Xeljanz (Tofacitinib) for Psoriatic Arthritis

What Members Say Top Tips Side Effects Copay Help FAQs

Xeljanz (tofacitinib) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults and children ages 2 years and older with active psoriatic arthritis.

What Members Say

MHT logo These insights are based on 361 comments about Xeljanz from MyPsoriasisTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Joint pain, swelling, and stiffness often improve.
Physical function sometimes improves, including walking, navigating stairs, and using hands.
Once-daily or twice-daily tablets can feel easier than injections.

Considerations:

Serious infection risk is an important concern, and treatment may be paused during infections.
Heart, stroke, and blood clot warnings can affect treatment decisions.
Insurance approval, copay assistance, and refills can require extra follow-up.

How Xeljanz Works and How It’s Taken

Xeljanz is a type of Janus kinase (JAK) inhibitor. JAK enzymes help carry signals inside cells that affect the immune system. Xeljanz changes this signaling process. In psoriatic arthritis, this helps reduce inflammation and overactive immune responses that can lead to joint pain and swelling.

Doctors prescribe Xeljanz for an adult or child ages 2 years or older with active psoriatic arthritis who did not respond well to, or could not tolerate, one or more tumor necrosis factor (TNF) blockers.

Xeljanz is available as tablets and an oral solution. Xeljanz XR is available as an extended-release tablet for adults only. These medicines are taken by mouth once or twice daily, depending on the prescribed form and dose. They may be taken with or without food.

Swallow Xeljanz XR tablets whole. Do not crush, split, or chew them. You may notice an empty tablet shell in your stool after your body has absorbed the medicine.

Typical Dosing for Psoriatic Arthritis

For adults with normal kidney and liver function, the recommended dose is Xeljanz 5 milligrams twice daily or Xeljanz XR 11 milligrams once daily.

For children ages 2 years and older, the Xeljanz dose is based on body weight:

10 kilograms to less than 20 kilograms — 3.2 milligrams, or 3.2 milliliters of oral solution, twice daily
20 kilograms to less than 40 kilograms — 4 milligrams, or 4 milliliters of oral solution, twice daily
40 kilograms or more — 5 milligrams twice daily, given as one 5-milligram tablet or 5 milliliters of oral solution

A healthcare provider may reduce, interrupt, or stop the dose because of kidney or liver problems, certain drug interactions, or changes in blood counts.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Xeljanz

MHT logo These insights are based on 361 comments about Xeljanz from MyPsoriasisTeam members.

Members who use Xeljanz often say it can take some trial and error to see whether it helps their joint symptoms, skin symptoms, or both. They also frequently mention staying in close touch with their rheumatologist about side effects, infections, lab work, insurance issues, and whether the medication is still working well enough.

1

Give it some time, but track how well it works.
“I started Xeljanz. After two weeks I felt a remarkable difference in my hands, wrists, and feet, and the psoriasis on my feet has cleared up for the most part. I’m early in this treatment course, but I’m encouraged.”
2

Pause and check in with your doctor if you get sick.
“Hey everyone, it’s been a while! So I have found that Xeljanz has helped me so much with my plaque psoriasis and my psoriatic arthritis, but I had to stop taking my medication due to having frequent sinus infections.”
3

Keep up with blood work and other monitoring.
“I now have to have a blood test done every three months. I’m currently on Xeljanz, and the testing helps track inflammation and other health changes.”

Connect with others who understand life with psoriasis. Join MyPsoriasisTeam for free.

Xeljanz Side Effects

In clinical studies of Xeljanz for active psoriatic arthritis, the most common side effects occurred in at least 2 percent of people. These include:

Upper respiratory tract infection (common cold-type infections)
Nasopharyngitis (cold symptoms, such as sore throat or stuffy nose)
Diarrhea
Headache

Serious Side Effects and Warnings

Xeljanz can cause serious side effects that may require immediate medical attention. These include:

Serious infections — Your immune system may not fight infections as well, including tuberculosis (TB) and other severe bacterial, fungal, viral, or opportunistic infections.
Reactivation of viral infections — Viral infections may reactivate.
Increased risk of death — This increased risk was seen in a study of people ages 50 and older with at least one cardiovascular risk factor.
Cancer, including lymphoma and skin cancers — The risk of certain cancers may increase.
Major adverse cardiovascular events — Serious heart-related events, such as heart attack, stroke, or cardiovascular death, can occur.
Blood clots — Issues from blood clots, such as deep vein thrombosis, pulmonary embolism, or clots in arteries, can occur.
Gastrointestinal perforation — Tears in the stomach or intestines can occur.
Hypersensitivity — Severe allergic reactions including angioedema or hives can occur.
Hypoglycemia — Low blood sugar in people with diabetes can occur and can be severe.

