Tofacitinib (<20 mg daily)/Estrogens Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The combination of estrogens and tofacitinib may make you more likely to have a blood clot.

What might happen:

Your body may form an unwanted blood clot, especially in the lungs, which may be life threatening.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together and if you smoke, have a history of blood clots, problems with your blood, or heart disease; or if you have been confined to a bed or wheelchair. These conditions may also increase your risk of a blood clot. Your doctor may lower the dose or stop your tofacitinib.Let your doctor know right away if you develop pain and/or swelling of an arm or leg with warmth over the area, discoloration of an arm or leg, unexplained shortness of breath, chest pain or discomfort that worsens on deep breathing, unexplained rapid pulse, excessive sweating, and/or numbness on one side of your body.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.European Medicines Agency. Increased risk of blood clots in lungs and death with higher dose of Xeljanz (tofacitinib) for rheumatoid arthritis. https://www.ema.europa.eu/en/documents/press-release/increased-risk-blood- clots-lungs-death-higher-dose-xeljanz-tofacitinib-rheumatoid-arthritis_en. pdf March 20, 2019.
  • 2.European Medicines Agency. Restrictions in use of Xeljanz while EMA reviews risk of blood clots in lungs. https://www.ema.europa.eu/en/documents/referral/xeljanz-article-20-procedu re-restrictions-use-xeljanz-while-ema-reviews-risk-blood-clots-lungs_en.pd f May 17, 2019.
  • 3.Xeljanz (tofacitinib) US prescribing information. Pfizer Inc. July, 2019. 4.USFood and Drug Administration. FDA Drug Safety Communication: Safety trial finds risk of blood clots in the lungs and death with higher dose of tofacitinib (Xeljanz, Xeljanz XR) in rheumatoid arthritis patients; FDA to investigate. https://www.fda.gov/drugs/drug-safety-and-availability/safety-trial-finds- risk-blood-clots-lungs-and-death-higher-dose-tofacitinib-xeljanz-xeljanz-x r February 25, 2019.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.