If you have Rheumatoid arthritis is a disease. (RA) or another autoimmune condition, your doctor may recommend Xeljanz or Xeljanz XR (tofacitinib). Knowing the possible side effects of these drugs may help you and your doctor decide if one is a good treatment option for you.

Your immune system attacks your body when you have an auto Immune condition can cause attacks on your own body. Xeljanz and Xeljanz XR are effective in reducing symptoms of some conditions.

Xeljanz and Xeljanz XR are used to treat a number of conditions in adults.

Additionally, Xeljanz is used in certain children with juvenile idiopathic arthritis.

If Xeljanz or Xeljanz XR works for you, your doctor may recommend the medication as a long-term treatment option.

Xeljanz is an oral solution or a tablet that you take by mouth. This form is immediately released. The extended-release tablets, Xeljanz XR, slowly release medication into your body. Both Xeljanz and Xeljanz XR have the same risks.

For more information about Xeljanz and Xeljanz XR, including details about uses, see this in-depth article on the drug.

Mild or serious side effects can be caused by Xeljanz and Xeljanz XR. Continue reading to learn more.

Mild or serious side effects may occur during Xeljanz or Xeljanz XR treatment.

Here are just a few of the more common side effects reported by people who took Xeljanz in studies. Both Xeljanz and Xeljanz XR have the same risks of side effects. Note that these effects can vary, depending on your condition.

More common side effects in people taking Xeljanz or Xeljanz XR for Rheumatoid arthritis is a disease., Psy arthritis., or juvenile idiopathic arthritis may include:

More common side effects in people taking Xeljanz or Xeljanz XR for It is called ulcerative colitis. may include:

See the side effects explained below for more information.

Mild side effects may occur while you are taking Xeljanz. If you have any that is bothering you, you should talk to your doctor. They may be able to recommend ways to decrease the side effects.

Depending on the condition you are using the drug to treat, the side effects can vary.

Examples of mild side effects that may occur in people taking Xeljanz or Xeljanz XR for Rheumatoid arthritis is a disease., Psy arthritis., or juvenile idiopathic arthritis include:

Examples of mild side effects that may occur in people taking Xeljanz or Xeljanz XR for It is called ulcerative colitis. include:

See the side effects explained below for more information.

“These side effects should be temporary. Some may be easy to manage. If you have any symptoms that bother you, talk to your doctor or pharmacist. Unless your doctor recommends it, don’t stop using Xeljanz or Xeljanz XR.”

Xeljanz and Xeljanz XR may cause mild side effects other than the ones listed above. For more information, see the drugs’ prescribing information.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Xeljanz, visit MedWatch.

There are serious side effects from taking Xeljanz. You should be aware of any side effects that may occur. You can immediately inform your doctor about them. There have been serious side effects reported with Xeljanz.

* To learn more about this side effect, see “Side effects explained” below.
† Xeljanz has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effects explained” below.
‡ An allergic reaction is possible after using Xeljanz. In studies, there were reports of swelling of the lips and There is a There is a rash.., which may indicate an allergic reaction.

If you develop serious side effects while taking Xeljanz or Xeljanz XR, call your doctor. If the side effects seem life threatening or if you think you have a medical emergency, immediately call the emergency number.

There are frequently asked questions about Xeljanz.

Does Xeljanz cause hair growth or hair loss?

It depends. Some studies have shown that people with alopecia may benefit from taking tofacitinib, the active drug in Xeljanz and Xeljanz XR. Alopecia is an autoimmune disease that causes hair loss. At this time, Xeljanz isn’t approved to treat alopecia.

As for hair loss, you shouldn’t experience this as a side effect of Xeljanz or Xeljanz XR. Hair loss wasn’t reported in people who took Xeljanz in studies.

Talk to your doctor if you are worried about hair loss. They may be able to recommend a medication that will help with hair loss.

Will I gain weight during Xeljanz treatment?

No, you shouldn’t experience weight gain while taking Xeljanz or Xeljanz XR. Weight gain wasn’t a side effect reported in studies of people taking Xeljanz.

