If you have a certain autoimmune disorder, your doctor may prescribe Xeljanz or Xeljanz XR for you. These prescription drugs are used in adults when certain other treatments haven’t worked to treat:

Additionally, Xeljanz is used in certain children to treat juvenile idiopathic arthritis that affects multiple joints.

To learn more about how Xeljanz and Xeljanz XR are used, see the “What is Xeljanz used for?” section below.

Xeljanz vs. Xeljanz XR

You can take Xeljanz and Xeljanz XR by mouth. Xeljanz is a long-acting form. Xeljanz is a liquid solution that is taken by mouth.

The active drug in Xeljanz and Xeljanz XR is tofacitinib. There isn’t a generic version of tofacitinib available. Instead, it only comes as the brand-name drugs Xeljanz and Xeljanz XR.

We will discuss the side effects, cost, and more of Xeljanz and Xeljanz XR.

Mild or serious side effects may occur with Xeljanz and Xeljanz XR. The side effects that Xeljanz and Xeljanz XR may cause are described in the lists below. All possible side effects are not included in these lists.

The doctor or the pharmacy can tell you more about the side effects of Xeljanz. They can suggest ways to reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Xeljanz and Xeljanz XR can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Xeljanz and Xeljanz XR’s prescribing information.

Mild side effects of Xeljanz and Xeljanz XR can be found.

Many drugs can have mild side effects that go away in a few days or weeks. If they become intolerable, talk to your doctor or pharmacist.

The side effect focus section gives more information about this side effect.

Serious side effects

There are serious side effects from Xeljanz and Xeljanz XR. If you have serious side effects from Xeljanz, you should call your doctor. If you think you have a medical emergency, you should call the emergency number.

Serious side effects can be serious.

* For more information about these side effects, see the “Side effect focus” section below.
Xeljanz and Xeljanz XR have a boxed warning about the risk of these side effects. These are serious warnings from the Food and Drug Administration (FDA).

Side effect focus

There are some side effects that Xeljanz and Xeljanz XR may cause.

Boxed warnings

Xeljanz and Xeljanz XR have a boxed warning for blood clots, serious infection, and certain cancers. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Risk of serious infections. Xeljanz and Xeljanz XR may increase your risk for serious infections. This risk is higher if you also take certain other immunosuppressant drugs, such as corticosteroids or methotrexate. Immunosuppressant drugs lower your body’s ability to fight infections. (Xeljanz and Xeljanz XR are immunosuppressant drugs, too.)

Infections reported in people taking Xeljanz or Xeljanz XR included certain types of bacterial infections, fungal infections, and viral infections like herpes zoster (shingles). Also, flare-ups of past infections, such as tuberculosis (TB), hepatitis B, and hepatitis C were reported.

The most commonly reported infections with Xeljanz and Xeljanz XR included pneumonia, skin infection, and urinary tract infection (UTI).

The symptoms of infections may include:

  • It is a case of a fever or chills.
  • cough
  • fatigue (lack of energy)
  • The muscles are sore.
  • There is a rash.

Risk of blood clots. If you’re age 50 years or older and have Rheumatoid arthritis is a disease. and at least one risk factor* for heart disease, Xeljanz and Xeljanz XR can increase your risk for blood clots. This includes clots such as:

Xeljanz and Xeljanz XR can increase the risk of death.

In studies, these risks were higher with a 10 mg dose of Xeljanz taken twice daily compared with lower doses of Xeljanz.

There are symptoms of blood clot.

  • There is chest pain.
  • There is pain in your arm or leg.
  • The breath was very thin.
  • “It’s swelling in your arm or leg.”
  • breathing problems

* Risk factors for heart disease include having high blood pressure., high cholesterol, or obesity. Smoking is also a risk factor for heart disease.

Risk of cancer and problems with your immune system. Xeljanz and Xeljanz XR can increase your risk for certain types of cancer.

Studies of people taking Xeljanz reported several types of cancer, including:

Some cancer symptoms are present.

The risk of cancer was also higher for people taking Xeljanz who’d had a kidney transplant and who were taking other certain immunosuppressant drugs. And certain people who are taking kidney transplant rejection drugs with Xeljanz may have increased risk for reactivation of certain immune system viruses such as Epstein-Barr virus.

Risk of death in certain people. Xeljanz and Xeljanz XR may increase the risk of death in some people. This includes people who have Rheumatoid arthritis is a disease., who are ages 50 years or older, and who have at least one risk factor for heart or blood vessel disease.

Risk factors for heart disease include having high blood pressure., high cholesterol, or obesity. Smoking is also a risk factor for heart disease.

