Tofacitinib (Xeljanz)
Content date: 14 November 2026
An oral Janus kinase (JAK) inhibitor for selected adults with ulcerative colitis when other treatments are unsuitable or have not worked well enough. It is not a standard treatment for Crohn’s disease.
Your next step
Review your current treatment-stage dose, blood-test and vaccine plan with the team. Bring your medicine list to appointments.
Get urgent help: Seek emergency care for chest pain, sudden breathlessness, a painful swollen leg, sudden weakness or visual change, or face/throat swelling. New severe abdominal pain, especially with fever or vomiting, needs urgent assessment.
Using your medicine
- Follow your written product, strength and schedule. Starting and maintenance doses differ; kidney or liver function and other medicines may change the dose. Do not switch between immediate- and prolonged-release tablets yourself.
- It may be taken with or without food. Never double a dose to make up for one missed; follow your product leaflet. Use the original packaging and storage instructions, protected from children, heat and moisture.
Before starting and monitoring
- The team checks tuberculosis, viral hepatitis, infections and vaccinations. Treatment is not started with a serious active infection. Discuss shingles vaccination; avoid live vaccines during treatment without specialist guidance.
- Keep scheduled blood counts, liver tests and cholesterol checks even when symptoms settle. Mention heart disease, blood clots, cancer, smoking, pregnancy or breastfeeding.
Side effects and individual risk
- Headache, nausea or diarrhoea can occur, but not in everyone. Report new or persistent symptoms rather than assuming they are due to colitis.
- Important infections and shingles may occur. This medicine class also carries risks of clots, cardiovascular events and certain cancers, particularly with risk factors. The specialist reviews alternatives and selects the lowest suitable effective dose; do not stop simply because you read a list of possible effects.
Interactions and pregnancy
- Ask the pharmacist to check all medicines, particularly antifungals and antibiotics. Do not combine it yourself with a biologic, azathioprine or another immune-suppressing treatment.
- Do not use during pregnancy or breastfeeding. Effective contraception is needed during treatment and for at least four weeks after the last dose. Discuss pregnancy plans early and contact your doctor immediately if pregnancy occurs.
Brand: ........................ | Dose and how I take or use the medicine: ........................
Next dose: ........................ | Next blood tests: ........................
Team contact: ........................
When to get help
Seek emergency care for chest pain, sudden breathlessness, a painful swollen leg, sudden weakness or visual change, or face/throat swelling. New severe abdominal pain, especially with fever or vomiting, needs urgent assessment.
Contact the team the same day for fever, signs of infection or a painful blistering rash, and before the next dose if infection is significant. The team decides whether to interrupt treatment.