Tofacitinib can make it harder for your body to fight infections. Therefore, if you have a fever or think you may have an infection, contact your health-care provider immediately. Also contact your prescriber if you are having surgery as you may need to stop tofacitinib until you are healed and there is no sign of infection.
Before taking tofacitinib, tell your health-care provider if you are pregnant or planning to become pregnant or are breastfeeding or planning to breastfeed. Women should not breastfeed while being treated with tofacitinib.
Ideally your vaccinations should be up to date prior to starting tofacitinib. If you have already started therapy with tofacitinib, most inactive vaccines are recommended, if indicated (e.g., influenza, pneumococcal). Live vaccines are not recommended due to risk of causing infection. Please speak with your health-care providers about vaccinations before starting tofacitinib.
Anyone who has had a previous allergic reaction to tofacitinib should avoid the medication.
Tofacitinib interacts with a number of other medications. Please speak with your health-care provider about whether any of the other medications you currently take interact with tofacitinib. It is also recommended that you avoid grapefruit juice and St. John’s wort while taking tofacitinib.
Your body may harbour the bacteria that can cause tuberculosis (TB) if you have been exposed to TB in the past. You may not know you are carrying TB as the bacteria remain in an inactive state and cause no symptoms. This is known as latent TB infection (LTBI). People with LTBI are not infectious and cannot spread TB to others. Tofacitinib can increase the risk of reactivation of LTBI. Prior to starting tofacitinib therapy, your prescriber will screen for LTBI. If you test positive you will be required to take an anti-TB medication prior to starting tofacitinib. Please speak with your health-care provider about LTBI screening before starting a tofacitinib.
Tofacitinib has been rarely associated with a small increased risk of developing certain types of cancer. Proof of a link between tofacitinib and the development of cancer is difficult as people with inflammatory arthritis are generally at a higher risk of developing certain cancers, as compared to the general population. The role of tofacitinib in the development of cancer is currently unknown. Please speak with your health-care provider if you have any questions.
If you are starting this medication and are a current or past smoker, or have had a heart attack, other heart problems, known malignancy or cancer, stroke, or blood clots in the past, you should ensure your doctor is aware of the risks factors you have and discuss the risks and benefits of this treatment. These factors may put you at higher risk for serious problems with this medication. It is important that your doctor is aware if you have any of these risk factors if you are starting this medication.
If you are unsure whether your doctor is aware of these risk factors you may have, you should contact your doctor and make an appointment to discuss these risk factors as well as the risks and benefits of using this medication.