Talk to your doctor if you are concerned about weight gain. They should be able to help you with your weight management.

Does Xeljanz cause depression?

No, depression isn’t a side effect of Xeljanz or Xeljanz XR. Depression wasn’t reported in studies of people taking Xeljanz.

However, many people who have autoimmune conditions also have symptoms of depression. If you’re having symptoms of depression, see your doctor right away. They can work with you to find the best treatment options for your depression.

Will stopping Xeljanz treatment cause any side effects?

It’s possible for symptoms of your condition to return when stopping Xeljanz or Xeljanz XR. For example, if you’re taking Xeljanz or Xeljanz XR for Rheumatoid arthritis is a disease. (RA), discontinuing treatment may cause your RA symptoms to worsen. This is because the drug was working to decrease your symptoms.

“This doesn’t happen to everyone who stops taking drugs. If your condition is mild, you may not have any symptoms when you stop Xeljanz or Xeljanz XR treatment.”

Discuss the possibility of worsening symptoms with your doctor if you want to stop Xeljanz or Xeljanz XR treatment. They may recommend other drugs to help you.

Does Xeljanz cause eye side effects?

No, treatment with Xeljanz or Xeljanz XR doesn’t cause eye problems to occur. Eye problems weren’t reported as a side effect in studies.

Eye problems may be symptoms of other side effects in some rare cases.

For example, yellowing of your eyes can indicate liver problems, such as hepatitis reactivation. Though rare, hepatitis reactivation is a serious side effect that may occur from taking Xeljanz or Xeljanz XR. For more information about possible liver problems, see the “Side effects explained” section below.

Swelling of the area around your eyes may indicate an allergic reaction. If you have this side effect while taking Xeljanz or Xeljanz XR, talk with your doctor at once. Allergic reactions can be very serious and should be treated immediately. For more information about allergic reaction, see the “Side effects explained” section below.

If you notice a change in your eyes, please tell your doctor. If you notice any changes in vision, please tell your doctor.

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

Gastrointestinal perforation

It’s possible to develop a gastrointestinal perforation (a tear in the digestive tract) while taking Xeljanz or Xeljanz XR. But this isn’t a common side effect.

Symptoms of gastrointestinal perforation can include:

In many cases, people who developed this side effect while using Xeljanz were also taking nonsteroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs include ibuprofen (Advil, Motrin), steroid drugs, and methotrexate (Xatmep, Rasuvo).

What can help?

Before you start Xeljanz or Xeljanz XR treatment, you should talk with your doctor about your medication. Tell them about any stomach issues. This will help your doctor determine if your condition increases your risk for gastrointestinal perforation.

If you develop any symptoms of gastrointestinal perforation, see your doctor. It is important to treat this condition immediately because it could become very serious.

Boxed warnings

Xeljanz has several boxed warnings, which are mentioned below. These are the most serious warnings from the Food and Drug Administration (FDA).

Risk of blood clots and death

Certain people taking Xeljanz or Xeljanz XR could be at higher risk of developing a blood clot that may be life threatening.

Blood clots are generally a rare side effect. However, they may occur more often in people with Rheumatoid arthritis is a disease. who are:

The risk of developing a blood clot may increase with higher Xeljanz or Xeljanz XR doses.

What can help?

Life threatening blood clot can be life threatening. If you have a blood clot, you should see a doctor.

There are symptoms of a blood clot.

  • It is severe pain in your chest or leg.
  • It can affect one leg.

The lowest dose of Xeljanz or Xeljanz XR is recommended by your doctor to prevent blood clot. They will monitor you for signs of a blood clot so that you can get treatment if needed.

If you have questions about Xeljanz, you should talk to your doctor.

Risk of serious infections

Although rare, it’s possible to develop a serious infection while taking Xeljanz or Xeljanz XR. This is because both forms may weaken the immune system. Serious infections can be life threatening. If you have symptoms of an infection, such as There is a high degree of fever., The breath was very thin., or There is a There is a rash.., tell your doctor right away.

What can help?

