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Xeljanz XR

Generic name: tofacitinib (TOE fa SYE ti nib)
Brand name: Xeljanz, Xeljanz XR
Drug class: Antirheumatics

Medically reviewed by on Sep 20, 2021. Written by Cerner Multum.

What is Xeljanz XR?

Xeljanz XR is used to treat moderate to severe rheumatoid arthritis or active psoriatic arthritis in adults who have tried methotrexate or other medications without successful treatment of symptoms. This medicine is sometimes given in combination with methotrexate or other arthritis medicines.

Xeljanz XR is also used to treat moderate to severe ulcerative colitis in adults who cannot use certain other medications, or after other treatments have failed.

Xeljanz XR is also used to treat polyarticular juvenile arthritis in adults and in children at least 2 years old.

Xeljanz XR may also be used for purposes not listed in this medication guide.


Taking Xeljanz XR may increase your risk of life-threatening medical problems including serious infections, a hole or tear in your digestive tract, a heart attack or stroke, blood clots, or cancer.

Tell your doctor if you have a weak immune system, diabetes, chronic lung disease, or an infection such as hepatitis, tuberculosis, shingles, or HIV. Also tell your doctor if you've ever had diverticulitis, an ulcer in your stomach or intestines, cancer, a kidney transplant, heart problems, or a history of smoking, heart attack, stroke, or blood clots.

Call your doctor right away if you have a fever, night sweats, constant tiredness, weight loss, stomach pain, diarrhea or changes in bowel habits, trouble breathing, wheezing, a severe cough, or lumps in your neck, armpits, or groin.

Seek emergency medical help if you have sudden shortness of breath, chest pain spreading to your neck or arms, nausea, severe dizziness, a cold sweat, weakness on one side of your body, slurred speech, or pain, redness, or swelling in an arm or leg.

Before taking this medicine

Taking Xeljanz XR can increase your risk of life-threatening medical problems including serious infections, a hole or tear in your digestive tract, a heart attack or stroke, blood clots, or cancer. Tell your doctor if you've had:

  • a weak immune system or chronic infection (such as tuberculosis, shingles, HIV, or hepatitis);

  • any type of cancer;

  • kidney disease, a kidney transplant, or if you are on dialysis;

  • diverticulitis, an ulcer in your stomach or intestines;

  • heart problems;

  • a heart attack, stroke, or blood clot;

  • high cholesterol; or

  • if you've ever smoked.

Tell your doctor if you've been sick with signs of infection, such as fever, chills, muscle aches, cough, trouble breathing, skin sores, diarrhea, or painful urination.

Tell your doctor if you've had or been exposed to tuberculosis, or if you recently traveled. Some infections are more common in certain parts of the world, and you may have been exposed during travel.

Also tell your doctor if you have ever had:

  • liver disease (especially hepatitis B or C);

  • chronic lung disease;

  • diabetes; or

  • if you are scheduled to receive any vaccine.

Using Xeljanz XR may increase your risk of developing certain cancers, such as lymphoma or lung cancer. Ask your doctor about this risk.

Tell your doctor if you are pregnant or plan to become pregnant. Having rheumatoid arthritis or ulcerative colitis during pregnancy may increase the risk of premature birth or low birth weight. The benefit of treating these conditions with Xeljanz XR may outweigh any risks to the baby.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of tofacitinib on the baby.

If you are a woman, Xeljanz XR may affect your ability to have children during treatment and in the future.

Do not breastfeed while you are using Xeljanz XR, and for at least 18 hours after your last dose (36 hours if you take extended-release tablets). If you use a breast pump during this time, do not feed the milk to your baby.

Do not give this medicine to a child without medical advice. The extended-release tablets are not approved for use by anyone younger than 18 years old.

How should I take Xeljanz XR?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take Xeljanz XR with or without food.

Swallow the extended-release tablet whole and do not crush, chew, or break it.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Doses are based on weight in children and teenagers. Your child's dose may change if the child gains or loses weight.

A safe dose of tofacitinib is not the same for all conditions. Avoid medication errors by using only the form and strength your doctor prescribes.

You may get infections more easily, even serious or fatal infections. You will need frequent medical tests.

If you've ever had shingles (herpes zoster) or hepatitis B or C, using Xeljanz XR can cause these viruses to become active or get worse.

Part of a tablet shell may appear in your stool but this will not make the medicine less effective.

Store this medicine in the original container at room temperature, away from moisture, heat, and light. Throw away any unused liquid after 60 days.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Xeljanz XR?

Avoid receiving a "live" vaccine. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles).

Xeljanz XR side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some people taking Xeljanz XR have developed heart attacks, strokes, or serious blood clots. Stop taking this medicine and seek emergency medical attention if you have:

  • sudden shortness of breath;

  • chest pain or pressure that may spread to your jaw, shoulder, arms, or back;

  • nausea, vomiting, cold sweat;

  • a light-headed feeling, like you might pass out;

  • weakness on one side of your body;

  • slurred speech, drooping on one side of your mouth; or

  • pain, swelling, or redness in an arm or a leg.

Call your doctor at once if you have:

  • fever, chills, night sweats, constant tiredness;

  • wheezing, trouble breathing, severe or worsening cough;

  • increased urination, pain or burning when you urinate;

  • unexplained weight loss;

  • lumps in your neck, armpits, or groin;

  • signs of shingles--flu-like symptoms, tingly or painful blistering rash on one side of your body;

  • a hole (perforation) in your digestive tract--fever, severe stomach pain, diarrhea or changes in bowel habits; or

  • signs of hepatitis--loss of appetite, vomiting, stomach pain (upper right side), dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Xeljanz XR?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can affect Xeljanz XR, especially:

This list is not complete and many other drugs may affect Xeljanz XR. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Does Xeljanz XR interact with my other drugs?

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Frequently asked questions

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.