Safety / Side Effects
If you are considering asking your doctor about XELJANZ, it’s important to learn more about the risks and benefits. The tools below can provide helpful information about taking XELJANZ and the safety and side effects of treatment.
The safety information below applies to all marketed formulations of XELJANZ. Specific risks associated with certain dosing is noted.
Possible Side Effects
XELJANZ (tofacitinib) may cause serious side effects.
XELJANZ can lower the ability of your immune system to fight infections. Do not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay. Serious Infections have happened in people taking XELJANZ. These serious infections include tuberculosis (TB) and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting and during treatment with XELJANZ.
Before and after starting XELJANZ, tell your doctor if you have an infection or symptoms of an infection, including:
- Fever, sweating, or chills
- Cough
- Blood in phlegm
- Warm, red, or painful skin or sores on your body
- Burning when you urinate
- Urinating more often than normal
- Muscle aches
- Shortness of breath
- Weight loss
- Diarrhea or stomach pain
- Feeling very tired
People taking the higher dose of XELJANZ (10 mg twice daily) or XELJANZ XR (22 mg one time each day) have a higher risk of serious infections or shingles.
These are not all of the possible side effects of
Increased risk of death in people 50 years of age and older with rheumatoid arthritis who have at least 1 heart disease (cardiovascular) risk factor and who are taking a higher than recommended dose of XELJANZ/XELJANZ XR. The recommended dose in patients with rheumatoid arthritis and psoriatic arthritis is XELJANZ 5 mg twice daily or
These are not all of the possible side effects of
XELJANZ may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers, including skin cancers, can happen. Tell your healthcare provider if you have ever had any type of cancer.
People taking the higher dose of XELJANZ (10 mg twice daily) or XELJANZ XR (22 mg one time each day) have a higher risk of skin cancers.
Some people who have taken XELJANZ with certain other medicines to prevent kidney transplant rejection have had a problem with certain white blood cells growing out of control (Epstein Barr
These are not all of the possible side effects of
Blood clots in the lungs (pulmonary embolism, PE), veins of the legs (deep vein thrombosis, DVT) and arteries (arterial thrombosis) have happened more often in patients with rheumatoid arthritis who are 50 years of age and older and with at least 1 heart disease (cardiovascular) risk factor taking a higher than recommended dose of
- Stop taking XELJANZ and tell your healthcare provider right away if you have any signs and symptoms of blood clots such as sudden shortness of breath, difficulty breathing, chest pain, swelling of a leg or arm, leg pain or tenderness, or red or discolored skin in the leg or arm.
These are not all of the possible side effects of
Tell your healthcare provider if you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking XELJANZ can get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate. Tell your healthcare provider right away if you have fever, stomach-area pain that does not go away, and a change in your bowel habits.
These are not all of the possible side effects of
Serious allergic reactions can occur. Stop using XELJANZ and call your healthcare provider right away if you have swelling of your lips, tongue, throat, or get hives.
These are not all of the possible side effects of
Your doctor should do blood tests to check your white and red blood cells before and while you are taking XELJANZ. Your doctor should also check certain liver tests. You should not receive XELJANZ if your lymphocyte count, neutrophil count, or red blood cell count is too low or your liver function test levels are too high. Changes in lab test results may cause your healthcare provider to stop your XELJANZ treatment for a time. Your cholesterol levels should be checked 4 to 8 weeks after you start receiving XELJANZ.