What can help?

“Before you start taking Xeljanz or Xeljanz XR, your doctor will order blood tests to make sure you are not carrying an infectious disease. If you have an illness, your doctor may want you to wait until it’s over to start Xeljanz or Xeljanz XR. They will monitor you for infections while you are taking Xeljanz or Xeljanz XR.”

“If you have a history of blood clot, you shouldn’t take Xeljanz or Xeljanz XR. If you develop blood clot during treatment, your doctor will have you stop taking the drug and monitor you to see if you need treatment.”

Your doctor can assess your risk of these side effects and decide if Xeljanz or Xeljanz XR is right for you. They can recommend a dose and treatment duration that is safe for you.

Ask your doctor about the risks and benefits of Xeljanz and Xeljanz XR. If you have had cancer in the past, you should tell your doctor if you are currently getting any cancer treatments.

Rash

Some people taking Xeljanz or Xeljanz XR may develop a There is a rash.. This was a common side effect during studies.

It’s possible to get a There is a rash. when past infections in your body flare up. For example, the chickenpox virus can flare up in your body causing shingles, which is a serious side effect of Xeljanz and Xeljanz XR. In addition, There is a rash. may also occur with an allergic reaction to Xeljanz or Xeljanz XR.

What can help?

It’s important to call your doctor if you develop a There is a rash. while you’re taking Xeljanz or Xeljanz XR. Your There is a rash. could mean you’re having a flare-up of a past infection or an allergic reaction.

Your doctor will check to see what type of There is a rash. you have. And they’ll recommend appropriate treatment for it.

Headache

Headache is a common side effect of Xeljanz and Xeljanz XR. In studies, people taking Xeljanz twice a day for It is called It is called ulcerative colitis.. (UC) had more headaches than did people taking the drug for its other approved uses.

What can help?

If you get headaches while taking Xeljanz or Xeljanz XR, keep a record. This can help your doctor understand what is causing your headaches.

Your doctor can recommend safe and effective treatments to help you with your headaches. Before taking pain medications, talk to your doctor or pharmacist.

Allergic reaction

Some people may have an allergic reaction to Xeljanz and Xeljanz XR.

A mild allergic reaction can include some symptoms.

  • skin There is a rash.
  • It is itchy.
  • flushing (warmth, swelling, redness, or discoloration in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause breathing problems.

If you have an allergic reaction to Xeljanz, you should call your doctor. If you think you have a medical emergency, call the emergency number.

There are many factors that affect the cost of prescription drugs. What your insurance plan covers is one of the factors.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Xeljanz and Xeljanz XR manufacturer’s website to see if they have support options.

If you have certain autoimmune conditions, your doctor may prescribe Xeljanz or Xeljanz XR for you. These prescription drugs are used in adults and some children.

Xeljanz and Xeljanz XR are used in adults.

  • Moderate to severe It is called It is called ulcerative colitis.. (UC). For UC, Xeljanz or Xeljanz XR is prescribed when another type of drug called a tumor necrosis factor (TNF) blocker didn’t work or caused bothersome side effects. An example of a TNF blockers includes adalimumab (Humira). With UC, you have inflammation in your digestive tract. And this can cause belly pain and abnormal bowel movements.
  • Moderate to severe Rheumatoid arthritis is a disease. (RA). For RA, Xeljanz or Xeljanz XR is prescribed when a TNF blocker didn’t work or caused bothersome side effects. With RA, you have pain, swelling, and possible deformities in your joints.
  • Psoriatic arthritis (PsA). For PsA, Xeljanz or Xeljanz XR is prescribed when a TNF blocker didn’t work or caused bothersome side effects. With PsA, you have pain and swelling in your joints. And you can also have patches of skin that are pink or darker in color and may become scaley in appearance.
  • Ankylosing spondylitis (AS). For AS, Xeljanz or Xeljanz XR is prescribed when a TNF blocker didn’t work or caused bothersome side effects. With AS, you have pain and swelling in your spine and back.

In addition, Xeljanz can be prescribed for children ages 2 years old and older with polyarticular course juvenile idiopathic arthritis. This condition is a type of arthritis that affects children. And being polyarticular, it affects many joints in their body.

With autoimmune conditions, your immune system attacks tissues in your own body and causes inflammation. Xeljanz and Xeljanz XR work to treat certain autoimmune conditions by blocking inflammatory responses inside your body.

