Xeljanz (tofacitinib) is a brand-name drug prescribed for psoriatic arthritis. This article covers topics such as side effects, dosage, and how Xeljanz works.Xeljanz is available in these forms: oral tablet, oral extended-release tablet (Xeljanz XR), and an oral solution. ('Extended release' means the drug contents are slowly released into your body over time.) Throughout this article, we'll use 'Xeljanz' to refer to all forms, except where noted otherwise when specific differences exist.Xeljanz belongs to a drug class called Janus kinase (JAK) inhibitors. The medication is not available in a generic version. Read on for more information about Xeljanz. You can also refer to this in-depth Xeljanz article. Xeljanz has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the 'Before taking Xeljanz' section. Psoriatic arthritis explainedPsoriatic arthritis (PsA) is an autoimmune condition where your body mistakenly attacks your healthy joints. This causes inflammation and can cause permanent joint damage over time without treatment.Psoriasis is an autoimmune condition that causes skin cells to rapidly turn over. This creates scaly lesions, called flare-ups, on your skin. About 30% of people with psoriasis also develop PsA. People with PsA typically develop psoriasis symptoms first, although this isn't the case for everyone.Symptoms of psoriatic arthritisSymptoms of psoriatic arthritis will differ for each person and range from mild to severe.Some general symptoms of psoriatic arthritis include:tender, swollen joints on one or both sides of your bodyswollen fingers or toesjoint stiffness in the morningpain in your muscles and tendonsscaly skin patches that may worsen simultaneously with flaring joint painnails separating from the nail bedflaky scalpfatigueeye painWho Xeljanz is prescribed forXeljanz is prescribed to adults with psoriatic arthritis whose symptoms have not responded to treatment with, or who had intolerable side effects to, one or more tumor necrosis factor (TNF) blockers. Examples of TNF blockers used to treat psoriatic arthritis include:adalimumab (Humira) and its biosimilars, such as adalimumab-ryvk (Simlandi)certolizumab (Cimzia)infliximab (Remicade) and its biosimilars, such as Avsola (infliximab-axxq)golimumab (Simponi and Simponi Aria)How Xeljanz treats psoriatic arthritis Psoriatic arthritis (PsA) is an autoimmune, inflammatory condition. With PsA, your immune system mistakenly attacks your joints, causing pain, inflammation, and other symptoms.If you're prescribed Xeljanz to treat PsA, you may wonder how the medication works to treat your condition. How a drug works is also referred to as its mechanism of action.The way Xeljanz worksXeljanz is a type of medication called a Janus kinase (JAK) inhibitor. It works by blocking an enzyme (a type of protein) called Janus kinase (JAK). The JAK enzyme plays a role in activating certain parts of your immune system, which send signals to increase inflammation that cause psoriatic arthritis (PsA) symptoms. Blocking the JAK enzyme helps decrease inflammation, easing PsA symptoms.How well Xeljanz works for psoriatic arthritisClinical studies found Xeljanz effective for treating psoriatic arthritis (PsA) in adults. These studies specifically evaluated how well Xeljanz worked to treat PsA symptoms in adults whose symptoms did not respond to or who had intolerable side effects to one or more tumor necrosis factor (TNF) blockers.Another way to gauge a medication's effectiveness is through clinical treatment guidelines. Xeljanz is a recommended treatment option for certain adults with psoriatic arthritis in guidelines from the American College of Rheumatology and National Psoriasis Foundation. Your doctor or pharmacist can provide more information on how Xeljanz fits into these treatment guidelines.Taking Xeljanz for psoriatic arthritisIf you're prescribed Xeljanz for psoriatic arthritis, it's important to understand your dosage and how to take the medication.DosageFor treating psoriatic arthritis, the following table lists recommended doses for Xeljanz and Xeljanz XR:Xeljanz (oral tablet and oral solution)Xeljanz XR (extended-release oral tablet)Recommended dosage5 milligrams (mg) twice daily11 mg once dailyYour doctor may adjust your Xeljanz dosage if you take certain other medications, have certain medical conditions, or experience certain side effects. To learn more, talk with your doctor or pharmacist. You can also learn more in the prescribing information for Xeljanz and Xeljanz XR.Note: In addition to treating psoriatic arthritis, Xeljanz has other uses. Keep in mind that the drug's dosage may differ when treating other conditions. To learn more, talk with your doctor.How to take XeljanzXeljanz is available in three forms: oral tabletoral extended-release* tablet (Xeljanz XR)oral solutionYou may take Xeljanz or Xeljanz XR with or without food.Xeljanz XR extended-release oral tablets should be swallowed whole. Do not chew, crush, or split Xeljanz XR tablets.