Tofacitinib is used for the treatment of some types of arthritis and inflammation of the large intestine. Learn how to use the medication, its common side effects, special precautions to watch out for, and more.

What is this medication for?

Tofacitinib is used for the treatment of some types of arthritis and inflammation of the large intestine.Tofacitinib works by suppressing the immune system to help reduce inflammation and improve the symptoms of joint pain and swelling. Tofacitinib does not work immediately and may take weeks to months before you notice any improvement in symptoms. 

Tofacitinib can also be used for other indications as prescribed by your doctor.     

How should I take or use this medication?

• As the dose of Tofacitinib varies among the disease conditions treated, your doctor will prescribe a suitable dose for you. 
• Do not stop taking your medication without checking with your healthcare professional.
• You may take this medication with or without food. 

What should I do if I forget to take or use this medication?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose. 

What precautions should I take when taking or using this medication?

Inform your healthcare professional if: 

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding. If you are a woman of childbearing age, you should use effective birth control during treatment with Tofacitinib and for at least four weeks after stopping Tofacitinib.
• You have a history of
  • Kidney condition
  • Liver condition
  • Heart condition
  • Stomach condition
  • Stroke
  • Hepatitis B or Hepatitis C
  • Cancer
• You have infections or low blood count
• You are taking any other medications, including supplements, traditional medications and herbal remedies. 

Tofacitinib may reduce your body’s ability to fight against infections.

• Avoid crowded places and direct contact with any sick person
• Avoid consuming raw or undercooked food

Discuss with your doctor before receiving any vaccines. Use of some vaccines with Tofacitinib may either raise the chance of an infection or make the vaccine less effective.

What are some common side effects of this medication?

Common side effects of Tofacitinib includes:

• Headache
• Nausea or vomiting
  • Take the medication with or after food if you experience nausea or vomiting
• Diarrhea
• Abdominal pain
• Signs of infection like fever, chills, severe sore throat
  • See a doctor immediately if you develop a fever or feel unwell. You should inform the doctor that you are on Tofacitinib.
• Increase in blood pressure
  • Monitor your blood pressure regularly and see a doctor if your blood pressure readings are high and out of target range.
• Increase in cholesterol
  • Your doctor will order a blood test to monitor your cholesterol levels. 
• Low red or white blood cell counts 
  • Your doctor will monitor the blood counts regularly, within the first three months of starting on this medication. You should see a doctor immediately if you develop signs of infection like fever, chills or a very bad sore throat.

Inform your doctor if any side effect persists, worsens or if you are unable to tolerate them.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Other rare but serious effects that may occur include: 

• Signs of liver problems like dark or tea-coloured urine, yellowing of eye white or skin
• Signs of a stomach ulcer like black tarry stools, vomiting of coffee ground material, severe stomach pain. 
• Blood clot which forms and blocks the veins or arteries. Symptoms of blood clot can include swelling or pain in the legs, chest pain, difficulty in breathing, numbness or weakness on one side of the body. 

If you experience any of these symptoms, you should consult your healthcare professional immediately.

There are case reports of higher risk of heart attack or stroke for patients on Tofacitinib with risk factors for heart disease. Your doctor will assess the benefits and risks before prescribing Tofacitinib and monitor for these risks during the treatment period. 

What food or medication should I avoid when I take or use this medication?

Avoid taking grapefruit or grapefruit juice when you are taking this medication as grapefruit may interact with your medication and increase the risk of side effects.

Please inform your doctor if you are taking any of the following medications, before you start taking Tofacitinib:

• Rifampicin, a tuberculosis medication
• Anti-fungal such as Ketoconazole, Fluconazole
• Immunosuppressant such as Azathioprine, Methotrexate, Cyclosporine, Tacrolimus

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

How do I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin. 

Disclaimer

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on March 2025