Before you start taking Xeljanz or Xeljanz XR, your doctor will test you for tuberculosis (TB). It’s possible to have TB* even if you don’t feel sick or show any symptoms. If you have TB, they’ll recommend treating this infection before you start taking Xeljanz or Xeljanz XR. They’ll also recommend treating any other active infections you have prior to starting Xeljanz or Xeljanz XR treatment.

If you develop symptoms of a serious infection while taking Xeljanz or Xeljanz XR, you should immediately tell your doctor. They may stop treatment if you have an infectious disease.

* This is called latent TB. It differs from active TB, also known as TB disease, which makes you feel sick and can be transmitted to others.

Risk of cancer and immune system disorders

Although rare, people taking Xeljanz or Xeljanz XR have developed cancer, such as skin cancer, or immune system disorders. This may be because Xeljanz and Xeljanz XR can weaken your immune system. People who have had kidney transplants may be at higher risk for developing immune system disorders from taking Xeljanz or Xeljanz XR.

What can help?

Your doctor will monitor you for any symptoms of cancer, such as irregular blood test results or changes in skin. If you notice any changes in your body, be sure to tell your doctor. They will be able to tell you what is causing the changes.

If you have concerns about taking Xeljanz or Xeljanz XR, you should talk to your doctor.

Risk of death in certain people

Some people with all of the following may be at increased risk of death due to Xeljanz and Xeljanz XR.

  • Rheumatoid arthritis is a disease.
  • An age of 50 years or older.
  • There is 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?

Your doctor can look at your risks. They will recommend if the medication is right for you. The doctor will prescribe a safe dose of Xeljanz or Xeljanz XR.

Changes in blood levels of cholesterol, liver enzymes, or certain blood cells

It is possible that taking Xeljanz or Xeljanz XR can cause changes in blood levels. Your doctor will watch you for any changes with Xeljanz or Xeljanz XR.

Increased cholesterol levels

Xeljanz or Xeljanz XR may cause an increase in your cholesterol levels. This side effect, if it occurs, usually happens within the first 6 weeks of treatment.

In studies, this was one of the more common side effects seen in people taking Xeljanz to treat It is called ulcerative colitis..

What can help?

Your doctor will monitor your cholesterol levels after you start Xeljanz. If your cholesterol levels start to go up, they may recommend that you take medication to treat it. They may be able to monitor your cholesterol levels more often.

Increased liver enzymes

Your liver enzyme levels may increase while you are taking Xeljanz. This increase could be a sign of damage to the body.

Symptoms of liver damage can include stomach pain or yellowing of the eyes or skin. You may be at even higher risk for developing liver damage if you’re also taking methotrexate (Xatmep, Rasuvo).

What can help?

Your doctor will recommend liver function tests to monitor your liver throughout Xeljanz or Xeljanz XR treatment. If your liver enzyme levels begin to increase, your doctor may order more blood work. They may also order imaging tests, such as an ultrasound, to see what may be causing this side effect. Or your doctor may recommend you switch to a different medication to treat your condition.

Decreased levels of white blood cells or red blood cells

It is rare that the amount of red or white blood cells decreases while you take Xeljanz or Xeljanz XR. A decrease in blood cells can cause a number of symptoms, such as infections, feeling weak, or being more tired than usual.

What can help?

After you start Xeljanz or Xeljanz XR treatment, your doctor will monitor your blood cell levels. They will check these levels every 3 months while you are taking Xeljanz or Xeljanz XR.

If your red or white blood cell levels become too low, your doctor may have you stop Xeljanz or Xeljanz XR treatment. They may suggest that you try a different medication.

Headache

It’s possible to have headaches while taking Xeljanz or Xeljanz XR. Headache is a common side effect that can occur regardless of which condition you’re treating with Xeljanz or Xeljanz XR.

What can help?

If you have headaches frequently, you should talk to your doctor. They may be able to suggest ways to prevent headaches. They may be able to recommend other pain-relief drugs.

