Xeljanz Dosages: Your GoodRx Guide
Key takeaways:
Xeljanz (tofacitinib) treats autoimmune conditions such as rheumatoid arthritis and ulcerative colitis. It comes as an immediate-release tablet, an oral solution, and an extended-release tablet (Xeljanz XR).
The typical adult maintenance dosage of Xeljanz is 5 mg by mouth twice a day. The typical adult maintenance dosage for Xeljanz XR is 11 mg once a day. Children’s Xeljanz dosages are based on body weight.
You may need to take a different Xeljanz dosage if you have kidney or liver problems, low white blood cells, or if you take interacting medications. Your prescriber will help determine the right dosage for you.
There are many ways to save on Xeljanz and Xeljanz XR. If you’re eligible, a manufacturer savings card can help you access Xeljanz or Xeljanz XR for $0. A patient assistance program is also available.
Access savings on related medications
Table of contents
If you have an autoimmune disorder such as rheumatoid arthritis (RA), the medication name Xeljanz (tofacitinib) may ring a bell. Xeljanz is an oral Janus kinase (JAK) inhibitor. It's typically prescribed if other medications aren’t working well enough for your symptoms.
Xeljanz comes in immediate-release (IR) and extended-release (ER) dosage forms. IR forms include an oral tablet and grape-flavored solution (liquid). The only ER form available is an oral tablet (Xeljanz XR).
If you’ve been prescribed Xeljanz, your prescriber likely gave you instructions for taking it. Make sure to follow their instructions since they are specific to you. But it can also help to know the usual recommended doses. Here, we’ll review the typical Xeljanz dosages for adults and children.
What’s the typical Xeljanz dosage for adults?
The typical Xeljanz dosage for adults varies depending on what condition it’s prescribed for and which dosage form you’re taking. Xeljanz comes in the following doses:
Xeljanz tablets: 5 mg and 10 mg
Xeljanz XR tablets: 11 mg and 22 mg
Xeljanz oral solution: 1 mg/mL
Xeljanz XR lasts longer in the body than Xeljanz. So Xeljanz is usually taken twice a day, while Xeljanz XR is only taken once a day.
Rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis
The typical Xeljanz dosage is the same for RA, psoriatic arthritis (PsA), and ankylosing spondylitis (AS). It’s recommended to take 5 mg by mouth twice daily with or without food.
The typical Xeljanz XR dosage for RA, PsA, and AS is 11 mg by mouth once a day. You can take it with or without food. But you should try to take it at about the same time each day. You should always swallow Xeljanz XR whole — never cut, chew, or crush the tablets.
Ulcerative colitis
The initial Xeljanz dosage for ulcerative colitis (UC) is 10 mg by mouth twice daily for 8 to 16 weeks (2 to 4 months). If the medication seems to be working well, your prescriber may lower your dose to 5 mg twice daily. This is the recommended maintenance dose. If your symptoms come back, your dose may be raised back to 10 mg twice daily.
The initial Xeljanz XR dosage for UC is 22 mg by mouth once daily for 8 to 16 weeks. If you’re responding well to the medication, your provider may lower this to 11 mg once daily. And if your symptoms return, you might need to go back to the 22 mg daily dosage. Be sure to swallow Xeljanz XR whole, and never cut, chew, or crush the tablets.
With both Xeljanz and Xeljanz XR, you should take the lowest effective dosage needed to treat UC symptoms. It’s not recommended to take the higher dosages (10 mg twice daily or 22 mg once daily) long term. What’s more, if you’re not responding well to the initial dose after 16 weeks, you shouldn’t keep taking it. You and your prescriber should explore alternative treatments.
What’s the typical Xeljanz dosage for children?
In children ages 2 and older, Xeljanz is approved for treating polyarticular course juvenile idiopathic arthritis. Xeljanz XR isn’t approved for use in children.
The typical children’s Xeljanz dosage is based on body weight, as listed in the table below.
Child’s body weight | Recommended Xeljanz dosage |
|---|---|
22 lbs (10 kg) to less than 44 lbs (20 kg) | Oral solution: 3.2 mg (3.2 mL) by mouth twice daily Tablets: Do not use |
44 lbs (20 kg) to less than 88 lbs (40 kg) | Oral solution: 4 mg (4 mL) by mouth twice daily Tablets: Do not use |
88 lbs (40 kg) or more | Oral solution: 5 mg (5 mL) by mouth twice daily Tablets: 5 mg (1 tablet) by mouth twice daily |
Xeljanz tablets and oral solution can be taken with or without food. Don’t refrigerate Xeljanz solution. And be sure to throw away the bottle once it’s been opened for 60 days (even if there’s medication left over).
If you’re giving your child the solution, use the dosing syringe that comes with the medication to measure it. If you lose the syringe, ask your pharmacist for a replacement device. Don’t use household spoons to measure liquid Xeljanz doses. This could result in giving too much or too little medication.
