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    Tofacitinib citrate

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Xeljanz is prescribed to treat adults with rheumatoid arthritis, ulcerative colitis, psoriatic arthritis, or ankylosing spondylitis. It can be prescribed off-label for psoriasis or alopecia.

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Xeljanz (generic name: tofacitinib) is a Janus Kinase inhibitor (JAKi) used to treat immune-mediated diseases (IMDs) such as rheumatoid arthritis, psoriatic arthritis, ulcerative colitis or ankylosing spondylitis in adults. 

It can also be prescribed off-label to treat psoriasis and hair loss caused by alopecia areata as well as conditions that have not responded well to alternative treatment, including rheumatic diseases like dermatomyositis, polymyositis, systemic sclerosis, systemic lupus erythematosus.

When treating various forms of arthritis, it aims to decrease the pain, tenderness, and swelling in affected joints. For ulcerative colitis, it reduces symptoms such as stomach pain, diarrhea, and rectal bleeding.


The usual procedure is to take the medicine orally with or without food. Follow the instructions from your prescribing healthcare provider and the guidelines printed on the patient instruction leaflet included in the package. 

Xeljanz may cause side effects in some users, such as headaches or diarrhea. They should be transient, but if either of these effects lasts or worsens, a doctor or pharmacist should be notified immediately.

The guidelines include specific warnings about an increased risk of infections, particularly for people aged 65 or older who have diabetes, chronic lung disease, or are taking corticosteroids. Symptoms that need immediate attention include painful skin rash or blisters, which may be a sign of herpes zoster, or notice any new growth or changes in existing moles or spots. If you have been in close contact with a person with tuberculosis, report this to a healthcare provider.

Please read the patient information leaflet that comes with the medication. This contains detailed information about the possible serious side effects of treatment with JAKi medications.

Xeljanz is approved for treating patients who have not responded adequately to prior treatment using tumor necrosis factor (TNF) blockers that did not work well or could not be tolerated. 

The main conditions for which Xeljanz has FDA approval are:

  • Moderately to severely active rheumatoid arthritis: an autoimmune and inflammatory disease in which the immune system attacks healthy cells in the body, causing painful swelling, mainly in the joints
  • Active psoriatic arthritis: a form of arthritis with swollen and painful joints and red, scaly rashes, and thick, pitted fingernails
  • Moderately to severely active ulcerative colitis: a chronic inflammatory bowel disease (IBD) caused by abnormal reactions of the immune system that result in inflammation and ulcers on the inner lining of the large intestine
  • Active ankylosing spondylitis: a type of arthritis that causes inflammation in the joints and ligaments of the spine.

Doctors are also now treating several other conditions with off-label Xeljanz, including:

  • Psoriasis
  • Alopecia areata causing hair loss
  • Rheumatic diseases include dermatomyositis, polymyositis, systemic sclerosis, and systemic lupus erythematosus.
  • Is Xeljanz an anti-inflammatory?
    Xeljanz (tofacitinib) belongs to a class of drugs called Janus kinase inhibitors. These drugs help to decrease inflammation in the body. Studies of patients with rheumatoid arthritis have shown that Xeljanz effectively reduces joint pain and swelling, improving joint movement.
  • Is Xeljanz used for lupus?
    A study of people with systemic lupus erythematosus (SLE) who were given tofacitinib therapy off-label showed that the drug quickly resolved arthritis symptoms in 40% of participants. In comparison, 60% saw their skin rashes improve.
  • What is the newest drug for rheumatoid arthritis?
    The newest drugs approved by the FDA for treating rheumatoid arthritis are the Janus kinase (JAK) inhibitors, available under the brand name Xeljanz. JAK inhibitors block the enzymes that play a role in cell signaling, leading to the inflammatory and immune responses seen in rheumatoid arthritis and other conditions.
  • Can you drink alcohol when taking Xeljanz?
    Although there are no warnings from the drug manufacturer of any interaction between alcohol and Xeljanz, it is generally advisable not to drink excessive amounts of alcohol while taking Xeljanz because the liver metabolizes both, which can lead to liver damage.
  • Is there a black box warning on Xeljanz?
    The FDA recently announced that drug manufacturers must include additional warnings for some Janus kinase inhibitors, such as Xeljanz, following a study linking this drug class to serious heart failure or cardiac arrest risks.

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