WARNING

Tofacitinib is a medication primarily used to treat certain autoimmune diseases like rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. However, like any medication, it comes with potential risks. Here are some of the key risks associated with taking Tofacitinib:

• Increased Risk of Infections: Tofacitinib can suppress the immune system, increasing the risk of infections such as pneumonia, tuberculosis, and opportunistic infections.
• Cardiovascular Risks: There may be an increased risk of cardiovascular events such as heart attack, stroke, and high blood pressure while taking Tofacitinib.
• Gastrointestinal Perforations: Tofacitinib may increase the risk of gastrointestinal perforations, particularly in patients with a history of diverticulitis.
• Liver Problems: Tofacitinib may cause liver enzyme elevations and liver damage in some patients.
• Lymphoma and Other Cancers: There may be an increased risk of certain cancers, including lymphoma and skin cancers, while taking Tofacitinib.
• Lung Problems: Tofacitinib may increase the risk of lung-related issues such as interstitial lung disease.
• Blood Clotting: There may be an increased risk of blood clots, including deep vein thrombosis and pulmonary embolism, while taking Tofacitinib.
• Laboratory Abnormalities: Tofacitinib can cause changes in laboratory parameters such as decreases in hemoglobin, neutrophil counts, and increases in cholesterol levels.

It’s crucial for patients taking Tofacitinib to be closely monitored by their healthcare provider for any signs of these potential risks and to report any new or worsening symptoms promptly. Patients should also discuss the risks and benefits of Tofacitinib with their doctor before starting the medication.

Why is this medication prescribed?

Tofacitinib is prescribed primarily to treat autoimmune diseases, particularly:

• Rheumatoid Arthritis (RA): Tofacitinib is used to treat moderate to severe rheumatoid arthritis in adults who have not responded well to other disease-modifying antirheumatic drugs (DMARDs) such as methotrexate.
• Psoriatic Arthritis (PsA): It is also used to treat active psoriatic arthritis in adults who have not responded well to other treatments.
• Ulcerative Colitis (UC): Tofacitinib is prescribed to treat moderate to severe ulcerative colitis in adults who have not responded well to other medications or who cannot tolerate other medications.

How should this medicine be used?

As for how Tofacitinib should be used:

• Dosage: The typical starting dose for rheumatoid arthritis and psoriatic arthritis is 5 mg twice daily. For ulcerative colitis, the starting dose is 10 mg twice daily for a certain period followed by a maintenance dose of 5 mg twice daily.
• Administration: Tofacitinib is usually taken orally as tablets.
• Monitoring: Patients should be regularly monitored by their healthcare provider for any signs of adverse effects or changes in their condition.
• Duration: The duration of treatment with Tofacitinib can vary depending on the condition being treated and how well the patient responds to the medication. It’s essential to follow the healthcare provider’s instructions regarding the duration of treatment.
• Adjustments: Dosage adjustments may be necessary based on individual response and tolerability. Patients should not adjust their dosage without consulting their healthcare provider.

It’s crucial for patients to follow their healthcare provider’s instructions carefully when taking Tofacitinib to ensure optimal effectiveness and minimize the risk of adverse effects.

Other uses for this medicine

Tofacitinib is primarily used for treating autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. However, there is ongoing research into its potential use for other conditions. It’s essential to note that any use of tofacitinib beyond its approved indications should be discussed thoroughly with a healthcare provider, as it may not be safe or effective for conditions other than those it is specifically approved to treat.

What special precautions should I follow?

Regarding special precautions for tofacitinib, here are some important considerations:

• Infections: Tofacitinib can increase the risk of serious infections due to its impact on the immune system. Patients should be monitored for signs of infection, and healthcare providers should assess the risks versus benefits of continuing treatment if an infection occurs. Patients should be educated about the signs and symptoms of infections and instructed to seek medical attention if any occur.
• Tuberculosis (TB): Patients should be screened for latent tuberculosis before starting tofacitinib therapy, as it can reactivate latent TB infections. Healthcare providers should be vigilant for signs of active tuberculosis during treatment.
• Malignancies: There is an increased risk of malignancies, including lymphoma and skin cancers, with tofacitinib treatment. Patients should undergo regular monitoring for signs of malignancies during treatment. The risks and benefits of tofacitinib therapy should be carefully evaluated in patients with a history of malignancies or in those with risk factors for developing malignancies.
• Gastrointestinal Perforation: Tofacitinib has been associated with an increased risk of gastrointestinal perforation. Patients should be monitored for signs and symptoms of gastrointestinal perforation, such as abdominal pain, fever, or bloody stool.
• Liver Function: Liver function tests should be monitored regularly during tofacitinib treatment, as liver enzyme elevations have been reported.
• Hypersensitivity Reactions: Patients should be monitored for signs of hypersensitivity reactions, including rash, itching, or difficulty breathing, and treatment should be discontinued if a severe reaction occurs.
• Vaccinations: Live vaccines should be avoided while on tofacitinib therapy due to the risk of infection.

