Your healthcare team has discussed the following subject with you: tofacitinib. Brand names include Xeljanz and Xeljanz XR. Here is some additional information regarding this medical therapy. Let us know if you have any questions regarding this information.
How it works: This medication is a small molecule which helps to reduce inflammation by specifically targeting part of the immune system that plays a role in inflammation in the intestine and other organs. Tofacitinib is a JAK (Janus kinase) inhibitor. JAK inhibitors are broken down in the gastrointestinal tract and are directly absorbed into the bloodstream through the intestines. Due to their small size, they can be carried to nearly anywhere in the body through the bloodstream to work directly on the immune system. In most cases, this medication is used by itself, with no other immunosuppressive treatments.
How it is taken: The medication is taken by mouth and can be taken once or twice daily depending on how your provider has prescribed the dose. This initial dose (used for eight weeks) can be higher or the same as the maintenance dose. Response to tofacitanib can be within a few days, and the clinical studies have shown improvement in ulcerative colitis symptoms within two weeks.
Possible side effects: The most common side effects in patients taking tofacitinib in the clinical trials for ulcerative colitis were headache, common cold (upper respiratory infection), and nasopharyngitis (sinus/throat infection).Serious infections such as herpes zoster or shingles have been reported with tofacitinib. If you have any side effects or you continue to have symptoms, speak to your health care team immediately.
Special considerations: Notify your provider if you had a past history of heart attack, or other heart problems, history of blood clots or stroke. If you have been diagnosed with diverticulitis, you may be at increased risk of a perforation (a tear in the colon) on tofacitinib. Patients who are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed should not take tofacitinib.
Monitoring: You will require frequent laboratory monitoring(complete blood cell count and liver function test) while taking this therapy. You will also have cholesterol checked after starting tofacitinib.
Points to remember: Before taking this medication, let your health care team know about other medical conditions you may have, or other medications (even over-the-counter medications or complementary therapies) you may be taking. The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication, or how frequently you take it, on your own.
Other tips: Live vaccines (especially the live shingles vaccine, Zostavax) should not be given once you have started tofacitinib. There is a non-live vaccination for shingles, Shingrix, which you could discuss further with your health care team.
For further information, please check out http://www.ibdmedicationguide.org/ or follow this link: