Tofacitinib (Xeljanz, Xeljanz XR)

JAKI drugs used for autoimmune disease including rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, and Crohn's disease. 

Inhibits JAK

Xeljanz

Ankylosing spondylitis

Ankylosing spondylitis: Oral:

IR tablet: 5 mg twice daily.

ER tablet: 11 mg once daily.

COVID-19, hospitalized patients

COVID-19, hospitalized patients (alternative agent) (off-label use):

Note: For use only as an alternative to baricitinib, for hospitalized patients with significant oxygen requirements (eg, high-flow oxygen, noninvasive ventilation, mechanical ventilation, extracorporeal membrane oxygenation) and those with lower but increasing oxygen requirements and evidence of systemic inflammation (Ref).

Oral: IR tablet: 10 mg twice daily, as part of an appropriate combination regimen, for 14 days or until hospital discharge, whichever is earlier (Ref).

Psoriasis

Psoriasis (off-label): Oral: IR tablet: 5 to 10 mg twice daily (Ref).

Psoriatic arthritis

Psoriatic arthritis (use in combination with nonbiologic disease-modifying antirheumatic drugs): Oral:

IR tablet: 5 mg twice daily.

ER tablet: 11 mg once daily.

Rheumatoid arthritis

Rheumatoid arthritis:

Note: For use as adjunctive therapy with nonbiologic disease-modifying antirheumatic drugs (DMARDs) in patients who have not met treatment goals despite maximally tolerated methotrexate therapy; may also be used off label as an alternative to methotrexate in DMARD-naive patients with moderate to high disease activity (Ref).

Oral:

IR tablet: 5 mg twice daily.

ER tablet: 11 mg once daily.

Ulcerative colitis

Ulcerative colitis (alternative agent): Oral:

IR tablet:

Induction: 10 mg twice daily for at least 8 weeks; based on therapeutic response, may continue 10 mg twice daily for a maximum of 16 weeks or transition to maintenance dose. Discontinue therapy if inadequate response achieved after 16 weeks using 10 mg twice daily.

Maintenance: 5 mg twice daily; if patient experiences loss of response on 5 mg twice daily, then use 10 mg twice daily after assessing the benefits and risks and use for the shortest duration; use lowest effective dose to maintain response.

ER tablet:

Induction: 22 mg once daily for at least 8 weeks; based on therapeutic response, may continue 22 mg once daily for a maximum of 16 weeks or transition to maintenance dose. Discontinue therapy if inadequate response achieved after 16 weeks using 22 mg once daily.

Maintenance: 11 mg once daily; if patient experiences loss of response on 11 mg once daily, then use 22 mg once daily after assessing the benefits and risks and use for the shortest duration; use lowest effective dose to maintain response.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult