Xeljanz and Xeljanz XR dosage

Xeljanz and Xeljanz XR (tofacitinib) are prescription brand-name medications. The Food and Drug Administration (FDA) has approved them to treat the following conditions* in adults:

• rheumatoid arthritis
• psoriatic arthritis
• moderate to severe ulcerative colitis
• ankylosing spondylitis

Additionally, Xeljanz is FDA-approved to treat a form of juvenile idiopathic arthritis in children ages 2 years and older.

Xeljanz and Xeljanz XR come as oral tablets. Xeljanz also comes as an oral solution. Xeljanz XR is an extended-release (long-acting) form of the drug.

Xeljanz contains the active drug tofacitinib. It belongs to a class of drugs called Janus kinase inhibitors. There are currently no generic versions of Xeljanz.

For information about the dosage of Xeljanz and Xeljanz XR, including their forms, strengths, and how to take the drugs, keep reading. For a comprehensive look at Xeljanz and Xeljanz XR, including details about their uses, see this article.

* Xeljanz and Xeljanz XR are approved to treat these conditions when certain other drugs haven’t worked well enough or have caused troublesome side effects.

This article describes typical dosages for Xeljanz and Xeljanz XR provided by the drug’s manufacturer. When taking Xeljanz and Xeljanz XR, always follow the dosage prescribed by your doctor.

Below you’ll find information about the usual recommended dosages of Xeljanz and Xeljanz XR for their approved uses.

Xeljanz and Xeljanz XR forms

Both Xeljanz and Xeljanz XR come in oral forms.

Xeljanz comes as a tablet and as a solution. Xeljanz tablets are immediate release. This means when the tablet dissolves in your digestive system, the drug is released all at once. Xeljanz solution also releases the drug all at once.

Xeljanz XR comes as an extended-release tablet. These tablets are long acting because they release the medication slowly as they pass through your digestive system.

Xeljanz and Xeljanz XR strengths

Xeljanz tablets come in the following strengths:

• 5 milligrams (mg)
• 10 mg

Xeljanz solution comes in one strength: 1 mg per milliliter (mL).

Xeljanz XR tablets come in the following strengths:

• 11 mg
• 22 mg

Typical dosages

The usual recommended dosages of Xeljanz and Xeljanz XR depend on the condition being treated and the form of Xeljanz prescribed.

The following information describes dosages that are commonly prescribed or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosages for ulcerative colitis

The dosage of Xeljanz and Xeljanz XR for ulcerative colitis (UC) depends on whether the medication is being used for induction or maintenance treatment.

Induction dosages

With induction treatment, a high dose of medication is taken for a short time to reduce symptoms and bring the condition under control. This is also called inducing (causing) remission. With remission, you have few or no UC symptoms.

To induce remission of UC in adults, the usual dosages are:

• 10 mg of Xeljanz twice daily for 8 to 16 weeks
• 22 mg of Xeljanz XR once daily for 8 to 16 weeks

Maintenance dosages

With maintenance treatment, a lower dosage of medication is taken long term. This is done to maintain remission and help prevent your symptoms from worsening.

To maintain remission of UC in adults, the usual dosages are:

• 5 mg of Xeljanz twice daily
• 11 mg of Xeljanz XR once daily

Dosages for psoriatic arthritis

To treat psoriatic arthritis in adults, the usual dosages are:

• 5 mg of Xeljanz twice daily
• 11 mg of Xeljanz XR once daily

Dosage for rheumatoid arthritis

To treat rheumatoid arthritis in adults, the usual dosages are:

• 5 mg of Xeljanz twice daily
• 11 mg of Xeljanz XR once daily

Dosage for ankylosing spondylitis

To treat ankylosing spondylitis in adults, the usual dosages are:

• 5 mg of Xeljanz twice daily
• 11 mg of Xeljanz XR once daily

Dosages for juvenile idiopathic arthritis

For polyarticular course juvenile idiopathic arthritis in children ages 2 years and older, the usual dosage of Xeljanz depends on your child’s body weight in kilograms (kg).* For children weighing 40 kg or more, this is the same whether they take the tablets or solution.

Below is a table that describes Xeljanz dosages for children.

* 1 kg is about 2.2 lb.

Children’s dosage

Xeljanz tablets and Xeljanz oral solution are used to treat polyarticular course juvenile idiopathic arthritis in children ages 2 years and older. The usual dosages are described above.

Xeljanz XR is not approved for use in children.

Long-term treatment

Xeljanz and Xeljanz XR are meant to be taken as long-term treatments. If you and your doctor determine that Xeljanz or Xeljanz XR is safe and effective for you, you’ll likely take the drug long term.

The Xeljanz or Xeljanz XR dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re taking Xeljanz or Xeljanz XR to treat
• which form of the drug you take
• other medications you take
• how well your liver and kidneys function
• body weight, for children ages 2 years and older with a certain form of juvenile idiopathic arthritis
• the side effects you have from taking Xeljanz

Other medical conditions you have can also affect your Xeljanz or Xeljanz XR dosage.

Dosage adjustments

Your doctor may adjust your dosage if you:

• start or stop taking certain other medications
• have changes in your liver or kidney function

Also, your doctor may stop your treatment temporarily if your blood cell counts or hemoglobin levels decrease. These are known side effects of Xeljanz and Xeljanz XR. For more information on side effects, see this article.

Boxed warnings

Xeljanz and Xeljanz XR have a boxed warning for increased risk of serious blood clots in certain people. These clots include pulmonary embolism, deep vein thrombosis, and arterial thrombosis.

A boxed warning is a serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

In clinical trials, people ages 50 years and older with risk factors for heart disease experienced blood clots when they took 10 milligrams (mg) of Xeljanz twice daily for rheumatoid arthritis (RA). Blood clots have also been reported in people taking 10 mg of Xeljanz twice daily for ulcerative colitis (UC).

Due to this risk, your doctor won’t prescribe 10 mg of Xeljanz twice daily or 22 mg of Xeljanz XR to treat RA or psoriatic arthritis. And for UC, your doctor will prescribe the smallest and most effective Xeljanz dosage possible. This helps reduce your risk of blood clots. If you have symptoms of a blood clot while taking Xeljanz or Xeljanz XR, your doctor will recommend that you stop taking the drug.

Xeljanz and Xeljanz XR also have boxed warnings for cancer and immune system problems, severe infection, and risk of death in certain people. See “Boxed warnings” at the top of this article for details about these warnings.

If you miss a dose of Xeljanz, take it as soon as you remember. However, if it’s nearly time for your next scheduled dose, skip the missed dose. Take your next scheduled dose as usual. Don’t take more than one dose at the same time to make up for a missed dose.

If you’re not sure whether to take or skip a missed dose, ask your doctor or pharmacist for advice.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Here are the answers to some frequently asked questions about Xeljanz and Xeljanz XR dosage.

How do the dosages of Xeljanz XR compare with those of Xeljanz’s other forms?

Xeljanz and Xeljanz XR come as oral tablets. Xeljanz also comes as an oral solution.

For the tablet forms, the recommended total daily dosages of Xeljanz and Xeljanz XR are similar. However, with Xeljanz XR you’ll take one daily dose, whereas with Xeljanz you’ll take two. This is because these drug forms release the medication in different ways:

• Xeljanz XR tablets are extended release. This means they release the medication slowly as the tablet passes through your digestive system. So you only need to take one dose per day.
• Xeljanz tablets are immediate release. They release the medication as soon as the tablet dissolves in your digestive system. So you’ll take a smaller dose twice per day.

Xeljanz oral solution is prescribed in smaller doses to treat children with a certain form of juvenile idiopathic arthritis. For more information, see “Children’s dosage” above.

Can I switch from Xeljanz to Xeljanz XR? Will my dosage be the same?

Maybe. If you’re an adult taking Xeljanz, it’s possible for your doctor to switch you to Xeljanz XR.

Xeljanz tablets are taken twice daily, while Xeljanz XR is taken once daily. So Xeljanz XR may be more convenient for you. However, your total daily dose won’t be identical. For example:

• If you currently take 5 mg of Xeljanz twice daily, your doctor may switch you to 11 mg of Xeljanz XR once daily.
• If you currently take 10 mg of Xeljanz twice daily, your doctor may switch you to 22 mg of Xeljanz XR once daily.

It’s important to note that Xeljanz XR is not approved for children. For more information, see “Children’s dosage” above.

If you’re interested in switching from Xeljanz to Xeljanz XR, talk with your doctor. They can recommend whether this is an option for you.

Xeljanz tablets, Xeljanz XR tablets, and Xeljanz solution are each taken by mouth. You can take them either with or without food.

If you’ve been prescribed Xeljanz tablets or Xeljanz solution, you’ll usually take a dose twice daily. Try to take your doses at the same times each day, preferably about 12 hours apart.

If you take Xeljanz tablets, you might be able to crush, split, or chew them. If you have trouble swallowing tablets, see this article or talk with your doctor. They may be able to give tips on how to swallow tablets more easily.

If you’re prescribed Xeljanz XR, you’ll take a dose once daily. You can take your dose at any time, but you should stick to the same time each day.

If you take Xeljanz XR, keep in mind that it’s an extended-release tablet. As the tablet passes through your digestive system, it releases the drug slowly over time. You shouldn’t split, crush, or chew these tablets. Doing this will cause the drug to be released in your body all at once, which may increase your risk of side effects.* Instead, you should swallow Xeljanz XR tablets whole, with a beverage.

* For more information on side effects, see this article.

It’s important that you do not take more Xeljanz or Xeljanz XR than your doctor prescribes. For some medications, taking more than the recommended amount may lead to side effects or overdose.

If you take more than the recommended amount of Xeljanz or Xeljanz XR

Call your doctor right away if you believe you’ve taken too much Xeljanz and Xeljanz XR. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Xeljanz or Xeljanz XR for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.

As with any drug, never change your dosage of Xeljanz or Xeljanz XR without your doctor’s recommendation. If you have questions about your dosage, talk with your doctor.

Besides learning about dosage, you may want other information about Xeljanz and Xeljanz XR. These additional articles might be helpful to you:

• More about Xeljanz and Xeljanz XR. For information about other aspects of these drugs, refer to this article.
• Side effects. To learn about side effects of Xeljanz and Xeljanz XR, see this article. You can also look at their prescribing information.
• Details on your condition. For details on ulcerative colitis (UC), see our list of UC articles. To learn more about arthritis, refer to our arthritis hub. You can also see our lists of psoriatic arthritis (PsA) articles and rheumatology articles.
• For support. If you have PsA and are looking for advice or support, consider joining our PsA community.

Disclaimer: Medical News Today 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 another 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.