Xeljanz Price, What Is It? How It Works, Information, a GuidePosted September 9, 2019 by Michael Chamberlain
In this article, we’re going to provide a complete guide for you, with some accurate information on Xeljanz, what it does, how to use it, and how to get it!
Throughout this, we must stress that your doctor should be consulted regarding any change or intentions you have concerning your current medication – or any aspect of your general health.
What Is Xeljanz? Xeljanz is the trade name for the medication Tofacitinib which is used to treat moderate to severely active rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. It is an oral medication that helps to reduce the pain, tenderness, and swelling in the joints associated with the above-mentioned diseases.
In 2012, the Food and Drug Administration (FDA) approved tofacitinib (which is the active ingredient in Xeljanz) to treat severe rheumatoid arthritis (RA) for people who cannot tolerate methotrexate. Xeljanz is also used for reducing the symptoms of ulcerative colitis such as diarrhea, rectal bleeding, and stomach pain.
More than 80 countries approved Xeljanz for the treatment of rheumatoid arthritis (RA). Whereas over 40 countries approved it for the treatment of active psoriatic arthritis (PsA), and 70 countries approved it for the treatment of ulcerative colitis (UC). Now that you know the approval concerns of this medication let’s get into more details.
How Long Does Xeljanz Last?
Xeljanz is a long-term treatment in which many patients notice a positive output (improvement in their body’s condition) within just four weeks of starting the medication. Alongside, patients experience further positive improvements in the first six months of treatment.
How Does Xeljanz Work?
The primary process of how Xeljanz works is by inhibiting the production of cytokines. Cytokines are proteins that help control immune system responses. The production of cytokines is increased when our body fights against infections. What happens in people with RA (rheumatoid arthritis) is the overproduction of cytokines.
This overproduction leads to inflammation and related pain, swelling, and tenderness. What Xeljanz does is disrupts the cell signals in the Janus kinase (JKA) pathways. This will reduce the production of cytokines, thereby reducing inflammation and related pain.
It’s also important to mention that Cytokines include various substances, such as tumor necrosis factor (TNF), interleukins, and transforming growth factor (TGF). These substances play a major role in reducing the pain associated with inflammatory diseases such as RA (rheumatoid arthritis).
Even in patients with psoriatic arthritis and ulcerative colitis, Xeljanz works the same way to lower inflammatory responses that causes their symptoms and related pain.
Due to safety concerns in July 2019, the FDA limited the use of this medication for ulcerative colitis in adults. Now the drug is approved only for adults with ulcerative colitis who tend to experience an inadequate response or are intolerant to tumor necrosis factor (TNF) blockers.
How Many Mg Of Tofacitinib Are There In Xeljanz?
Xeljanz comes in the form of tablets (oral medication). It consists of 5 mg of tofacitinib in one tablet.
How Much Is Xeljanz Without Insurance?
The cost of Xeljanz oral tablet is around $4,686 for a supply of 60 tablets. This will, however, vary depending on the pharmacy you visit.
Is There A Substitute For Xeljanz?
Currently, there are no substitutes or alternatives for Xeljanz. But there are two versions of Xeljanz as “Xeljanz” and “Xeljanz XR”. The only difference between these two versions is the number of time you take it for each day. Xeljanz is taken two times a day with or without food, whereas Xeljanz XR is taken once a day with or without food.
Xeljanz releases medication into the bloodstream over several hours, whereas, Xeljanz XR releases medication into the bloodstream over a day. Xeljanz comes in the form of a 5 mg tablet, whereas Xeljanz XR comes in the form of an 11 mg extended tablet. The other features of these two versions remain the same including the ability to be taken without methotrexate for moderate to severe rheumatoid arthritis.
Does Medicare Pay For Xeljanz?
Yes! Medicare Part D covers 69% of Xeljanz and even Medicare Advantage plans cover this drug. Even many private insurance companies can cover most of the cost of this drug, or the entire cost.
Is there a PAP For Xeljanz?
Pfizer the manufacturers of Xeljanz offers a patience assistance program (PAP) from which patients can receive Xeljanz or Xeljanz XR at no cost. The two main general eligibility to enroll for this program are (1) The enrollee must be uninsured and (2) must be residing in the US or US territory.
Things To Consider Before Taking Xeljanz
Before you take Xeljanz, make sure you talk with your doctor regarding all your concerns including your medical history. You’ll probably be recommended to take blood tests before you are prescribed to take this medication. This is because a blood test will give access to your diseases to find out if the drug is suitable for you.
This includes checking if you have had a history of exposure to tuberculosis (TB) or some forms of hepatitis. And, if you have been exposed to TB, you will be taken through a treatment course for latent (asymptomatic) TB before starting Xeljanz.
Whereas if you have been exposed to hepatitis, the risk of hepatitis being reactivated is high with the use of Xeljanz. So for these situations and if you’re taking any other specific drugs alongside Xeljanz, you will need to have regular blood checks.
How To Take Xeljanz
Xeljanz comes in the form of a tablet which patients can take as a whole with or without food. Patients even have the freedom to take Xeljanz with a combination of a nonbiologic disease-modifying antirheumatic drug (DMARD) such as methotrexate or azathioprine.
But, if Xeljanz is taken as a combination, the dosage will have to be reduced to half than the regular Xeljanz dosage. And at the same time, Xeljanz cannot be used with biologic DMARDs or potent immune suppressants such as cyclosporine.
As a piece of cautionary information, your doctor may interrupt or stop you from taking this medication if you are developing the following conditions:
- Low blood cell counts, which leads to a disease known as anemia
- Low white blood cell counts, which leads to a disease known as neutropenia
- Low lymphocyte count, which leads to a disease known as lymphopenia
- Other severe infections
In pregnant patients, some put forward suggestions of a link between Xeljanz and miscarriages, preterm labor and low birth weight. However, there is no such evidence or enough data to establish a clear link in this scenario.