Are there any dosage adjustments for health conditions?
Your Xeljanz dosage may need to be adjusted in certain situations. If you have kidney problems, liver problems, or low white blood cell counts, you may need a lower dosage. If you take certain medications that interact with Xeljanz, you might also need a lower Xeljanz dosage.
Your prescriber will be in charge of determining if you need a different Xeljanz dosage. Follow their instructions carefully, and go for any recommended blood tests. Don’t make changes to your Xeljanz dosage on your own.
People with kidney problems
If you have moderate or severe kidney problems, your dose of Xeljanz or Xeljanz XR may be reduced by about half.
People taking Xeljanz 5 mg twice a day may take 5 mg once a day instead. If you’re taking Xeljanz XR 11 mg once a day, you may need to switch to Xeljanz IR tablets and take 5 mg once a day.
People with liver problems
If you have moderate liver problems, your dosage may be reduced by about half, similar to what’s discussed above for people with kidney problems. If you have severe liver problems, you shouldn’t take Xeljanz.
People taking certain medications that interact with Xeljanz
Several medications interact with Xeljanz. In some cases, this could mean that you need to take a lower Xeljanz dosage. Examples of medications that have this interaction include oral azole antifungals, such as fluconazole, and macrolide antibiotics, such as clarithromycin.
Similar to kidney or liver problems, it’s recommended to lower the Xeljanz dosage by about half when these interactions happen. Your prescriber may also suggest a different medication to avoid the interaction. Make sure to show your medical care team and pharmacist a current medication list so they can screen for possible interactions.
People with low white blood cell counts
Xeljanz affects parts of your immune system, including white blood cells (WBCs). It’s possible for the medication to lower your WBC counts. In most cases if this happens or if you develop a serious infection, your prescriber will ask you to stop taking Xeljanz until your WBC levels come back up.
However, if you’re taking Xeljanz for UC, recommended dosage changes are a bit different, as outlined in the table below. But, if your WBC levels are dangerously low, your provider may ask you to stop taking Xeljanz.
Current Xeljanz dosage | Recommended dosage change |
|---|---|
10 mg of Xeljanz twice daily | Lower dosage to 5 mg of Xeljanz twice daily |
5 mg of Xeljanz twice daily | Temporarily stop Xeljanz until WBC levels come back up |
22 mg of Xeljanz XR once daily | Lower dosage to 11 mg of Xeljanz XR once daily |
11 mg of Xeljanz XR once daily | Temporarily stop Xeljanz until WBC levels come back up |
What happens if you miss a dose of Xeljanz?
If you forget to take a dose of Xeljanz, take it as soon as you remember. But if it’s close to your next dose, skip the missed one. Then, resume your regularly scheduled doses. Don’t take a double dose or an extra dose to make up for a missed dose. This can raise your risk for side effects.
What should you do if you take too much Xeljanz?
If you take too much Xeljanz, you’re more likely to experience side effects, such as headache or diarrhea. Accidentally taking an extra dose or two usually doesn’t cause significant problems. But it’s a good idea to check with your prescriber or pharmacist to understand what to watch for.
Taking excessive or large amounts of Xeljanz hasn’t been well studied. So experts aren’t sure whether this can cause serious problems. Call your prescriber or contact Poison Control at 1-800-222-1222 for next steps. If anything seems severe or life-threatening, call 911 or go to the nearest ER.
How to save on Xeljanz
There are ways to save on Xeljanz and Xeljanz XR, which are only available as brand-name medications. GoodRx can help you navigate between patient assistance programs and copay cards to save money on your prescription.
Save with a copay card. If you have commercial insurance, you may be eligible to pay as little as $0 for Xeljanz or Xeljanz XR using a savings card from the manufacturer.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for the manufacturer’s patient assistance program, which offers the medication free of cost.
The bottom line
The usual adult maintenance dosage of Xeljanz (tofacitinib) is 5 mg by mouth twice a day. The typical adult maintenance dosage of Xeljanz XR is 11 mg once a day. Children’s dosages are based on their body weight.
You may need a lower Xeljanz dosage if you have kidney or liver problems or low white blood cells. You may also need a lower dosage if you take certain medications that interact with Xeljanz. Be sure to follow your prescriber’s instructions. They can help determine the best dose for you.
Why trust our experts?
References
Nemours KidsHealth. (2021). Polyarticular juvenile idiopathic arthritis.
Padda, I. S., et al. (2023). Tofacitinib. StatPearls.
Pfizer Laboratories Division, Pfizer Inc. (2023). Xeljanz - tofacitinib tablet (film coated), tablet (extended release), solution [package insert].
Safe Medication. (n.d.). Measurement of liquid medications.
Was this page helpful?
Related Articles
Browse medications
View AllResearch prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.