AdultPediatricDosage Forms & Strengths tablet (Xeljanz) 5mg 10mg tablet, extended-release (Xeljanz XR) 11mg 22mg Rheumatoid Arthritis Indicated for moderate-to-severe active rheumatoid arthritis (RA) in adults with an inadequate response or intolerance to ≥1 tumor necrosis factor (TNF) blockers Xeljanz: 5 mg PO BID Xeljanz XR: 11 mg PO qDay Psoriatic Arthritis Indicated for active psoriatic arthritis in adults who have had an inadequate response or intolerance to ≥1 TNF blockers Recommended dose in combination with nonbiologic DMARDs Xeljanz: 5 mg PO BID Xeljanz XR: 11 mg PO qDay Ulcerative Colitis Indicated for adults with moderately to severely active ulcerative colitis (UC), who have had an inadequate response or intolerance to ≥1 TNF blockers Xeljanz Induction 10 mg PO BID for at least 8 weeks; evaluate patients and transition to maintenance therapy depending on therapeutic response If needed, continue 10 mg BID for maximum of 16 weeks; discontinue after 16 weeks if adequate therapeutic benefit not achieved Maintenance 5 mg PO BID; may consider 10 mg BID (limited to shorter duration) in patients with loss of response during maintenance treatment Use the lowest effective dose needed to maintain response Xeljanz XR Induction 22 mg PO qDay for at least 8 weeks; evaluate patients and transition to maintenance therapy depending on therapeutic response If needed, continue 22 mg qDay for maximum of 16 weeks; discontinue after 16 weeks if adequate therapeutic benefit not achieved Maintenance 11 mg PO qDay; may consider 22 mg qDay (limited to shorter duration) in patients with loss of response during maintenance treatment Use the lowest effective dose needed to maintain response Ankylosing Spondylitis Indicated for active ankylosing spondylitis (AS) in adults who have an inadequate response or are intolerant to ≥1 TNF blockers Xeljanz: 5 mg PO BID Xeljanz XR: 11 mg PO qDay Dosage Modifications Strong CYP3A4 inhibitors OR moderate CYP3A4 inhibitors with strong CYP2C19 inhibitors RA, PsA, or AS Xeljanz: Not to exceed 5 mg qDay Xeljanz XR: Switch to Xeljanz 5 mg qDay UC Xeljanz: If taking 10 mg BID, reduce to 5 mg BID; if taking 5 mg BID, reduce to 5 mg qDay Xeljanz XR: If taking 22 mg qDay, reduce to 11 mg qDay; if taking 11 mg qDay, switch to Xeljanz 5 mg qDay Lymphopenia RA, PsA, AS, or UC Lymphocytes <500 cells/mm3: Confirmed by repeat testing; discontinue until infection controlled ANC 500-1000 cells/mm³ RA, PsA, or AS Interrupt dosing for persistent decreases; when ANC >1000/mm3, resume dose at Xeljanz 5 mg BID or Xeljanz XR 11 mg qDay ANC <500 cells/mm3: Confirmed by repeat testing; discontinue UC Xeljanz: If taking 10 mg BID, reduce to 5 mg BID; when ANC >1000, increase to 10 mg BID based on clinical response; if taking 5 mg BID, interrupt dosing; when ANC >1000, resume 5 mg BID Xeljanz XR: If taking 22 mg qDay, reduce to 11 mg qDay when ANC >1000, increase to 22 mg qDay based on clinical response; if taking 11 mg qDay, interrupt dosing; when ANC >1000, resume 11 mg qDay Anemia RA, PsA, AS, or UC Hgb >2 g/dL decrease or level <8.0 g/dL: Confirmed by repeat testing; interrupt treatment until Hgb levels have normalized Renal impairment RA, PsA, or AS Mild: No dosage adjustment required Moderate-to-severe (Xeljanz): Not to exceed 5 mg qDay Moderate-to-severe (Xeljanz XR): Switch to Xeljanz 5 mg qDay Patients undergoing hemodialysis: Administer dose after dialysis session on dialysis days; if dose administered before dialysis session, supplemental doses are not recommended UC Mild (Xeljanz and Xeljanz XR): No dosage adjustment required Moderate-to-severe (Xeljanz): If taking 10 mg BID, reduce to 5 mg BID; if taking 5 mg BID, reduce to 5 mg qDay Moderate-to-severe (Xeljanz XR): If taking 22 mg qDay, reduce to 11 mg qDay; if taking 11 mg qDay, switch to Xeljanz 5 mg qDay Patients undergoing hemodialysis: Administer dose after dialysis session on dialysis days; if dose administered before dialysis session, supplemental doses are not recommended Hepatic impairment Safety and efficacy have not been studied in patients with positive hepatitis B virus or hepatitis C virus serology (Add to adult) RA, PsA, or AS Mild (Xeljanz and Xeljanz XR): No dosage adjustment required Moderate (Xeljanz): Not to exceed 5 mg qDay Moderate (Xeljanz XR): Switch to Xeljanz 5 mg qDay Severe (Xeljanz and Xeljanz XR): Not recommended UC Mild (Xeljanz and Xeljanz XR): No dosage adjustment required Moderate (Xeljanz): If taking 10 mg BID, reduce to 5 mg BID; if taking 5 mg BID, reduce to 5 mg qDay Moderate (Xeljanz XR): If taking 22 mg qDay, reduce to 11 mg qDay; if taking 11 mg qDay, switch to Xeljanz 5 mg qDay Severe (Xeljanz and Xeljanz XR): Not recommended Dosing Considerations Higher incidence of infections in geriatric patients; use with caution Do not initiate if Absolute lymphocyte count <500 cells/mm3 OR ANC <1000 cells/mm3 OR Hgb <9 g/dL Limitations of use RA, PsA, AS: Use in combination with biologic disease-modifying antirheumatic drugs (DMARDS) or potent immunosuppressants (eg, azathioprine, cyclosporine) is not recommended UC: Use in combination with biologic therapies or potent immunosuppressants (eg, azathioprine, cyclosporine) is not recommended Dosage Forms & Strengths oral solution (Xeljanz) 1mg/mL tablet (Xeljanz) 5mg 10mg Polyarticular Course Juvenile Idiopathic Arthritis Indicated for active polyarticular course juvenile idiopathic