Note: Xeljanz and Xeljanz XR should not be used together with other strong immunosuppressant drugs. This includes azathioprine and cyclosporine. In addition, Xeljanz and Xeljanz XR should not be used with biologic disease-modifying antirheumatic drugs (DMARDs). Talk with your doctor about which medications are safe to use with Xeljanz or Xeljanz XR.

Find answers to questions about Xeljanz.

Can Xeljanz be used for alopecia such as alopecia areata?

No, Xeljanz and Xeljanz XR aren’t approved to treat alopecia or alopecia areata. Alopecia is also simply called hair loss. With alopecia areata, you have hair loss in small patches.

Doctors may prescribe Xeljanz or Xeljanz XR off-label for this purpose. With off-label use, a drug is used for another purpose than what it’s approved for.

Some studies have shown that tofacitinib (the active drug in Xeljanz and Xeljanz XR) may be effective for treating hair loss. But people taking tofacitinib who then stopped it had hair shedding within 4 to 5 weeks of stopping the drug.

If you want to learn more about using Xeljanz or Xeljanz XR for hair loss, you should talk to your doctor. They can help you understand the risks and benefits of treatment. Your insurance may not cover off-label use of Xeljanz.

Does Xeljanz cause weight gain or weight loss?

No, Xeljanz and Xeljanz XR don’t lead to weight gain or weight loss. But serious side effects of these drugs or your condition itself may cause unexplained weight loss.

For example, weight loss can be seen with There is a lot of diarrhea., serious infection, and cancer. And these side effects can occur with Xeljanz and Xeljanz XR. (For more information about serious infection and cancer risks, see the “What are side effects of Xeljanz?” section above.)

Other medications may cause weight changes.

It’s important to let your doctor know if you have any changes in your appetite or body weight while you’re taking Xeljanz. Your doctor will order tests to make sure you’re not having certain serious side effects from treatment. And your doctor can discuss ways to help you manage a body weight that’s healthy for you.

How does Xeljanz compare with Rinvoq?

Xeljanz, Xeljanz XR, and Rinvoq all belong to the same group of medications called Janus kinase (JAK) inhibitors. This means they have some similar uses and side effects. But they also have some differences, too.

The active drug tofacitinib is found in Xeljanz and Xeljanz XR.

Xeljanz, Xeljanz XR, and Rinvoq are approved to treat some conditions in adults when other drugs have failed. They are used for:

Xeljanz is also approved to treat a type of juvenile idiopathic arthritis in some children. And Rinvoq treats atopic dermatitis in certain adults and children.

Xeljanz, Xeljanz XR, and Rinvoq have similar serious side effects as well. To learn more about Xeljanz and Xeljanz XR’s side effects, see the “What are side effects of Xeljanz?” section above. And to learn more about Rinvoq’s side effects, see the drug’s medication guide.

If you want to know more about these drugs, you should talk to your doctor.

You may wonder how Xeljanz and Xeljanz XR compare to Humira.

The active drug tofacitinib is in both types of Xeljanz. The injection is done under the skin. Xeljanz and Xeljanz XR are taken with their mouths. Xeljanz is a liquid solution and a tablets.

Some of the medications have different uses. They are used in adults.

They’re also both used for juvenile idiopathic arthritis in certain children.

Humira is also approved to treat Crohn’s disease, plaque psoriasis, hidradenitis suppurativa, and uveitis in certain people.

To learn more about how these drugs compare, check out this side-by-side comparison. Also, ask your doctor if either medication is right for your condition.

“Your doctor will tell you how to take Xeljanz. They will explain how much to take and how often. Follow your doctor’s instructions.”

Your doctor will determine how you do with the drug after you start on the lowest dose. Your doctor may change your dose if necessary. That depends on how the treatment is working.

Below are commonly used dosages, but always take the dosage your doctor prescribes.

Taking Xeljanz

You can take Xeljanz and Xeljanz XR by mouth.

When you take Xeljanz, it releases into your body at once, which is an immediate-release form of the drug. Xeljanz is an extended-release form. It is released into your body for a long time after it has been taken.

Xeljanz can be taken by mouth in children.

You can take Xeljanz at any time of the day. It is not a good time to take it. Try to take the drug at the same time every day to avoid missing doses.

If you are prescribed Xeljanz, you should take it twice a day, once in the morning and once in the evening.

Dosage

Depending on your condition and the type of drug your doctor prescribes, how often you take Xeljanz or Xeljanz XR depends on your condition. For example:

  • Xeljanz may be taken twice a day.
  • Xeljanz may be taken once a day.

Depending on your doctor, he or she will recommend the right amount.

  • Your age.
  • You may have a medical condition.
  • You may be taking other drugs.

