Jaknat Tofacitinib 5mg Tablets

Q1: What is Tofacitinib (Jaknat) 5mg used for?

Tofacitinib is a JAK (Janus kinase) inhibitor approved for rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, and ankylosing spondylitis. In HIV patients, it is used for co-existing inflammatory conditions like rheumatoid arthritis, requiring careful coordination with antiretroviral therapy.

Q2: How does Tofacitinib reduce inflammation?

Tofacitinib selectively inhibits JAK1 and JAK3 enzymes, blocking JAK-STAT signaling pathways critical for pro-inflammatory cytokine production (IL-6, IL-2, IFN-γ). This reduces T-cell activation, B-cell activity, and inflammatory cascades driving autoimmune joint destruction.

Q3: What is the standard dose of Tofacitinib 5mg?

For rheumatoid arthritis and psoriatic arthritis: 5mg twice daily (morning and evening). For ulcerative colitis: 10mg twice daily induction then 5mg twice daily maintenance. Dosing may be adjusted for renal impairment or drug interactions.

Q4: How does Tofacitinib interact with HIV antiretrovirals?

Tofacitinib is metabolised by CYP3A4 and CYP2C19. Strong CYP3A4 inhibitors in HIV regimens (ritonavir, cobicistat) increase Tofacitinib levels — dose reduction to 5mg once daily may be required. Discuss with your HIV specialist before starting.

Q5: What infection risks does Tofacitinib add in HIV patients?

Tofacitinib increases the risk of serious infections including TB reactivation, opportunistic infections, and bacterial/viral infections. In HIV-positive patients this risk is compounded — regular infection screening, TB testing, and adequate CD4 count monitoring are essential.

Q6: What blood clot risk is associated with Tofacitinib?

Tofacitinib at doses of 10mg twice daily is associated with increased risk of deep vein thrombosis and pulmonary embolism. The 5mg twice daily dose carries a lower but real risk. Use with caution in patients with known cardiovascular risk factors.

Q7: What are the most common side effects?

Common side effects include upper respiratory tract infections, nasopharyngitis, diarrhea, headache, and elevated liver enzymes. Neutropenia and anemia can also occur, requiring blood count monitoring.

Q8: What serious side effects require emergency care?

Seek immediate care for: signs of serious infection (high fever, severe chills), thromboembolism (leg swelling, chest pain, shortness of breath), signs of liver damage (jaundice), or GI perforation (sudden severe abdominal pain).

Q9: What TB screening is required before starting Tofacitinib?

All patients must be tested for latent TB before starting Tofacitinib. Positive tests require preventive TB treatment before Tofacitinib is initiated. Annual TB screening during therapy is recommended for high-risk patients.

Q10: What monitoring is required during Tofacitinib treatment?

Complete blood count (including lymphocyte count), liver function tests, lipid profile, and renal function at baseline and every 3 months initially. CD4 count and viral load monitoring continues for HIV management alongside Tofacitinib therapy.

Q11: Can Tofacitinib be taken during pregnancy?

No. Tofacitinib is contraindicated during pregnancy due to fetal harm demonstrated in animal studies. Effective contraception is required during treatment and for at least 4 weeks after stopping.

Q12: Do I need a prescription for Jaknat Tofacitinib?

Yes. Tofacitinib is a prescription-only specialist medicine. In HIV patients, it must be prescribed in close coordination between rheumatology and HIV/infectious disease specialists.