The National Institutes of Health (NIH) are having an ongoing pregnancy exposure registry that monitors the pregnancy outcomes in patients who take Xeljanz or Xeljanz XR. Pregnant women who are taking this medication can enroll in this program by calling the toll-free number 1-977-311-8972.
As this medication treats many diseases, the dosage depends on what you have, your body condition, and so on. Your doctor may prescribe you Xeljanz or Xeljanz XR. Below is a clear guide on the recommended dosage for both Xeljanz and Xeljanz XR for specific health conditions.
The general dosage for this health condition is Xeljanz 5mg daily or Xeljanz XR 11 mg once daily. Whereas for conditions such as severe renal impairment or moderate hepatic impairment, the recommended dosage is Xeljanz 5 mg once daily.
Psoriatic Arthritis (in combination with nonbiologic DMARDs)
The general dosage for this health condition is Xeljanz 5 mg twice daily or Xeljanz XR 11 mg once daily. Again, for patients with moderate and severe renal impairment or moderate hepatic impairment, the recommended dosage is Xeljanz 5 mg once daily.
For this health condition, the recommended dosage is Xeljanz 10 mg twice daily for at least eight weeks. Followed by 5 mg or 10 mg daily, depending on which is effective (which your doctor will prescribe). However, if you have been taking 10 mg daily for 16 weeks and you don’t see any result or output, talk to your doctor about stopping the drug.
Again for patients with moderate and severe renal impairment or moderate hepatic impairment, the recommended dosage will be half the dose recommended for people with normal liver and kidney function.
People with kidney or any other liver problems will find difficulties in metabolizing Xeljanz. This is where they will have high concentrations of Xeljanz in their blood. Because of this, the doctor will usually prescribe a lower dosage for people who have moderate to severe kidney or liver damage.
Pfizer, the manufacturer of Xeljanz, studied the effectiveness of Xeljanz in patients who took the drug alone and with other DMARD’s such as methotrexate. The study was conducted for six months involving more than 4,200 patients with moderate to severe RA.
In the clinical study, the medication showed a reduction in RA joint pain within as little as two weeks. But the medication may sometimes take three to six months to work for some people.
Whereas in the Oral Solo Study of patients who took Xeljanz without methotrexate, involving about 240 patients resulted in 30% (71 patients) experiencing a 20% reduction in tender and swollen joints two weeks after using Xeljanz. In comparison, in the placebo-controlled study, around 12% (that’s 14 out of 119 patients) experienced the same result as the oral solo study.
Treating rheumatoid arthritis, psoriatic arthritis, or ulcerative colitis by combining tofacitinib with other medication may increase the risk of infection. The packaging of the Xeljanz will recommend a list of medications that should not be mixed with Xeljanz. To give you a better understanding, the following is a list of drugs that should not be mixed with tofacitinib, due to interactions.
- Kineret (anakinra)
- Entyvio (vemdolizumab)
- Remicade (infliximab)
- Actemra (tocilizumab)
- Cosentyx (secukinumab)
- Stelara (ustekinumab)
- Enbrel (etanercept)
- Rituxan (rituximab)
- Humira (adalimumab)
- Simponi (golimimab)
- Orencia (abatacept)
- Cimzia (certolizumab)
- Medications that affect liver enzymes
The above list does not include all the drugs that may interact with Xeljanz. Make sure you tell your doctor about all the supplements, vitamins and any other drugs you are taking before starting Xeljanz.
Effects On Other Treatments
The following are the possible (not limited to) treatments you may have to consider when you’re planning to take Xeljanz.
The best recommendation here is that you discuss any vaccination you are about to take before starting Xeljanz. It’s usually recommended that people on Xeljanz avoid live vaccines such as yellow fever and the same applies to a shingles vaccination (Zostavax). Shingles vaccination are recommended to be taken before starting Xeljanz. Pneumovax (which protects against the most common cause of pneumonia) and yearly flu vaccines and are considered safe while you are on Xeljanz.
Having an operation/surgery
If you ever think of having surgery or if you have recently finished surgery and are on its treatment, you might have to talk about this with your doctor. Most likely, your doctor will recommend you to stop taking this medication before and for some time after the surgery.
Currently, there is no evidence of any interaction that takes place between tofacitinib and alcohol. But if you are going to take it with methotrexate, you should keep up to the recommended limits.
The recommended limit does not exceed 14 units of alcohol per week for adults. This is because methotrexate and alcohol interaction can interact and affect your liver. But again, depending on your body and the related risks your doctor may even recommend lower limits that are below 14 units of alcohol.
Fertility, pregnancy, and breastfeeding
Like I already mentioned above, there is very little evidence on how this drug works while you’re pregnant or trying for a baby. There is also no information on whether the use of Xeljanz will affect male or female fertility. Because of this, you should avoid taking this drug and even your doctor will not prescribe it if you’re planning for a baby. Women who can become pregnant are advised to use effective contraception while on tofacitinib and are recommended to continue it for at least four weeks after stopping Xeljanz.
Generally taking Xeljanz can even affect treatments for infection, lung disease, hepatitis or other liver problems, kidney disease, heart problems, high blood pressure, high cholesterol, stomach ulcers, and cancer. So, make sure any treatments you are currently taking is specified to your doctor before you start taking Xeljanz.
So, to close…
If you have any questions about how Prescription Hope can help you save money on Xeljanz, Gabapentin or any other drugs that we offer, then visit our website here. If you’re having trouble affording any of the medications you’ve been prescribed, contact us, or visit the enrollment page to create an account and fill out an application to start saving.