Diarrhea

You may have diarrhea while taking Xeljanz or Xeljanz XR. It can be a common side effect of either drug, regardless of the health condition you’re treating.

What can help?

If you are having a bad experience with scurvy, talk to your doctor. They may be able to determine if Xeljanz is the cause. They can suggest ways to treat this side effect.

Allergic reaction

Like most drugs, Xeljanz or Xeljanz XR may cause an allergic reaction in some people. In studies of Xeljanz, allergic reaction was a reported side effect.

Mild or serious symptoms can be present.

  • skin There is a There is a rash..
  • It is itchy.
  • flushing (temporary warmth, redness, or deepening of skin color)
  • “It’s swelling under your skin, usually in your lips, hands, or feet.”
  • It can be hard to breathe if you have swelling of your mouth, tongue, or throat.

What can help?

If you have mild symptoms of an allergic reaction, such as a mild There is a There is a rash.., call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine), or a topical product, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you had an allergic reaction to Xeljanz or Xeljanz XR, they will decide if you should continue using it.

If you have a severe allergic reaction, you should call the emergency number. These symptoms could be life threatening and need immediate medical care.

If your doctor confirms you had a serious allergic reaction to Xeljanz or Xeljanz XR, they may have you switch to a different treatment.

Keeping track of side effects

Keep notes on any side effects you have during your Xeljanz treatment. You can share this information with your doctor. This is helpful when you are starting to use a combination of treatments.

Your side effect notes can include things.

  • What dose of drug did you take when you had the side effect?
  • How soon after starting that dose did you experience side effects?
  • What were your symptoms after the side effect?
  • How did it affect your daily activities?
  • What other drugs were you taking?
  • Other information is important to you.

Sharing notes with your doctor will help him learn more about how Xeljanz affects you. Your doctor can use this information to adjust your treatment plan.

There are several warnings that may affect whether you can use it safely.

Boxed warnings

There are several warnings for Xeljanz and Xeljanz XR. The FDA has the most serious warnings. A boxed warning is a warning about drug effects.

Boxed warnings for Xeljanz and Xeljanz XR include:

  • risk of blood clots
  • risk of serious infections
  • risk of cancer and immune system disorders
  • There is a risk of death in certain people.

For details, see the “Side effects explained” section above.

Other warnings

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

Liver problems. On rare occasions, Xeljanz or Xeljanz XR can cause increased liver enzymes. This may be a sign of liver damage. Before taking Xeljanz, be sure to tell your doctor if you have a history of liver problems, such as hepatitis. They may order liver function tests more frequently during your treatment to monitor you. Or they may recommend a different medication to treat your condition.

Allergic reaction. It’s possible to have an allergic reaction while taking Xeljanz or Xeljanz XR. If you’ve had an allergic reaction to either drug or any of their ingredients, you shouldn’t take Xeljanz or Xeljanz XR. Ask your doctor about other medications that might be better options for you.

Kidney problems. If you have any kidney problems, taking the recommended dosage of Xeljanz or Xeljanz XR may result in having too much of either drug in your body. This can increase your risk for side effects. If you have any kidney problems, talk with your doctor before starting Xeljanz. They may monitor you for side effects more frequently during your treatment. Or they may recommend a different dose of Xeljanz or another medication altogether.

Digestive tract problems. Gastrointestinal perforation (a tear in the digestive tract) is a possible side effect of Xeljanz or Xeljanz XR. Digestive tract problems, such as a history of diverticulitis or ulcers, may increase the risk of this side effect. Xeljanz XR can also make narrowing or blockages of the digestive tract worse. Tell your doctor about any digestive tract problems that you have before you start Xeljanz or Xeljanz XR. They may monitor you more carefully during treatment. Or they may recommend a different medication for your condition.

Conditions affecting your blood cells. Either drug may not be right for you if you have certain blood disorders that affect your blood cell counts. Both drugs can cause low levels of red or white blood cells. If you already have low levels of blood cells, Xeljanz or Xeljanz XR may further decrease these levels. This in turn can increase your risk for infections or anemia.