These are not all of the possible side effects of
Before you use XELJANZ, tell your healthcare provider if you:
- Are being treated for an infection, have an infection that won’t go away or keeps coming back, or think you have symptoms of an infection
- Have TB, or have been in close contact with someone with TB, or were born in, lived in, or traveled where there is more risk for getting TB
- Have diabetes, chronic lung disease, HIV, or a weak immune system. People with these conditions have a higher chance for infections
- Live or have lived in certain areas (such as Ohio and Mississippi River Valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections
- Have or have had Hepatitis B or C
- Have had blood clots
- Have liver or kidney problems
- Have any stomach area (abdominal) pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines
- Have recently received or plan to receive a vaccine. People taking XELJANZ should not receive live vaccines but can receive non-live vaccines
- Are pregnant, planning to become pregnant, breastfeeding or planning to breastfeed. You should not take XELJANZ and breastfeed
- Have had a reaction to tofacitinib or any of the ingredients
- Are taking other medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take any of the following medicines while taking XELJANZ since this may increase your risk of infection:
- tocilizumab (Actemra®)
- etanercept (Enbrel®)
- adalimumab (Humira®)
- infliximab (Remicade®)
- rituximab (Rituxan®)
- abatacept (Orencia®)
- anakinra (Kineret®)
- certolizumab (Cimzia®)
- golimumab (Simponi®)
- ustekinumab (Stelara®)
- secukinumab (Cosentyx®)
- vedolizumab (Entyvio®)
- sarilumab (Kevzara®)
- azathioprine, cyclosporine, or other immunosuppressive drugs
- Tell your healthcare provider if you are taking medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
These are not all of the possible side effects of
If you are a carrier of the Hepatitis B or C virus (viruses that affect the liver), the virus may become active while you use XELJANZ. Your healthcare provider may do blood tests before starting and while using treatment with XELJANZ. Tell your healthcare provider if you have any signs of these symptoms: feel very tired, little or no appetite, clay-colored bowel movements, chills, muscle aches, skin rash, skin or eyes look yellow, vomiting, fevers, stomach discomfort, or dark urine.
Common side effects in adults with rheumatoid arthritis and psoriatic arthritis include upper respiratory tract infections (common cold, sinus infections), headache, diarrhea, nasal congestion, sore throat, runny nose (nasopharyngitis), and high blood pressure (hypertension).
Common side effects in adults with ulcerative colitis include nasal congestion, sore throat, runny nose (nasopharyngitis), increased cholesterol levels, headache, upper respiratory tract infections (common cold, sinus infections), increased muscle enzyme levels, rash, diarrhea, and shingles (herpes zoster).
Common side effects in children (2 & older) with polyarticular juvenile idiopathic arthritis include upper respiratory tract infections (common cold, sinus infections), nasal congestion, sore throat, and runny nose (nasopharyngitis), headache, fever, nausea, and vomiting.
These are not all of the possible side effects of
Questions About XELJANZ
XELJANZ can lower the ability of your immune system to fight infections. Do not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay. Serious Infections have happened in people taking XELJANZ. These serious infections include tuberculosis (TB) and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting and during treatment with XELJANZ.
People taking the higher dose of XELJANZ (10 mg twice daily) or XELJANZ XR (22 mg one time each day) have a higher risk of serious infections or shingles.
Take XELJANZ/XELJANZ Oral Solution 2 times a day with or without food.
Take XELJANZ XR 1 time a day with or without food.
Swallow XELJANZ XR tablets whole and intact. Do not crush, split, or chew.
When you take XELJANZ XR, you may see something in your stool that looks like a tablet. This is the empty shell from the tablet after the medicine has been absorbed by your body.
If you take too much XELJANZ/XELJANZ XR/XELJANZ Oral Solution, call your healthcare provider or go to the nearest hospital emergency room right away.
For the treatment of psoriatic arthritis, take XELJANZ/
XELJANZ XR should not be used instead of XELJANZ Oral Solution.
Contact your healthcare provider if you miss a dose or forget to take XELJANZ for an extended period of time.
When you take XELJANZ XR, you may see something in your stool that looks like a tablet. This is the empty shell from the tablet after the medicine has been absorbed by your body.
XELJANZ may affect the ability of females to get pregnant. It is not known if this will change after stopping XELJANZ. It is not known if XELJANZ will harm an unborn baby.
Pregnancy Registry: Pfizer has a registry for pregnant women who take XELJANZ. The purpose of this registry is to check the health of the pregnant mother and her baby. If you are pregnant or become pregnant while taking XELJANZ, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at
You and your healthcare provider should decide if you will take XELJANZ or breastfeed. You should not do both. After you stop your treatment with XELJANZ do not start breastfeeding again until 18 hours after your last dose of XELJANZ or 36 hours after your last dose of XELJANZ XR.