In some cases, your dose of Xeljanz may be adjusted based on your liver or kidney function.

Questions about taking Xeljanz

We answer some questions about taking Xeljanz.

  • What if I miss a dose of Xeljanz and Xeljanz XR? Take the missed dose as soon as you remember. But if it’s close to the time you’ll take your next dose, don’t take two doses together. Instead, just take your next scheduled dose like usual. And try setting a reminder to help you remember to take your doses on a regular schedule.
  • Will I need to use Xeljanz and Xeljanz XR long term? As long as the drug is working well to manage your symptoms, your doctor may have you keep taking it regularly. Ask your doctor if taking Xeljanz or Xeljanz XR long term is right for you.
  • Can Xeljanz and Xeljanz XR be chewed, crushed, or split? You may be able to crush or chew Xeljanz (immediate-release) tablets. But don’t split, crush, or chew Xeljanz XR (extended-release) tablets. Doing so can alter how they work. If you have trouble swallowing pills, ask your pharmacist or doctor about other options.
  • Should I take Xeljanz and Xeljanz XR with food? Food doesn’t change how Xeljanz and Xeljanz XR work. So, you can take Xeljanz or Xeljanz XR with or without food.
  • How long does Xeljanz and Xeljanz XR take to work? Xeljanz and Xeljanz XR start to work soon after you take a dose. But keep in mind, it may take a few weeks to see improvements in your symptoms. Ask your doctor when you can expect to see Xeljanz relieving your symptoms. When you start taking the drug, your doctor will monitor you to make sure the drug is working.

Questions for your doctor

You may have questions about your treatment plan. Discuss your concerns with your doctor.

Here are a few tips that might help you.

  • Before your appointment, write down questions like:
    • How will Xeljanz affect my body, mood, and lifestyle?
  • Bring someone with you to your appointment to make you feel more comfortable.
  • “If you don’t understand something, ask your doctor to explain it.”

“Your doctor and other healthcare providers are available to help you. They want you to get the best care possible. Don’t be afraid to ask questions or give feedback on your treatment”

Discuss any medical conditions you have with your doctor before starting treatment with Xeljanz or Xeljanz XR.

If you have kidney or liver problems, your doctor may check how your liver and kidneys are working. In some cases, your dose of Xeljanz may be adjusted based on your liver or kidney function.

Let your doctor know if you are doing well.

Tell your doctor about any supplements you are taking.

There are a few risks and precautions that we describe below.

Interactions

You can interact with other drugs and vaccines. This can change the effectiveness of the drug.

Before taking Xeljanz or Xeljanz XR, you should tell your doctor about all your medication. You should also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions that may occur with Xeljanz and Xeljanz XR.

Note: The lists below do not contain all types of drugs that may interact with Xeljanz and Xeljanz XR. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Xeljanz and Xeljanz XR.

Interactions with drugs or supplements

Xeljanz and Xeljanz XR can interact with a lot of drugs. Your doctor or pharmacist can tell you more about the interactions.

Drugs can either increase or decrease their effects when taken with certain medications.

The drugs that slow down the removal of Xeljanz and Xeljanz XR are called drugs. This can raise your risk for side effects from Xeljanz. These drugs can be examples.

Some drugs can speed up the removal of Xeljanz and Xeljanz XR from your body. This can make Xeljanz and Xeljanz XR less effective. There are a few examples of these kinds of drugs.

Interactions with immunosuppressant drugs

If taken with other immunosuppressant drugs, Xeljanz and Xeljanz XR can increase the risk of serious infection. (Immunosuppressant drugs lower your body’s ability to fight infections.)

There are examples of immunosuppressant drugs.

Boxed warnings

Xeljanz and Xeljanz XR have boxed warnings for the risks of certain health conditions. A boxed warning is a serious warning from the Food and Drug Administration (FDA). These warnings are described below.

Risk of serious infections. Taking Xeljanz or Xeljanz XR can increase your risk for serious infection. Taking either drug may increase your risk for serious bacterial, viral, and fungal infections.

Risk of blood clots. If you’re age 50 years or older and have Rheumatoid arthritis is a disease. and at least one risk factor for heart disease, Xeljanz can increase your risk for blood clots. This includes clots such as pulmonary embolism (blood clot in the lungs), A clot in an arteries., and deep venous thrombosis (blood clot in a vein). Xeljanz and Xeljanz XR can increase the risk of death.

Risk of cancer and problems with your immune system. Xeljanz and Xeljanz XR can increase your risk for certain cancers including lymphoma (cancer in your lymphatic system). These drugs can also increase the risk of immune system disorders in certain people.