* 'Extended release' means the drug contents are slowly released into your body over time.How often to take XeljanzIf you're prescribed Xeljanz oral tablet or oral solution, you'll likely take Xeljanz twice per day. Xeljanz XR extended-release tablets are usually taken once per day.For more information about dosing schedules for Xeljanz, see this Xeljanz dosage article.Xeljanz side effects The use of Xeljanz for psoriatic arthritis may cause side effects that are mild or serious. Xeljanz is also approved to treat the following conditions: rheumatoid arthritis (RA)ankylosing spondylitis (AS)ulcerative colitispolyarticular juvenile idiopathic arthritis (JIA) It's important to note that side effects from Xeljanz may differ slightly depending on the condition it's used to treat.The lists below include some of the main side effects that have been reported with Xeljanz. For information about other potential side effects of the drug, talk with your doctor or pharmacist. You can also see our side effect article about Xeljanz or refer to Xeljanz's prescribing information.Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Xeljanz and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.Mild side effects of XeljanzMild side effects reported by people who took Xeljanz to treat psoriatic arthritis in clinical trials include:upper respiratory infection, such as sinusitisrunny nose, coughing, and sneezingdiarrheaheadacheinsomniafatigueabdominal painindigestionnausea and vomitingincreased cholesterol levelsThese side effects of Xeljanz may be temporary, lasting a few days to weeks. But if they last longer than this, bother you, or become severe, it's important to talk with your doctor or pharmacist.Serious side effects of XeljanzWhile not common, serious side effects with Xeljanz are possible. These include:blood cell problems, including: low lymphocyte countlow neutrophil countlow red blood cell count (anemia)high blood pressureincreased liver enzymes, which can be a sign of drug-induced liver damageperforations (holes) in your stomach or intestinesrisk of serious infection*increased risk of death in certain people*risk of cancer and lymphoproliferative disorders*risk of serious cardiovascular side effects, in certain people*risk of blood clots*Call your doctor right away if you develop serious side effects while using Xeljanz. If the side effects seem life threatening or you think you're having a medical emergency, call 911 or your local emergency number immediately.* Xeljanz has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the 'Before taking Xeljanz' section. ALLERGIC REACTIONFor some people, Xeljanz can cause an allergic reaction.In general, symptoms of allergic reaction can be mild or serious.Ways to manageFor mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They'll also let you know whether you should keep taking the medication.For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care as they can become life threatening. If you've had a serious allergic reaction to Xeljanz drug, your doctor may recommend a different medication instead.Before taking XeljanzBefore you take Xeljanz, there's some important information to keep in mind. The drug may not be a safe option if you have certain medical conditions or other factors that affect your health. Some of these are mentioned here.Boxed warningsThis drug has boxed warnings about the risk for serious infections, an increased risk of death in certain people, risk of cancer, risk of serious cardiovascular side effects in certain people, and the risk of blood clots. These are the most serious warnings from the Food and Drug Administration (FDA).Risk of serious infection: Treatment with Xeljanz lowers the ability of your immune system to fight off infections. This can raise your risk for serious infections, including herpes zoster (shingles) and tuberculosis (TB). Before you begin taking Xeljanz, your doctor will test you for TB. If you have TB or another infection, your doctor may want to treat it before you begin taking Xeljanz. If you develop symptoms of an infection while taking Xeljanz, immediately let your doctor know. They may want to pause your Xeljanz treatment until the infection clears.Increased risk of death in certain people: In studies, people with rheumatoid arthritis (RA) who were age 50 or older, had at least one cardiovascular risk (heart and blood vessel) factor, and