"Nov. 6, 2012 -- The FDA has approved Pfizer's Xeljanz (tofacitinib), a first-of-its-kind treatment for rheumatoid arthritis.
Xeljanz is approved for use by patients not helped by methotrexate, the usual first treatment for RA. It's a "...
Read this Medication Guide before you start taking XELJANZ and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking to your healthcare provider about your medical condition or treatment.
What is the most important information I should know about XELJANZ? XELJANZ may cause serious side effects including:
1. Serious infections.
XELJANZ is a medicine that affects your immune system. XELJANZ can lower the ability of your immune system to fight infections. Some people have serious infections while taking XELJANZ, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections.
- Your healthcare provider should test you for TB before starting XELJANZ.
- Your healthcare provider should monitor you closely for signs and symptoms of TB infection during treatment with XELJANZ.
You should not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay.
Before starting XELJANZ, tell your healthcare provider if you:
- think you have an infection or have symptoms of an
infection such as:
- fever, sweating, or chills
- warm, red, or painful skin or sores on your body
- muscle aches
- cough o diarrhea or stomach pain
- shortness of breath
- burning when you urinate or urinating more often
- blood in phlegm than normal
- weight loss
- feeling very tired
- are being treated for an infection
- get a lot of infections or have infections that keep coming back
- have diabetes, HIV, or a weak immune system. People with these conditions have a higher chance for infections.
- have TB, or have been in close contact with someone with TB
- live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis). These infections may happen or become more severe if you use XELJANZ. Ask your healthcare provider if you do not know if you have lived in an area where these infections are common.
- have or have had hepatitis B or C
After starting XELJANZ, call your healthcare provider right away if you have any symptoms of an infection. XELJANZ can make you more likely to get infections or make worse any infection that you have.
2. Cancer and immune system problems.
XELJANZ may increase your risk of certain cancers by changing the way your immune system works.
- Lymphoma and other cancers including skin cancers can happen in patients taking XELJANZ. Tell your healthcare provider if you have ever had any type of cancer.
- Some people who have taken XELJANZ with certain other medicines to prevent kidney transplant rejection have had a problem with certain white blood cells growing out of control (Epstein Barr Virus-associated post transplant lymphoproliferative disorder).
3. Tears (perforation) in the stomach or intestines.
- Tell your healthcare provider if you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking XELJANZ get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.
- Tell your healthcare provider right away if you have fever and stomach-area pain that does not go away, and a change in your bowel habits.
4. Changes in certain laboratory test results. Your healthcare provider should do blood tests before you start receiving XELJANZ and while you take XELJANZ to check for the following side effects:
- changes in lymphocyte counts. Lymphocytes are white blood cells that help the body fight off infections.
- low neutrophil counts. Neutrophils are white blood cells that help the body fight off infections.
- low red blood cell count. This may mean that you have anemia, which may make you feel weak and tired.
Your healthcare provider should routinely check certain liver tests.
Your healthcare provider may stop your XELJANZ treatment for a period of time if needed because of changes in these blood test results.
You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests to check your cholesterol levels 4 to 8 weeks after you start receiving XELJANZ, and as needed after that. Normal cholesterol levels are important to good heart health.
See “What are the possible side effects of XELJANZ?” for more information about side effects.
What is XELJANZ?
XELJANZ is a prescription medicine called a Janus kinase (JAK) inhibitor. XELJANZ is used to treat adults with moderately to severely active rheumatoid arthritis in which methotrexate did not work well.
It is not known if XELJANZ is safe and effective in people with Hepatitis B or C.
XELJANZ is not for people with severe liver problems.
It is not known if XELJANZ is safe and effective in children.
What should I tell my healthcare provider before taking XELJANZ?
XELJANZ may not be right for you. Before taking XELJANZ, tell your healthcare provider if you:
- have an infection. See “What is the most important information I should know about XELJANZ?”
- have liver problems
- have kidney problems
- have any stomach area (abdominal) pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines
- have had a reaction to tofacitinib or any of the ingredients in XELJANZ
- have recently received or are scheduled to receive a vaccine. People who take XELJANZ should not receive live vaccines. People taking XELJANZ can receive non-live vaccines.
- have any other medical conditions
- plan to become pregnant or are pregnant. It is not known
if XELJANZ will harm an unborn baby.
Pregnancy Registry: Pfizer has a registry for pregnant women who take XELJANZ. The purpose of this registry is to check the health of the pregnant mother and her baby. If you are pregnant or become pregnant while taking XELJANZ, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at 1-877-311-8972 to enroll.
- plan to breastfeed or are breastfeeding. You and your healthcare provider should decide if you will take XELJANZ or breastfeed. You should not do both.
Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. XELJANZ and other medicines may affect each other causing side effects.
Especially tell your healthcare provider if you take:
- any other medicines to treat your rheumatoid arthritis. You should not take tocilizumab (Actemra®), etanercept (Enbrel®), adalimumab (Humira®), infliximab (Remicade®), rituximab (Rituxan®), abatacept (Orencia®), anakinra (Kineret®), certolizumab (Cimzia®), golimumab (Simponi®), azathioprine, cyclosporine, or other immunosuppressive drugs while you are taking XELJANZ. Taking XELJANZ with these medicines may increase your risk of infection.
- medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
How should I take XELJANZ?
- Take XELJANZ as your healthcare provider tells you to take it.
- Take XELJANZ 2 times a day with or without food.
- If you take too much XELJANZ, call your healthcare provider or go to the nearest hospital emergency room right away.
What are possible side effects of XELJANZ?
XELJANZ may cause serious side effects, including:
- See “What is the most important information I should know about XELJANZ?”
- Hepatitis B or C activation infection in people
who carry the virus in their blood. If you are a carrier of the hepatitis B
or C virus (viruses that affect the liver), the virus may become active while
you use XELJANZ. Your healthcare provider may do blood tests before you start
treatment with XELJANZ and while you are using XELJANZ. Tell your healthcare
provider if you have any of the following symptoms of a possible hepatitis B or
- feel very tired
- skin or eyes look yellow
- little or no appetite
- stomach discomfort
- muscle aches
- clay-colored bowel movements
- dark urine
- skin rash
Common side effects of XELJANZ include:
- upper respiratory tract infections (common cold, sinus infections)
- nasal congestion, sore throat, and runny nose (nasopharyngitis)
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of XELJANZ. For more information, ask your healthcare provider or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
You may also report side effects to Pfizer at 1-800-438-1985.
How should I store XELJANZ?
Store XELJANZ at 68°F to 77°F (room temperature).
Safely throw away medicine that is out of date or no longer needed.
Keep XELJANZ and all medicines out of the reach of children.
General information about the safe and effective use of XELJANZ.
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use XELJANZ for a condition for which it was not prescribed. Do not give XELJANZ to other people, even if they have the same symptoms you have. It may harm them.
This Medication Guide summarizes the most important information about XELJANZ. If you would like more information, talk to your healthcare provider. You can ask your pharmacist or healthcare provider for information about XELJANZ that is written for health professionals.
What are the ingredients in XELJANZ?
Active ingredient: tofacitinib citrate
Inactive ingredients: microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, HPMC 2910/Hypromellose 6cP, titanium dioxide, macrogol/PEG3350, and triacetin.
This Medication Guide has been approved by the U.S. Food and Drug Administration.
Last reviewed on RxList: 5/27/2014
This monograph has been modified to include the generic and brand name in many instances.
Additional Xeljanz Information
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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