How long does it take Xeljanz to work?

Medically reviewed by Dr. Jamie Winn
Aug 8, 2023

Xeljanz is an oral medication used to treat certain types of arthritis where your immune system attacks itself and causes pain and stiffness in your joints. It is also commonly used to treat ulcerative colitis which causes inflammation and ulcers on the inner lining of your large intestine. Xeljanz is typically used to treat these conditions if you have tried other medications that either didn’t work or you couldn’t tolerate the side effects.

Xeljanz typically begins to relieve symptoms within 2 weeks for some patients while others make take a few months to see any improvements in their condition. The time it takes to start working will depend on several factors including the condition being treated.

Xeljanz FAQS

What is Xeljanz?

Xeljanz (tofacitinib) is a Janus kinase or JAK inhibitor that is manufactured by Pfizer. It works by blocking enzymes that play a role in activating your body's immune system to help reduce inflammation.

Xeljanz is approved by the U.S. Food and Drug Administration (FDA) to treat adults with certain types of arthritis including active rheumatoid arthritis and active psoriatic arthritis, which is a type of arthritis that some people with psoriasis can develop. It is also used to treat active ulcerative colitis and ankylosing spondylitis, which is an inflammatory condition that can cause some of the bones in your spine to fuse together. In pediatric patients 2 years of age and older, Xeljanz is approved to treat juvenile idiopathic arthritis (JIA).

Xeljanz is typically given if you did not respond to at least one tumor necrosis factor (TNF) blocker such as the biologic Humira (adalimumab). It can be used alone or with other arthritis medications such as Rheumatrex (methotrexate). However, the use of Xeljanz along with biologic disease-modifying antirheumatic drugs (DMARDs) or potent immunosuppressants such as Imuran (azathioprine) and Neoral (cyclosporine) should be avoided as it can increase your risk of serious infections.

What doses of Xeljanz are available?

Xeljanz is available in 5 mg and 10 mg tablets as well as a 1 mg/mL oral solution. Xeljanz XR is available in 11 mg and 22 mg extended-release tablets.

How quickly does Xeljanz work?

For some people, Xeljanz will work very quickly while for others, it may take a lot longer to see any symptom relief. How quickly Xeljanz may work can depend on the condition being treated.

For some adults being treated for rheumatoid arthritis and psoriatic arthritis, Xeljanz can begin to work in as little as 2 weeks. For other adults, it can take up to 4 months before they see improvements in swelling and joint pain.
For adults with ankylosing spondylitis, less than 30% saw significant improvements within 2 weeks. After 16 weeks, this number improved to about 56%.
For adults with ulcerative colitis, Xeljanz typically works quickly. For some, it may take only a few days to see symptom improvement, while most will see improvements within 2 weeks.
For children being treated for juvenile idiopathic arthritis, some saw improvements in their symptoms within 2 weeks of beginning Xeljanz. The majority of children taking Xeljanz saw significant improvement by 18 weeks of treatment with Xeljanz.

How long does Xeljanz stay in your body?

For Xeljanz and Xeljanz oral solution the half-life is about 3 hours while the half-life of Xeljanz XR is around 6 to 8 hours. So Xeljanz and Xeljanz oral solution will be removed from your body after around 15 hours while Xeljanz XR will take 30 to 40 hours to be removed.

How often should you take Xeljanz?

Xeljanz and Xeljanz oral solution are typically taken twice a day, with or without food. If you have kidney or liver problems, your dose may be decreased to once daily.

Xeljanz XR is taken once a day, with or without food. If you have kidney or liver problems, your dose may need to be adjusted as well.

What drug interactions are there with Xeljanz?

When Xeljanz is taken with other medications, it can change how they work or make some side effects more likely or severe. You should ask your healthcare provider if any of the prescription medications, over-the-counter (OTC) drugs, vitamins, or supplements you take may interact with Xeljanz, including:

CYP3A4 inhibitors, including fluconazole which is used to treat fungal infections
CYP3A4 inducers such as rifampin
Immunosuppressant medications such as azathioprine and cyclosporine

What are the side effects of Xeljanz?

The most common side effects of Xeljanz when compared to placebo during clinical trials were:

Upper respiratory tract infection
Nausea
Diarrhea
Common cold symptoms
Increased cholesterol levels
Shingles (herpes zoster infection)
Hypertension (high blood pressure)

Sometimes, Xeljanz can cause more serious side effects, including:

Serious, life-threatening allergic reactions
Increased risk of serious infections
Increased risk of death from cardiovascular events such as heart attack and stroke in people 50 years of age and older who have at least 1 heart-related risk factor
Increased risk of blood clots (thrombosis) and pulmonary embolism
Increased risk of certain cancers including lymphoma, lung cancer, breast cancer, and skin cancer
Holes (perforations) in your stomach or intestines, especially if you take NSAIDs (nonsteroidal anti-inflammatory drugs), corticosteroids, or methotrexate
Low white blood cell (neutrophils or lymphocytes) and red blood cell counts
Liver damage and increased liver enzymes

Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking Xeljanz. You can also read Xeljanz’s prescribing information to learn more. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Are there any precautions with the use of Xeljanz?

You’ll have blood tests before treatment starts to assess your condition and whether the drug is suitable for you. Before beginning Xeljanz, make sure your healthcare provider is aware of your medical conditions, including: