Tofacitinib
About Tofacitinib
Tofacitinib is a prescription medicine used to manage moderate to severe autoimmune inflammatory conditions, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. It is also prescribed to treat moderate to severe ulcerative colitis, an inflammatory bowel disease. By targeting key inflammatory pathways in the body, this medicine helps reduce painful swelling and prevents further damage to your joints and tissues.
To achieve the best results, you must take Tofacitinib consistently every day exactly as prescribed by your doctor. It is typically taken once or twice daily, and you can take it either with or without food. Along with taking your medicine regularly, adopting a balanced, anti-inflammatory diet and incorporating gentle physical exercise can significantly improve your mobility and overall treatment outcomes.
While taking Tofacitinib, you may experience some common, mild side effects such as headaches, diarrhoea, or cold-like symptoms. However, because this medicine affects your immune system, it is crucial to consult your doctor immediately if you develop any signs of serious infections, unusual bruising, high fever, or shingles.
Talk to your doctor before starting this medicine if you have a history of tuberculosis, chronic infections, liver damage, kidney issues, or heart problems. Do not take this if you currently have a severe active infection, severe liver problems, or if you are allergic to any of its ingredients.
This medicine can interact with other drugs that suppress your immune system or certain medications processed by your liver, which can increase the risk of severe side effects or reduce how well the treatment works. You should avoid drinking excess alcohol, stop smoking, and consult your doctor before starting treatment if you are pregnant, planning a pregnancy, breastfeeding, or are an older adult.
Uses of Tofacitinib
Medicinal Benefits
Tofacitinib helps control excessive immune system activity that causes inflammation in autoimmune conditions. By reducing ongoing inflammation, it helps relieve symptoms, improve daily function, and lower the risk of long-term damage associated with these diseases.
Key benefits include:
- Easier Daily Movement: By reducing inflammation in the joints, Tofacitinib helps restore flexibility, making daily tasks like walking, bending, and reaching much more comfortable.
- Long-Term Control Over Flares: Regular use helps keep your immune system from overreacting, which reduces the frequency and severity of painful symptom flare-ups.
- Improved Bowel Comfort: For those managing ulcerative colitis, this medicine helps calm gut inflammation, leading to fewer urgent bathroom trips, less cramping, and healthier digestion.
Directions for Use
- Tofacitinib can be taken with or without food.
- It is recommended to take Tofacitinib 1-2 times a day, depending on your medical condition, or as prescribed by your doctor.
- Swallow Tofacitinib as a whole with a glass of water.
- Do not crush, chew, or break it.
Storage
Side Effects of Tofacitinib
Common Side Effects (Usually mild):
- Cold-like symptoms, such as a runny nose, stuffy nose, or sore throat
- Headaches
- Diarrhoea
- Upset stomach or nausea
- Increased blood pressure
Serious Side Effects (Call a doctor right away):
- Signs of a serious infection, such as high fever, chills, persistent cough, or burning during urination
- Signs of shingles, such as a painful skin rash with blisters, usually on one side of the body
- Sudden shortness of breath, sharp chest pain, or painful swelling and warmth in one of your legs (signs of blood clots)
- Severe stomach pain, diarrhoea with blood, or unexplained changes in bowel movements (signs of a tear in the stomach or intestines)
- Yellowing of your skin or eyes, dark urine, and deep fatigue (signs of liver damage)
- Unexplained lumps or swollen lymph nodes, persistent night sweats, unexplained weight loss, or unusual skin lesions (possible signs of lymphoma, skin cancer, or other malignancies)
- Signs of an allergic reaction, including hives, difficulty breathing, or swelling of your face, lips, tongue, or throat
Medicines Containing this Salt
View AllDrug Warnings
- Complete recommended screening tests: Your doctor should screen you for tuberculosis (TB) and perform blood tests before you start Tofacitinib.
- Avoid live vaccines during treatment: Do not receive live vaccines, such as certain shingles vaccines or the nasal spray influenza vaccine, unless your doctor advises otherwise, as your immune system may be weakened.
- Attend regular monitoring appointments: Keep all scheduled blood tests so your doctor can monitor your blood cell counts, liver function, kidney function, and cholesterol levels throughout treatment.
- Watch for signs of infection or shingles: Contact your doctor immediately if you develop fever, persistent cough, unexplained skin rashes, or painful blisters on one side of your body.
- Seek emergency medical care for serious symptoms: Stop taking Tofacitinib and get immediate medical attention if you experience sudden chest pain, difficulty breathing, swelling or pain in one leg, or symptoms suggestive of a blood clot.
Drug Interactions
- Other immunosuppressants: Taking Tofacitinib with medicines such as cyclosporine, azathioprine, tacrolimus, or biologic therapies can greatly increase the risk of serious infections and is generally not recommended.
- Medicines affecting liver enzymes: Strong CYP3A4 inhibitors (such as ketoconazole) may increase Tofacitinib levels, while strong CYP3A4 inducers (such as rifampicin) may reduce its effectiveness. Your doctor may adjust your dose if necessary.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionIt is not known if alcohol interacts with Tofacitinib, so please consult a doctor.
Pregnancy
unsafeTofacitinib must not be taken during pregnancy. If you are a woman of child-bearing potential, use effective contraception during the treatment with Tofacitinib and for 4 weeks after discontinuation.
Breast Feeding
unsafeAvoid breastfeeding while taking Tofacitinib. Please consult a doctor if you have any concerns.
Driving
safeTofacitinib generally does not affect your ability to drive. However, drive or operate machinery only if you are alert.
Liver
cautionDose adjustment may be needed in patients with liver impairment. Please consult your doctor if you have a liver impairment or any concerns regarding this. Tofacitinib is not recommended for patients with severe liver problems.