Get medical help right away if you think you are having a serious reaction.

How To Save on Xeljanz

Pfizer, the manufacturer of Xeljanz, offers the Xeljanz Co-Pay Savings Program. Eligible people with commercial insurance may pay as little as $0 per month for their prescription.

The program can also provide support with understanding insurance coverage, determining out-of-pocket costs, assisting with prior authorizations when needed, and tracking the status of Xeljanz prescriptions.

To learn more, visit the Xeljanz Co-Pay Savings Program website or call 844-935-5269.

What To Know Before Taking Xeljanz

Before starting Xeljanz, your doctor will test or check for:

Active or latent (hidden) TB
Viral hepatitis
Blood counts, including lymphocytes, neutrophils, and hemoglobin
Liver function
Whether your vaccines are up to date

Xeljanz is not recommended for people with severe liver problems. Do not receive live vaccines while taking Xeljanz.

Tell your doctor if you have any allergies to tofacitinib or any ingredients in Xeljanz.

Before starting Xeljanz, tell your doctor if you:

Have an infection or often get infections
Have smoked in the past or currently smoke
Have or have had cancer
Have had a heart attack, stroke, or other heart problems
Have had blood clots
Have liver or kidney problems
Have stomach pain, diverticulitis, or ulcers in your stomach or intestines
Have diabetes
Have had a reaction to tofacitinib or any ingredient in Xeljanz
Recently received a vaccine or are scheduled to receive one

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Using Xeljanz with biologic medicines or strong immune-suppressing medicines, such as azathioprine or cyclosporine, is not recommended because it may increase immune suppression and the risk of infection.

Also let your doctor know if you have had recent infections or have had cancer in the past.

Xeljanz is also FDA approved to treat rheumatoid arthritis, ankylosing spondylitis, and ulcerative colitis.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Xeljanz, talk with your doctor about the risks and benefits.

Animal studies show that Xeljanz/Xeljanz XR/Xeljanz oral solution may affect the ability of females to get pregnant. It is not known whether this effect can be reversed.

Breastfeeding is not recommended during treatment and for at least 18 hours after the last dose of Xeljanz or 36 hours after the last dose of Xeljanz XR. Consider pregnancy planning and prevention if you can become pregnant.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Xeljanz for psoriatic arthritis?

In two clinical studies of adults with active psoriatic arthritis, people taking Xeljanz 5 milligrams twice daily had higher ACR20 and ACR50 response rates at month 3 than people taking a placebo.

ACR20 means a person had at least a 20 percent improvement in tender and swollen joints, along with improvement in other arthritis symptoms or measures. ACR50 means at least a 50 percent improvement.

In one study, more people taking Xeljanz also achieved an ACR70 response by month 3. ACR70 means a person had at least a 70 percent improvement.

People taking Xeljanz also had greater improvement in their ability to perform daily physical activities than people taking a placebo.

How long does Xeljanz take to work for psoriatic arthritis?

In two clinical studies, improvement in ACR20 response was seen as early as week 2, the first study visit after treatment began. ACR20 means at least a 20 percent improvement in tender and swollen joints, along with improvement in other arthritis measures.

By month 3, people taking Xeljanz 5 milligrams twice daily had higher response rates than people taking a placebo. Results may be different for each person.

What tests or monitoring are needed with Xeljanz for psoriatic arthritis?

Before starting Xeljanz, a doctor may check for active or latent TB, screen for viral hepatitis, order a complete blood count, check liver function, and make sure vaccines are up to date.

During treatment:

Lymphocyte counts are checked at baseline and every three months.
Neutrophil counts and hemoglobin are checked at baseline, after four to eight weeks, and then every three months.
Cholesterol and other blood fats are checked about four to eight weeks after treatment starts.
Liver tests are monitored routinely.