took Xeljanz had a small but increased risk of death compared to people receiving tumor necrosis factor (TNF) blocker therapy. Your doctor can assess the benefits and risks of Xeljanz treatment and discuss this with you before you begin taking the medication. Due to this risk, your doctor likely will not prescribe a Xeljanz dosage of 10 milligrams (mg) twice per day or a Xeljanz XR dosage of 22 mg once per day to treat your psoriatic arthritis.Risk of cancer and lymphoproliferative disorders: Lymphoma and other types of cancer have been reported in studies of people taking Xeljanz. This risk may be higher if you use tobacco or have in the past. Taking Xeljanz can also increase the risk for lymphoproliferative disorders if you've received a kidney transplant and take certain other medications that decrease immune system activity.Because of this risk, your doctor likely will not prescribe a Xeljanz dosage of 10 mg twice per day or a Xeljanz XR dosage of 22 mg once per day to treat your psoriatic arthritis.Tell your doctor if you have or have had cancer before you start taking Xeljanz. They can determine whether Xeljanz is safe for you to take.Risk of serious cardiovascular side effects, in certain people: According to studies where Xeljanz was used to treat rheumatoid arthritis, certain people may have an increased risk of serious cardiovascular side effects from taking the medication. These side effects include heart attack and stroke. To help lower your risk for these side effects, your doctor likely will not prescribe a Xeljanz dosage of 10 mg twice per day or a Xeljanz XR dosage of 22 mg once per day to treat your psoriatic arthritis. If you experience serious cardiovascular side effects during treatment, your doctor will likely have you stop taking Xeljanz.Be sure to tell your doctor if you've had a heart attack or stroke in the past before you begin treatment with Xeljanz. You're also at higher risk for serious cardiovascular side effects from taking Xeljanz if you use tobacco or have in the past. Having heart problems, including heart disease, can also increase this risk.Risk of blood clots: Treatment with Xeljanz may increase your risk for blood clots. Due to this risk, your doctor likely will not prescribe a Xeljanz dosage of 10 mg twice per day or a Xeljanz XR dosage of 22 mg once per day to treat your psoriatic arthritis. Get immediate medical treatment if you think you have symptoms of a blood clot while taking Xeljanz. If you experience this side effect, your doctor will likely have you stop taking Xeljanz.Before you begin taking Xeljanz, let your doctor know if you have a blood clot or have had one in the past. If this applies to you, or you have other risk factors for blood clots, your doctor may prescribe a different treatment for psoriatic arthritis.Other warningsIn addition to boxed warnings, Xeljanz has other warnings. If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before taking Xeljanz:if you use or have used tobaccoif you have liver problemsif you have kidney problemsif you have or have had diverticulitisif you have or have had ulcers in your stomach or intestinesif you currently have abdominal painif you have recently received or are scheduled to receive a vaccinepregnant or breastfeedingalcohol consumptionif you've had an allergic reaction to Xeljanz or any of its ingredientsFrequently asked questionsBelow are answers to some frequently asked questions about Xeljanz.Besides psoriatic arthritis, does Xeljanz have other indications?Yes, Xeljanz does have other indications besides psoriatic arthritis. (An indication refers to the condition or conditions that a drug is approved to treat.)Besides psoriatic arthritis, other Xeljanz indications include:rheumatoid arthritis (RA)ankylosing spondylitis (AS)ulcerative colitispolyarticular juvenile idiopathic arthritis (JIA)Talk with your doctor or pharmacist if you have questions about the conditions Xeljanz is approved to treat.Does Xeljanz come as an injection?No, Xeljanz isn't available as an injection. Xeljanz is available in these forms: oral tablet, oral extended-release tablet (Xeljanz XR), and an oral solution.There are injectable medications for psoriatic arthritis available. Your doctor or pharmacist can provide more information if you'd like to learn how they compare to Xeljanz.Xeljanz cost and coupons The cost of Xeljanz is based on several factors. These include your prescribed treatment regimen, your insurance plan, the pharmacy you use, and your location.Xeljanz is a brand-name drug that currently is not available as a generic. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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