Kidney
cautionDose adjustment may be needed in patients with kidney impairment. Please consult your doctor if you have kidney impairment or any concerns regarding this.
Children
unsafeTofacitinib is not recommended for children below 18 years as safety and effectiveness were not established.
Habit Forming
Diet & Lifestyle Advise
- Anti-inflammatory diet: Focus on eating a diet rich in anti-inflammatory foods, such as olive oil, leafy green vegetables, and fish rich in omega-3 fatty acids, to support your joints and gut health.
- Protect your joints: Keep active with low-impact physical activities like swimming, walking, or stationary cycling. This helps maintain joint flexibility and muscle strength without putting too much strain on your joints.
- Manage gut triggers: If you are taking this medicine for ulcerative colitis, keep a food journal to identify and avoid foods that trigger your symptoms (such as highly spiced, greasy, or high-fibre foods during active flares).
- Practise strict hand hygiene: Since Tofacitinib dampens your immune system, wash your hands frequently with soap and water, and avoid close contact with people who have contagious illnesses like the cold or flu.
- Schedule non-live vaccinations: Talk to your doctor about keeping your vaccinations up to date, such as the flu or pneumonia vaccines, ensuring you only receive non-live versions while on this treatment.
Special Advise
- Your doctor may advise you to get a blood test done before starting treatment with Tofacitinib, after 4-8weeks of treatment and then every three months to determine your blood cell count.
- Your doctor might advise regular tests to determine blood cholesterol levels and liver functioning.
Patients Concern
Disease/Condition Glossary
Rheumatoid arthritis: It is an auto-immune disease (the body's immune system attacks its tissue) that leads to joint pain and damage. Symptoms of rheumatoid arthritis include pain, swelling, stiffness, deformities and loss of joint function.
Psoriatic arthritis: It is a type of inflammatory arthritis which occurs in patients with psoriasis. It could also occur in patients without psoriasis, particularly in those who have relatives with psoriasis. It affects large joints in the lower extremities, distal joints of toes and fingers, back and pelvis. Symptoms include inflammation of joints, difficulty moving, swelling, patches of red, scaly skin and pain.
Ulcerative colitis: It is a type of chronic inflammatory bowel disease that causes inflammation of the lining of the large intestine (colon) and produces ulcers on the lining of the colon, which may cause bleeding and discharge of pus and mucus. The common symptoms include bloody stools, stomach pain, rectal pain, diarrhoea, fever, and weight loss. Additionally, it may cause other problems such as joint pain or swelling, mouth sores, skin problems, decreased appetite or nausea.
FAQs
Tofacitinib is used to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.
Tofacitinib works by blocking Janus kinase enzyme, thereby lowers inflammation and symptoms associated with rheumatoid and psoriatic arthritis.
Hypertension/high blood pressure could be a side-effect of Tofacitinib. Consult your doctor before taking Tofacitinib if you have high blood pressure or if you are taking anti-hypertensive medicines.
Diarrhoea might be a side-effect of Tofacitinib. Eat non-spicy meals and drink plenty of fluids to prevent dehydration if you experience diarrhoea. If you find blood in stools (tarry stools) or if you experience severe diarrhoea, consult your doctor. Do not take anti-diarrheal medicine on your own.
Tofacitinib might impair fertility in females of reproductive potential. It is not known if the effect is reversible. Therefore, talk to a doctor before starting Tofacitinib if you are trying to become pregnant or if you have any concerns regarding this.
Tofacitinib affects the immune system and might lower the ability of the immune system to fight infections. Inform your doctor if you have an active infection, if you have a condition that increases the chance of having infections, if you are taking immunosuppressants, medicines that affect the immune system or corticosteroids.
Tofacitinib is not recommended for patients with severe liver impairment. Dose adjustment may be needed in patients with mild to moderate liver impairment. Please consult the doctor if you have liver problems.
Tofacitinib may increase the risk of cancer by changing the way the immune system works. Inform the doctor if you ever had any type of cancer.
Tofacitinib may begin working within 2-8 weeks after starting the treatment.
Tofacitinib should not be taken along with tocilizumab as it might increase the risk of infections. Before starting Tofacitinib, inform the doctor if you are taking tocilizumab.
Prior to starting Tofacitinib, active or latent tuberculosis test, CBC (complete blood count), LFT (liver function test), and lipid profile tests should be done.
No, Tofacitinib is not a steroid. It belongs to a group of medicines known as JAK inhibitors, which specifically target and block certain inflammatory signals inside cells. Talk to your doctor to learn more.
You can receive non-live vaccines, such as the standard flu shot, while taking Tofacitinib. However, you should avoid live vaccines because your immune system is less active and you could develop an infection from the vaccine itself. Talk to your doctor or pharmacist before getting any vaccine.
It is not recommended to take Tofacitinib during pregnancy, as it may cause harm to an unborn baby. If you are pregnant, planning to become pregnant, or breastfeeding, talk to your doctor to discuss safer treatment options.
Alcohol does not directly interfere with how Tofacitinib works, but both substances are processed by the liver. Consuming alcohol while on this medication can increase the risk of liver damage, so it is best to limit your intake. Talk to your doctor for personalised advice.
Because Tofacitinib can affect your immune system and how your body heals, you may need to temporarily stop taking it before and after a planned surgical procedure. Talk to your doctor and surgeon to create a safe plan.
Since Tofacitinib lowers your ability to fight germs, watch closely for a fever, chills, persistent cough, burning when you urinate, or extreme tiredness. If you experience any of these symptoms, contact your doctor immediately for medical advice. Do not stop taking Tofacitinib on your own unless your doctor tells you to do so.
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