Tofacitinib 5 mg Tablets: Comprehensive Overview of Side Effects and Management

Tofacitinib is a medication used to treat conditions such as rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. However, like any other medication, it can come with a range of side effects. This article provides a detailed overview of the side effects associated with tofacitinib 5 mg tablets, along with management strategies.

Side Effects

Common and Very Common Side Effects

Common or very common side effects include:

Thymia (Feeling weak or exhausted) Cough Diarrhea Headache Increases in blood pressure (Hypertension) Feeling sick General discomfort in the stomach (Gastrointestinal discomfort and disorders) Fatigue Fever Joint pain or swelling (Joint disorders) Nausea Swelling in the extremities (Peripheral edema) Skin reactions (such as rashes or itching) Vomiting

Uncommon Side Effects

Uncommon side effects include:

Decreased white blood cells (Leucocytes) Dehydration High cholesterol (Dyslipidemia) Difficulty breathing (Dyspnoea) Liver fat accumulation (Hepatic steatosis) Negative effects on sleep (Insomnia) Sprains (Ligament sprain) Twisting or pulling injuries to muscles (Muscle strain) Musculoskeletal pain Blood clots (Thrombosis) Neoplastic changes (Changes in tissue that may indicate cancer) Decreased white blood cells (Neutropenia) Numbness or tingling sensations (Paraesthesia) Nose congestion (Sinus congestion) Joint or tendon inflammation (Tendinitis) Deep vein thrombosis (DVT) Weight gain

Rare and Very Rare Side Effects

Rare or very rare side effects include:

Severe brain infection (Meningitis) Deep fungal infection (Cryptococcal sepsis)

Side Effects with Unknown Frequency

Side effects with unknown frequency include:

Swelling under the skin (Angioedema) Infection caused by BK virus Deep vein thrombosis (DVT) Severe lung disease (Interstitial lung disease, including fatal cases) Cancer Stomach or blood vessel blockage (Pulmonary embolism) Reactivation of existing infections

Special Considerations

Conception and Contraception

Manufacturers advise using effective contraception during and for at least four weeks after treatment for women who can become pregnant.

Pregnancy and Breastfeeding

Due to potential toxicity in animal studies, manufacturers recommend avoiding tofacitinib during pregnancy and breastfeeding until further research is available.

Hepatic and Renal Impairment

Manufacturers advise caution in patients with moderate hepatic impairment and avoid its use in those with severe impairment. Dose adjustments may be necessary in these cases.

Monitoring and Management

Monitoring patient parameters during and after treatment with tofacitinib 5 mg tablets is crucial to prevent and manage side effects. Regular evaluations include the following:

Monitoring for signs and symptoms of infection: Physicians should regularly observe for any signs of infection in patients. Regular skin examinations: Frequent skin checks are required, especially in patients at a higher risk of developing skin cancer. Periodic liver function tests: Routine monitoring of liver function is essential, particularly after treatment initiation, to detect any liver toxicity. Lymphocyte count: Baseline and periodic monitoring of lymphocyte levels are required to ensure immune function. Neutrophil and haemoglobin levels: Monitoring these parameters regularly, both at start and during treatment, helps in ensuring hemoglobin stability and avoiding neutropenia.

Conclusion

While tofacitinib 5 mg tablets offer significant benefits for patients managing chronic inflammatory conditions, it is essential to be aware of potential side effects and the appropriate monitoring measures to ensure safety and efficacy.