arthritis (pcJIA) in patients aged ≥2 years ≥2 years Oral solution 10 to <20 kg: 3.2 mg PO BID 20 to <40 kg: 4 mg PO BID Oral solution or tablet ≥40 kg: 5 mg PO BID Dosage Modifications Coadministration with strong CYP3A4 inhibitors, OR a moderate CYP3A4 inhibitor(s) with a strong CYP2C19 inhibitor(s) pcJIA If taking 3.2 mg BID, reduce to 3.2 mg qDay If taking 4 mg BID, reduce to 4 mg qDay If taking 5 mg BID, reduce to 5 mg qDay Hematologic abnormalities Do not initiate in patients with an absolute lymphocyte count <500 cells/mm3, ANC <1000 cells/mm3 or Hgb <9 g/dL Lymphocyte count <500 cells/mm3: Confirmed by repeat testing; discontinue dosing ANC 500-1000 cells/mm3: Interrupt dosing until ANC >1000 cells/mm3 ANC <500 cells/mm3: Discontinue dosing Hgb <8 g/dL or a decrease of >2 g/dL: Interrupt dosing until Hgb normalized Renal impairment pcJIA Mild: No dosage adjustment required Moderate-to-severe: Reduce dosing frequency to qDay (eg, 3.2 mg BID to 3.2 mg qDay) Hemodialysis: Administer after dialysis session on dialysis days; if dose taken before dialysis, supplemental doses are not recommended after dialysis Hepatic impairment pcJIA Mild: No dosage adjustment required Moderate: Reduce dosing frequency to qDay (eg, 3.2 mg BID to 3.2 mg qDay) Severe: Not studied; not recommended Safety and efficacy have not been studied in patients with positive hepatitis B virus or hepatitis C virus serology (Add to adult) Dosing Considerations Limitation of use: Use in combination with biologic DMARDs or potent immunosuppressants (eg, azathioprine, cyclosporine) is not recommendedInteraction CheckerEnter a drug name and tofacitinibNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (119)abametapirabametapir increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.abataceptabatacept, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.antithymocyte globulin equineantithymocyte globulin equine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.antithymocyte globulin rabbitantithymocyte globulin rabbit, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.apalutamideapalutamide will decrease the level or effect of tofacitinib by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.apalutamide will decrease the level or effect of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.atazanaviratazanavir increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with potent CYP3A4 inhibitors.auranofinauranofin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.axicabtagene ciloleuceltofacitinib, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.azathioprineazathioprine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.baricitinibbaricitinib, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Baricitinib is not recommended in combination with other JAK inhibitors, biologic DMARDs, or potent immunosuppressives.basiliximabbasiliximab, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.belataceptbelatacept, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.bendamustinebendamustine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.betamethasonebetamethasone, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.brexucabtagene autoleuceltofacitinib, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.busulfanbusulfan, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.capecitabinecapecitabine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.carboplatincarboplatin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.carmustinecarmustine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ceritinibceritinib will increase the level or effect of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.certolizumab pegolcertolizumab pegol, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.chlorambucilchlorambucil, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.chloramphenicolchloramphenicol will increase the level or effect of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.ciltacabtagene autoleuceltofacitinib, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cimetidinecimetidine increases levels of tofacitinib by decreasing metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with 1 or more concomitant medications that result in both moderate CYP3A4 inhibition and potent CYP2C19 inhibition.cisplatincisplatin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cladribinecladribine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.clarithromycinclarithromycin increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with potent CYP3A4 inhibitors.clofarabineclofarabine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cobicistatcobicistat increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with potent CYP3A4 inhibitors.conivaptanconivaptan increases levels of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Reduce tofacitinib dose to 5 mg qDay when coadministered with potent CYP3A4 inhibitors.corticotropincorticotropin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cortisonecortisone, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cyclophosphamidecyclophosphamide, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cyclosporinecyclosporine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cytarabinecytarabine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.dacarbazinedacarbazine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.darunavirdarunavir increases levels of tofacitinib