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 or low blood cell counts, or if you take interacting medications. Your prescriber will help determine the right dosage for you.
There are 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.
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If you’re living with an autoimmune disorder such as rheumatoid arthritis (RA), the name Xeljanz (tofacitinib) may sound familiar. Xeljanz is an oral Janus kinase (JAK) inhibitor. It’s typically considered if other treatments, such as Humira (adalimumab), aren’t working well enough to manage your symptoms.
Xeljanz comes in immediate-release (IR) and extended-release (ER) dosage forms. IR forms include an oral tablet (called Xeljanz) and grape-flavored solution (liquid). The only ER form available is an oral tablet (called Xeljanz XR).
If you’ve been prescribed Xeljanz, your prescriber likely gave you instructions for taking it. Make sure to follow those instructions, since they are specific to you. But it can also help to know the usual recommended doses. Here, we’ll review the FDA-approved 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 you only need to take Xeljanz XR once a day, while most people take Xeljanz twice a day.
Good to know: If you’re taking Xeljanz XR, you may see what looks like a pill in your stool. This is normal and doesn’t mean your body didn’t absorb the medication. Xeljanz XR tablets have an outer coating that helps release the medication slowly. Your body can’t digest the coating, so it comes out when you have a bowel movement.
Xeljanz dosage for 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.
Xeljanz dosage for 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 temporarily 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 prescriber may lower this to 11 mg once daily. But if your symptoms return, you might need to go back to the 22 mg daily dosage for a short time. 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. Work with your prescriber to explore alternative treatments.
What’s the typical Xeljanz dosage for children?
In children ages 2 and older, Xeljanz is approved for treating polyarticular juvenile idiopathic arthritis. Xeljanz XR isn’t approved for use in children.
Managing side effects: Learn about notable Xeljanz (tofacitinib) side effects — from diarrhea to blood clots — and how to manage them.
Medications to avoid: Read more about which medications interact with Xeljanz and which ones require dosage changes.
Comparing options: Xeljanz is one of several Janus kinase (JAK) inhibitors available. Read about how these medications compare, plus ways you can save on them.
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 to less than 88 lbs (40 kg) | Oral solution: 4 mg (4 mL) by mouth twice daily Tablets: Do not use |
88 lbs or more | Oral solution: 5 mg (5 mL) by mouth twice daily Tablets: 5 mg (1 tablet) by mouth twice daily |
Your child can take Xeljanz tablets or oral solution with or without food. Don’t refrigerate Xeljanz solution. Instead, store the bottle at room temperature and in its original box. 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 and bottle adapter that come with the medication to measure it. If you lose the syringe or adapter, 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 Xeljanz 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 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 determine if you need a different Xeljanz dosage. Follow their instructions carefully, and go for any recommended blood tests. Don’t change your Xeljanz dosage on your own.
Xeljanz dosage for people with kidney problems
If you have moderate or severe kidney problems, your daily dose of Xeljanz or Xeljanz XR may be reduced by about half.
For example, 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. And if you’re taking Xeljanz XR 22 mg once a day, you may need to take Xeljanz XR 11 mg once a day instead.
Xeljanz dosage for 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.
Xeljanz dosage for people taking certain medications that interact with Xeljanz
Several medications interact with Xeljanz. These medications can raise Xeljanz levels in your body. And this can make side effects more likely to happen.
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 (Diflucan), and macrolide antibiotics, such as clarithromycin (Bixain XL).
As with 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.
Xeljanz dosage for people with low blood cell counts
Xeljanz affects parts of your immune system. It’s possible for the medication to lower certain blood counts, including red blood cells (RBCs) and white blood cells (WBCs). If this happens or you develop a serious infection, your prescriber in most cases will ask you to stop taking Xeljanz until your blood count levels come back up.
However, if you’re taking Xeljanz for UC and your WBC is low, recommended dosage changes are a bit different, as outlined in the table below. And if your WBC levels are dangerously low, your prescriber 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 being time for 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.
The risk of 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 available as brand-name medications. GoodRx can help you navigate between copay cards and patient assistance programs 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.
Frequently asked questions
It’s possible for some people to gain weight while taking Xeljanz. One study found that about 1 in 4 people gained 5% or more of their starting body weight after taking Xeljanz for 3 to 6 months. Longer studies are needed to know how likely weight gain is with Xeljanz, especially with long-term use.
No, but they’re similar. Rinvoq (upadacitinib) and Xeljanz are both oral JAK inhibitors. They’re used to treat some of the same autoimmune conditions, including RA and UC. Rinvoq is also approved for eczema and Crohn’s disease. Rinvoq also has slightly different dosage options. Both medications come as once-daily tablets and oral liquids. But Xeljanz also comes in an IR tablet that you typically take twice a day.
You may want to limit or avoid alcohol while taking Xeljanz. There are no direct interactions between the two. But alcohol can worsen certain Xeljanz side effects, such as diarrhea and nausea. Both Xeljanz and alcohol weaken the immune system. Regular or heavy alcohol use can also contribute to inflammation, potentially worsening the condition you’re taking Xeljanz for.
It’s possible for some people to gain weight while taking Xeljanz. One study found that about 1 in 4 people gained 5% or more of their starting body weight after taking Xeljanz for 3 to 6 months. Longer studies are needed to know how likely weight gain is with Xeljanz, especially with long-term use.
No, but they’re similar. Rinvoq (upadacitinib) and Xeljanz are both oral JAK inhibitors. They’re used to treat some of the same autoimmune conditions, including RA and UC. Rinvoq is also approved for eczema and Crohn’s disease. Rinvoq also has slightly different dosage options. Both medications come as once-daily tablets and oral liquids. But Xeljanz also comes in an IR tablet that you typically take twice a day.
You may want to limit or avoid alcohol while taking Xeljanz. There are no direct interactions between the two. But alcohol can worsen certain Xeljanz side effects, such as diarrhea and nausea. Both Xeljanz and alcohol weaken the immune system. Regular or heavy alcohol use can also contribute to inflammation, potentially worsening the condition you’re taking Xeljanz for.
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 extended-release 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 blood cell counts. 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.
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References
Nemours KidsHealth. (2021). Polyarticular juvenile idiopathic arthritis.
MedlinePlus. (2022). Tofacitinib.
Padda, I. S., et al. (2023). Tofacitinib. StatPearls.
Pfizer Laboratories Division of Pfizer. (2025). XELJANZ- tofacitinib tablet, film coated, XELJANZ XR- tofacitinib tablet, film coated, extended release, XELJANZ- tofacitinib solution [package insert].
SafeMedication.com. (n.d.). Measurement of liquid medications. ASHP.
Wollenhaupt, J., et al. (2025). Analysis of the impact of tofacitinib treatment on weight and body mass index in patients with rheumatoid arthritis. ACR Open Rheumatology.
