Xeljanz Dosage

Generic name: tofacitinib citrate
Dosage form: tablet, film coated

This dosage information does not include all the information needed to use Xeljanz safely and effectively. See full prescribing information for Xeljanz.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

XELJANZ is given orally with or without food.

Rheumatoid Arthritis

XELJANZ may be used as monotherapy or in combination with methotrexate or other nonbiologic disease modifying antirheumatic drugs (DMARDs). The recommended dose of XELJANZ is 5 mg twice daily.

  • Dose interruption is recommended for management of lymphopenia, neutropenia and anemia [see Dosage and Administration (2.3), Warnings and Precautions (5.4), and Adverse Reactions (6.1)].
  • XELJANZ dosage should be reduced to 5 mg once daily in patients:
    • with moderate or severe renal insufficiency
    • with moderate hepatic impairment
    • receiving potent inhibitors of Cytochrome P450 3A4 (CYP3A4) (e.g., ketoconazole)
    • receiving one or more concomitant medications that result in both moderate inhibition of CYP3A4 and potent inhibition of CYP2C19 (e.g., fluconazole).

General Considerations for Administration

  • XELJANZ should not be used in patients with severe hepatic impairment.
  • It is recommended that XELJANZ not be initiated in patients with a lymphocyte count less than 500 cells/mm3, an absolute neutrophil count (ANC) less than 1000 cells/mm3, or who have hemoglobin levels less than 9 g/dL.
  • Coadministration of XELJANZ with potent inducers of CYP3A4 (e.g., rifampin) may result in loss of or reduced clinical response to XELJANZ.

Dosage Modifications

XELJANZ treatment should be interrupted if a patient develops a serious infection until the infection is controlled.

Table 1: Dose Adjustments for Lymphopenia
Low Lymphocyte Count [see Warnings and Precautions (5.4)]
Lab Value
(cells/mm3)
Recommendation
Lymphocyte count greater than or equal to 500 Maintain dose
Lymphocyte count less than 500 Discontinue XELJANZ
(Confirmed by repeat testing)
Table 2: Dose Adjustments for Neutropenia
Low ANC [see Warnings and Precautions (5.4)]
Lab Value
(cells/mm3)
Recommendation
ANC greater than 1000 Maintain dose
ANC 500–1000 For persistent decreases in this range, interrupt dosing until ANC is greater than 1000
When ANC is greater than 1000, resume XELJANZ 5 mg twice daily
ANC less than 500 Discontinue XELJANZ
(Confirmed by repeat testing)
Table 3: Dose Adjustments for Anemia
Low Hemoglobin Value [see Warnings and Precautions (5.4)]
Lab Value
(g/dL)
Recommendation
Less than or equal to 2 g/dL decrease and greater than or equal to 9.0 g/dL Maintain dose
Greater than 2 g/dL decrease or less than 8.0 g/dL Interrupt the administration of XELJANZ until hemoglobin values have normalized
(Confirmed by repeat testing)

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