Risk of death in certain people. Xeljanz and Xeljanz XR may increase the risk of death in certain people. This includes people ages 50 years and older who have Rheumatoid arthritis is a disease. and certain risk factors.

If you’d like to know more about these boxed warnings, see the “What are side effects of Xeljanz?” section for more information.

Other warnings

If you have a medical condition that affects your health, Xeljanz and Xeljanz XR may not be right for you. Before you take Xeljanz and Xeljanz XR, you should talk to your doctor. The factors to consider are listed below.

  • Gastrointestinal (GI) tract problems. Xeljanz and Xeljanz XR can cause serious problems with your digestive tract. Such problems can include tears in your stomach and small or large intestine. This risk is higher for people taking other drugs that have GI-related side effects, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Also, if you have any conditions that cause narrowing in your digestive tract, taking Xeljanz XR may cause a blockage. Ask your doctor for more information about your risks for GI issues with Xeljanz or Xeljanz XR.
  • Liver problems. If you have liver problems, your doctor may adjust your dosage of Xeljanz or Xeljanz XR. And they’ll monitor your liver while you’re taking either drug. If you have serious liver conditions, such as hepatitis B or hepatitis C, ask your doctor if Xeljanz or Xeljanz XR is safe for you.
  • Allergic reaction. If you’ve had an allergic reaction to Xeljanz and Xeljanz XR or any of their ingredients, you shouldn’t take Xeljanz and Xeljanz XR. Ask your doctor what other medications are better options for you.

Xeljanz and alcohol

Drinking alcohol can increase the risk of liver problems. And Xeljanz and Xeljanz XR may worsen liver function in some people. The drugs can also raise your levels of liver enzymes.

This risk may be higher if Xeljanz or Xeljanz XR is used with certain other immunosuppressant drugs. (Immunosuppressant drugs lower your body’s ability to fight infections.)

Ask your doctor if it’s safe for you to drink alcohol while you’re taking Xeljanz or Xeljanz XR. Your doctor may order liver function tests to see how your liver is working before and while you take Xeljanz.

Pregnancy and breastfeeding

If you are pregnant, it is not known if Xeljanz is safe to take. Discuss the risks and benefits of using either drug with your doctor.

If you’ve taken Xeljanz or Xeljanz XR while pregnant or are planning to take them during pregnancy, ask your doctor about the Xeljanz pregnancy registry. Or you can visit the registry’s website or call 877-311-8972 to learn more about it.

If you take Xeljanz or Xeljanz XR, you may be unable to become pregnant while you are taking them. Before you start this treatment, be sure to talk with your doctor about your reproductive desires.

If you are breastfeeding, Xeljanz and Xeljanz XR are not recommended for use. Ask your doctor about the risks of using drugs while breastfeeding.

“Don’t take more Xeljanz than your doctor prescribes. Side effects can be serious if you use more than this.”

What to do in case you take too much Xeljanz or Xeljanz XR

Call your doctor if you think you’ve taken too much Xeljanz or Xeljanz XR. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Xeljanz and Xeljanz XR are prescription medications that can be used to treat certain autoimmune disorders. These drugs are used when certain other medications haven’t worked. And they can be taken alone or together with other medications.

Talk to your doctor about other treatment options if you are starting Xeljanz or Xeljanz XR.

You can also talk with your child’s doctor about other treatment options for juvenile idiopathic arthritis.

Ask your doctor what you can expect with Xeljanz. Here are a few questions to ask.

  • What can I do to reduce my risk of infections while taking Xeljanz?
  • Will Xeljanz or Xeljanz XR help with pain?
  • Can I take Xeljanz if I have a cold?

To learn more about psoriasis, Rheumatoid arthritis is a disease., and IBD, sign up for Healthline’s newsletters on these conditions.

Q:

Is it possible to take Aspirin with Xeljanz?

Anonymous

A:

It’s not advised that you take ibuprofen (Advil) with Xeljanz or Xeljanz XR.

There’s not an interaction between the medications, but each of them increases your risk for gastrointestinal perforations. (With a gastrointestinal perforation, you have a tear in your stomach or intestines.)

Taking Xeljanz or Xeljanz XR with Ibuprofen may increase your risk of having a perforation.

If you feel like you need more pain relief while you are taking Xeljanz or Xeljanz XR, talk to your doctor. They may change your treatment plan. Before taking any medication with Xeljanz or Xeljanz XR, be sure to check with your doctor or pharmacist.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.