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Writer's pictureTeresa Mendoza, PharmD

Med of the Week: Tofacitinib



Tofacitinib feature with a picture of skeleton and knee joint

Tofacitinib (Xeljanz), commonly prescribed for rheumatoid arthritis, can increase your patient’s risk of developing severe infections. Even more, this drug has interactions with steroids, NSAIDs, antibiotics, and antifungals. Read on to learn more:


Generic Name: Tofacitinib

Brand Name(s): Xeljanz, Xeljanz XR

Pronunciation: TOE fa SYE ti nib


About this drug:

  • Tofacitinib is a Janus kinase (JAK) inhibitor that is used to treat adults with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and ulcerative colitis. 

  • It is usually prescribed when other treatments are not successful or tolerated and sometimes given in combination with Methotrexate.

  • It is also used to treat adults and children ages 2 and older with active polyarticular juvenile idiopathic arthritis (JIA).


Dentistry-related tidbits:

  • Tofacitinib may increase a patient's chance of developing various types of cancers and serious infections. Follow any dental infections closely.

  • For dental practices in the Ohio and Mississippi River valleys and the Southwest, there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis) if a patient is taking Tofacitinib.

  • Avoid prescribing NSAIDs, Aspirin, and Aspirin-containing products to avoid an increased risk of thromboembolism.

  • Combining Tofacitinib with steroids will increase the risk of serious infections (only prescribe steroids if absolutely necessary for the shortest duration of therapy).

  • Exercise caution when prescribing macrolide, quinolone, antifolate, and oxazolidinone antibiotics and azole antifungals to avoid an increased risk of myelosuppression. Make sure to check for potential interactions before prescribing using a tool like Rx Check.


Fun facts:

  • Tofacitinib inhibits the Janus Kinase (JAK) enzyme which stimulates immune cell function.

  • Tofacitinib should be used with caution in patients of Asian descent as it increases the frequency of side effects.

  • There is an increased risk of death in people 50 years of age and older who have at least 1 heart disease (cardiovascular) risk factor and are taking XELJANZ 5 mg twice daily or XELJANZ 10 mg twice daily.


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