Correct usage and dosage of tofacitinib/Shangjie

The usage and dosage of Tofacitinib/Shangjie (Tofacitinib) vary significantly depending on the disease type, treatment stage and dosage form. Therefore, clinical application must be strictly implemented in accordance with professional guidelines. The drug's mechanism works on the JAK pathway, so precise control of dosage is critical for both efficacy and safety, especially when managing patients with chronic diseases who have chronically active immune responses.

For adult patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, the conventionally recommended dosage is 5 mg tofacitinib tablets twice daily; if a sustained-release dosage form is used, 11 mg once daily can meet the stable release requirements. This dosage form provides a more convenient option for patients who are unable to take medication in divided doses on time for a long time, which can reduce missed doses and improve treatment compliance.

For ulcerative colitis, due to different disease characteristics, a relatively stronger inhibitory effect is usually required in the early stage of treatment. Therefore, it is recommended to administer 10 mg twice a day during the induction period for at least 8 weeks; if satisfactory relief is achieved, it can be adjusted to 5 mg twice a day or a sustained-release dosage form of 11 mg once a day for maintenance. During treatment, it is necessary to judge whether to extend the induction period based on individual response, but the longest is generally not recommended to exceed 16 weeks.

In children with polyarticular juvenile idiopathic arthritis, tofacitinib is administered as an oral solution in doses based primarily on body weight, e.g., 10–20 kg 3.2 mg each time, 20–40 kg 4 mg each time, and 40 kg For children above, the dosage is close to that of adults. This type of dosage design aims to take into account pharmacokinetic characteristics so that children can obtain sufficient immunomodulatory effects within a safe range.

Different dosage forms of tofacitinib are not interchangeable, especially the extended-release formulation and oral solution are not equivalent. If you need to switch from the regular tablets to the extended-release version, you should start taking the corresponding dose of the extended-release tablets the day after the last dose of the regular tablets. In addition, patients should avoid increasing or decreasing the dose on their own while taking the medication or taking it with immunosuppressive drugs without notifying their doctor to avoid increasing the risk of adverse reactions.

Reference:https://www.xeljanz.com/