The usage, dosage, and special population use of Tofacitinib
Tofacitinib, as a JAK inhibitor, needs to be adjusted according to indications in terms of usage and dosage. Special attention should be paid to liver and kidney function, pregnancy and lactation status when using it in special populations. The following provides a systematic explanation of the standard dosage regimen, adjustment principles, and precautions for special populations.
1. Standard usage and dosage
(1) Rheumatoid arthritis: The recommended dose is 5mg orally twice a day, which can be used in combination with methotrexate. Continuous treatment requires regular evaluation of efficacy and safety.
(2) Psoriatic arthritis: The initial dose for rheumatoid arthritis of the same type can be reduced to 5mg once a day for maintenance once therapeutic effect is achieved.
(3) Ulcerative colitis: Induction therapy with 10mg twice a day for 8 weeks, with effective treatment converted to 5mg twice a day for maintenance.
2. Principle of dose adjustment
(1) Liver dysfunction: Moderate injury (Child Pugh B) should be halved in dosage, and severe injury (Child Pugh C) should be avoided.
(2) Renal insufficiency: moderate injury (eGFR 30-59mL/min) should be adjusted to 5mg once daily, and severe injury (eGFR<30mL/min) should be avoided.
(3) Combination therapy: When used in combination with strong CYP3A4 inhibitors, the dosage should be reduced by 50%, and when used in combination with strong inducers, the efficacy should be monitored.
3. Medication for special populations
(1) Pregnancy period: Animal studies have shown teratogenic risks, and pregnant women should avoid using it. Women of childbearing age should take effective contraceptive measures during medication.
(2) Breastfeeding period: Medication can enter breast milk. Breastfeeding is prohibited during treatment and within 18 hours after discontinuation of medication.
(3) Elderly patients: The risk of infection increases in the population aged 65 and above, and monitoring needs to be strengthened without adjusting the dosage.
(4) Children with idiopathic arthritis aged 2 years and above should adjust their dosage according to their weight.
4. Medication precautions
(1) Infection monitoring: screen tuberculosis and hepatitis B before treatment, and be alert to opportunistic infection during treatment.
(2) Laboratory examination: Regular monitoring of blood routine, liver and kidney function, and timely intervention in case of abnormalities.
(3) Vaccination: Avoid using live vaccines, and inactivated vaccines should be administered 2 weeks before medication.
Disclaimer：《The usage, dosage, and special population use of Tofacitinib》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！