Taking XELJANZ/XELJANZ XR
Depending on your diagnosis and other factors, your doctor may prescribe you a different dosage of XELJANZ or
XELJANZ XR should not be used instead of XELJANZ Oral Solution.
- Moderate to SevereRheumatoid Arthritis
- ActivePsoriatic Arthritis
- Moderate to SevereUlcerative Colitis
What are my options?
XELJANZ (5 mg)
How It’s Taken
Twice a day with or without food
How It’s Delivered
Immediate release into the bloodstream over the course of several hours
XELJANZ XR (11 mg)
How It’s Taken
Once a day with or without food*
How It’s Delivered
Extended release into the bloodstream over the course of a day
What are my options?
XELJANZ (5 mg)*
How It’s Taken
Twice a day with or without food
How It’s Delivered
Immediate release into the bloodstream over the course of several hours
XELJANZ XR (11 mg)*
How It’s Taken
Once a day with or without food†
How It’s Delivered
Extended release into the bloodstream over the course of a day
What are my options?
XELJANZ (5 mg)*
How It’s Taken
Twice a day with or without food
How It’s Delivered
Immediate release into the bloodstream over the course of several hours
XELJANZ (10 mg)*
How It’s Taken
Twice a day with or without food
How It’s Delivered
Immediate release into the bloodstream over the course of several hours
XELJANZ XR (11 mg)*
How It’s Taken
Once a day with or without food†
How It’s Delivered
Extended release into the bloodstream over the course of a day
XELJANZ XR (22 mg)*
How It’s Taken
Once a day with or without food†
How It’s Delivered
Extended release into the bloodstream over the course of a day
XELJANZ/XELJANZ XR (tofacitinib) is used to treat adults with:
- Moderately to severely active rheumatoid arthritis in whom methotrexate did not work well or cannot be tolerated
- Active psoriatic arthritis in which methotrexate or other similar medicines called nonbiologic disease-modifying antirheumatic drugs (DMARDs) did not work well or cannot be tolerated
- Moderately to severely active ulcerative colitis when medicines called tumor necrosis factor (TNF) blockers did not work well or cannot be tolerated
XELJANZ/XELJANZ Oral Solution is used to treat patients 2 years of age and older with active polyarticular juvenile arthritis.
It is not known if XELJANZ/XELJANZ XR is safe and effective in people with Hepatitis B or C.
XELJANZ/XELJANZ XR/XELJANZ Oral Solution is not recommended for people with severe liver problems.
It is not known if XELJANZ/XELJANZ Oral Solution is safe and effective in children for treatment other than active polyarticular juvenile arthritis.
It is not known if XELJANZ XR is safe and effective in children.
XELJANZ/XELJANZ XR (tofacitinib) is used to treat adults with:
- Moderately to severely active » Read More
XELJANZ/XELJANZ XR (tofacitinib) is used to treat adults with:
- Moderately to severely active rheumatoid arthritis in whom methotrexate did not work well or cannot be tolerated
- Active psoriatic arthritis in which methotrexate or other similar medicines called nonbiologic disease-modifying antirheumatic drugs (DMARDs) did not work well or cannot be tolerated
- Moderately to severely active ulcerative colitis when medicines called tumor necrosis factor (TNF) blockers did not work well or cannot be tolerated
XELJANZ/XELJANZ Oral Solution is used to treat patients 2 years of age and older with active polyarticular juvenile arthritis.
It is not known if XELJANZ/XELJANZ XR is safe and effective in people with Hepatitis B or C.
XELJANZ/XELJANZ XR/XELJANZ Oral Solution is not recommended for people with severe liver problems.
It is not known if XELJANZ/XELJANZ Oral Solution is safe and effective in children for treatment other than active polyarticular juvenile arthritis.
It is not known if XELJANZ XR is safe and effective in children.
XELJANZ/XELJANZ XR (tofacitinib) is used to treat adults with:
- Moderately to severely active » Read More
Indications
Important Safety Information