacist.

• Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily.
• If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
• This Xeljanz(tofacitinib) tablet dosage is based on your medical condition, response to treatment, lab tests, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Children's dosage is also based on weight. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of serious side effects will increase.