It’s crucial for patients to communicate openly with their healthcare providers about any existing medical conditions, medications, or concerns before starting tofacitinib therapy. Regular monitoring and adherence to prescribed monitoring schedules are essential for safe and effective treatment with tofacitinib.

What special dietary instructions should I follow?

• There are no specific dietary restrictions associated with tofacitinib. However, maintaining a healthy and balanced diet is generally recommended to support overall health and well-being.
• Some individuals may experience gastrointestinal symptoms such as nausea or diarrhea while taking tofacitinib. In such cases, avoiding spicy, greasy, or acidic foods may help alleviate symptoms.

What should I do if I forget a dose?

• If you forget to take a dose of tofacitinib, take it as soon as you remember, unless it’s almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule.
• Do not take a double dose to make up for a missed one.
• If you’re unsure about what to do, contact your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Tofacitinib, like any medication, can cause side effects in some individuals. It’s important to note that not everyone will experience these side effects, and their severity can vary from person to person. Some potential side effects of tofacitinib include:

• Increased Risk of Infections: Tofacitinib can suppress the immune system, increasing the risk of infections. Common infections may include upper respiratory tract infections, urinary tract infections, and pneumonia.
• Gastrointestinal Symptoms: Nausea, diarrhea, and abdominal pain are common gastrointestinal side effects associated with tofacitinib.
• Headache: Some individuals may experience headaches while taking tofacitinib.
• Liver Enzyme Elevations: Tofacitinib can cause increases in liver enzyme levels, which may indicate liver inflammation or damage.
• Hypertension (High Blood Pressure): Tofacitinib may lead to elevated blood pressure in some patients.
• Changes in Blood Cell Counts: Tofacitinib can affect blood cell counts, including decreases in white blood cells, red blood cells, and platelets.
• Increased Cholesterol Levels: Tofacitinib may lead to increases in cholesterol and lipid levels in some individuals.
• Skin Reactions: Skin rash, itching, and eczema may occur as side effects of tofacitinib.
• Malignancies: There is an increased risk of certain types of cancer, including lymphoma and skin cancer, associated with tofacitinib use.
• Gastrointestinal Perforation: Rarely, tofacitinib may cause gastrointestinal perforation, which is a serious condition that requires immediate medical attention.
• Hypersensitivity Reactions: Some individuals may experience allergic reactions to tofacitinib, which can include rash, itching, and difficulty breathing.
• Thrombosis (Blood Clots): Tofacitinib may increase the risk of blood clots in some patients.

It’s essential for patients to be aware of these potential side effects and to report any concerning symptoms to their healthcare provider promptly. Healthcare providers will monitor patients regularly for side effects and adjust treatment as necessary to minimize risks while maximizing benefits. Additionally, patients should not stop taking tofacitinib without consulting their healthcare provider, as abruptly discontinuing the medication can lead to adverse effects or disease flares.

What should I know about storage and disposal of this medication?

Regarding the storage and disposal of Tofacitinib:

Storage:

• Store Tofacitinib at room temperature between 68°F to 77°F (20°C to 25°C).
• Keep it in its original container with the lid tightly closed to protect it from moisture and light.
• Do not store Tofacitinib in the bathroom or in areas with excessive moisture or heat.

Disposal:

• Dispose of any unused or expired Tofacitinib according to local regulations or guidelines.
• Do not flush Tofacitinib down the toilet or pour it down the drain unless instructed to do so by a pharmacist or local waste disposal company.

In case of emergency/overdose

• In case of an overdose or emergency, call your local emergency services immediately or go to the nearest emergency room.
• If possible, bring the Tofacitinib packaging or container to help healthcare providers identify the medication and dosage.

What other information should I know?

• Keep all appointments with your healthcare provider for regular check-ups and monitoring while taking Tofacitinib.
• Inform your healthcare provider about all medications, vitamins, and supplements you are taking, as they may interact with Tofacitinib.
• Avoid drinking grapefruit juice while taking Tofacitinib, as it may interact with the medication.
• Do not change your dose or stop taking Tofacitinib without consulting your healthcare provider.
• If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of Tofacitinib with your healthcare provider.
• Inform all healthcare providers involved in your care that you are taking Tofacitinib, especially before undergoing surgery or dental procedures.
• Carry a medical alert card or wear a medical alert bracelet to inform healthcare providers about your Tofacitinib treatment in case of emergencies.
• Report any new or worsening symptoms to your healthcare provider promptly.

Always follow your healthcare provider’s instructions and recommendations regarding the storage, disposal, and use of Tofacitinib. If you have any questions or concerns, don’t hesitate to discuss them with your healthcare provider or pharmacist.