Tofacitinib is used on its own or together with other medicines to treat rheumatoid arthritis (inflammation in joints of fingers, wrist, feet, ankles) and ankylosing spondylitis (inflammation of the joints of your spine).
This medicine can also be used to treat ulcerative colitis (inflammation of the large intestines), and together with other medicines to treat psoriatic arthritis (inflammation in joints that affects people with psoriasis, a type of skin disease that allows the skin cells to rapidly build up causing itchy patches of thick, red skin and silvery scales).
Tofacitinib may be used to treat other conditions as decided by your doctor.
Take Tofacitinib exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Tofacitinib is available as a conventional tablet, extended-release tablet, or as an oral solution.
If you are taking the conventional tablet, swallow it whole with a glass of water. If you have difficulty swallowing tablet(s), you may crush and mix it with water, stir and drink it immediately.
If you are taking the extended-release type of tablet (usually labelled as “XR”), swallow it whole. Do not divide, chew or crush the tablet.
If you have been given the oral solution, use the oral syringe supplied with each bottle to measure out your dose.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Tofacitinib must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- active serious infections e.g. tuberculosis or TB
- severe liver disease
as Tofacitinib may not be suitable for you.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with Tofacitinib, alert your doctor immediately. This medicine may cause harm to your unborn child.
It is important that you do not get pregnant while taking this medicine. You must use proven birth control methods during Tofacitinib therapy and for at least 4 weeks after stopping the treatment. You may wish to discuss reliable methods of birth control with your doctor.
Do not breastfeed while you are being treated with this medicine.
Do not take Tofacitinib with other medicines for rheumatoid arthritis that is produced from biological sources, and medicines for organ transplant rejection or certain immune disorders such as azathioprine, mercaptopurine, tacrolimus, and ciclosporin.
Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated. You must avoid any vaccinations without consulting with your doctor.
Inform your doctor if you have the following conditions:
- long-term or recurring infections
- history of TB
- long-term lung disease
- diabetes
- history of stomach or bowel perforation
- heart problems e.g. recent heart attack, heart failure, coronary artery disease (narrowing of the blood vessels of the heart), chest pain
- current or history of cancer
- moderate liver disease
- moderate to severe kidney disease
- conditions that increase the risk of blood clots e.g. history of blood clotting problems, high blood pressure, smoking, problems with mobility, major surgery
Be sure to check with your doctor or pharmacist before taking Tofacitinib. Elderly people and individuals of Asian ancestry such as Japanese or Korean may be more sensitive to the side effects.
Inform your doctor if you have resided in or travelled to areas with endemic cases of TB or fungal infections.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Your doctor may conduct a test for TB and viral hepatitis infections before and during treatment with this medicine.
- Routine tests (e.g. blood count, liver and kidney function test) may be done before and while you are being treated with Tofacitinib. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure regularly.
- Regular monitoring for signs of infection, stomach perforation, and blood clots may be needed.
Tofacitinib may cause any of the following side effects: headache, nausea, diarrhoea, vomiting, indigestion, stomach pain, cough, sore throat, muscle pain, joint pain, difficulty sleeping, and rash.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- shortness of breath, chest pain or tightness
- pain, swelling and tenderness in your leg accompanied by redness and warmth
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness
- pass out bloody stools
- rashes, breathlessness, swelling of the face, eyes, mouth or throat
Tofacitinib will cause the level of your red blood cells and white blood cells to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, or a cough or flu that does not go away.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Tofacitinib with other medicines for rheumatoid arthritis that is produced from biological sources, and medicines for organ transplant rejection or certain immune disorders such as azathioprine, mercaptopurine, tacrolimus, and ciclosporin.
Avoid vaccination with live vaccines during treatment with this medicine. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat fungal infection e.g. ketoconazole, fluconazole
- NSAIDs (medicines for pain and inflammation)
- corticosteroids (anti-inflammatory medicines)
- rifampicin (medicine used to treat tuberculosis or TB)
This list does not include all medicines that may interact with Tofacitinib.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Protect the conventional and extended-release tablets from moisture.
The oral solution must be protected from light.
Medicines must not be used past the expiry date.
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