“Your doctor will check your blood cell levels before you start taking Xeljanz. If your blood cell levels are low, they may recommend a different treatment. Your doctor will keep a close eye on these levels to make sure they don’t go too low.”

Alcohol use and Xeljanz

“Alcohol isn’t known to interact with Xeljanz or Xeljanz XR Both alcohol and drugs can cause damage to the bile duct. If you drink while taking Xeljanz or Xeljanz XR, you may be at increased risk of developing a serious condition called hepatocellular carcinoma. If you are taking either drug, talk to your doctor about how much you can drink while you are taking it.”

Pregnancy and breastfeeding while taking Xeljanz

It is not known if Xeljanz is safe to take while pregnant or breastfeeding. There is not enough information to know if the drugs may harm a fetus or breastfeeding child.

Pregnancy

In animal studies of tofacitinib, pregnant animals did have an increased risk for pregnancy loss or birth defects. (Tofacitinib is the active drug in Xeljanz and Xeljanz XR.) However, animal studies don’t always predict what will happen in humans.

Two of the conditions that the drugs treat, Rheumatoid arthritis is a disease. and It is called ulcerative colitis., may cause harm to a developing fetus. If you have any questions about how to treat either condition during pregnancy, talk with your doctor.

If you become pregnant while taking Xeljanz or Xeljanz XR, you should participate in the pregnancy exposure registry. The side effects of people taking drugs when they become pregnant or throughout their pregnancies are monitored by the pregnancy exposure registry. Call to enroll.

If you are pregnant or planning to become pregnant, you should talk to your doctor.

Breastfeeding

In animal studies of tofacitinib, the drug was present in the milk of lactating animals. (Tofacitinib is the active drug in Xeljanz and Xeljanz XR.) However, animal studies don’t always predict what will happen in humans.

You should not be breastfeeding while taking Xeljanz.

If you are stopping Xeljanz, you should wait at least 18 hours after your last dose. You need to wait at least 36 hours before breastfeeding if you are taking Xeljanz. This will prevent your child from being exposed to the drug.

If you are planning to breastfeeding, you should talk with your doctor before taking Xeljanz or Xeljanz XR.

If you have Rheumatoid arthritis is a disease., Psy arthritis., Ankylosing spondylitis is a disease., juvenile idiopathic arthritis, or It is called ulcerative colitis., Xeljanz or Xeljanz XR may help treat your condition. Taking either drug can cause side effects to occur.

Mild side effects are caused by Xeljanz and Xeljanz XR. There are some serious side effects that you should be aware of.

If you have questions about the side effects of Xeljanz or Xeljanz XR, you should talk to your doctor or pharmacist. Some examples of questions that you may want to ask.

  • How can I keep the side effects from Xeljanz under control?
  • Is it possible that I will have an increased risk for side effects if I take other medications with Xeljanz?
  • What should I do if I become pregnant while taking Xeljanz?
  • Is my personal health history increasing my risk for any side effects?

If you use Xeljanz or Xeljanz XR for Rheumatoid arthritis is a disease. (RA), sign up for the Healthline RA newsletter for information on treatments, pain management, and more.

Q:

I’m worried about getting cancer or a blood clot from this medication. How can I prevent these side effects, and what symptoms should I watch for?

Anonymous

A:

There is a risk of developing cancer while taking Xeljanz, but these side effects are rare.

If you have been diagnosed with cancer or a blood clot, tell your doctor before you start Xeljanz.

Your risk for developing a blood clot is increased if you have Rheumatoid arthritis is a disease. (RA), are 50 years of age or older, or have at least one risk factor for heart disease, such as high blood pressure. The risk was also increased for people who took higher doses of Xeljanz.

Blood clot can be fatal. If you have a blood clot, stop taking Xeljanz and tell your doctor. Symptoms include:

If you think you have a medical emergency, call the emergency number.

Xeljanz can also increase your risk for certain cancers, such as lymphoma or skin cancer. This is because the drug can decrease how well your immune system works.

Your doctor will monitor you for any symptoms of cancer while you are being treated with Xeljanz.

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.