Answer
Aug 19, 2026 - 02:16 PM
While taking Xeljanz or Xeljanz XR (tofacitinib), the main things to avoid are:
- Live vaccines while on treatment. Non-live vaccines can generally be given.
- Certain immune-suppressing medications unless your specialist specifically directs them, particularly biologic DMARDs and potent immunosuppressants such as azathioprine or cyclosporine.
- Drug interactions without checking first. Strong CYP3A4 inhibitors such as ketoconazole and combinations involving fluconazole may require a Xeljanz dose adjustment, while strong CYP3A4 inducers such as rifampin are not recommended with Xeljanz.
- Taking Xeljanz during a serious active infection unless your healthcare provider specifically tells you to continue. Xeljanz suppresses the immune system and can increase the risk of serious infections.
- Smoking, if possible. Current or former smokers taking Xeljanz have an increased risk of certain cancers and major cardiovascular events compared with nonsmokers in the safety data.
- If you're taking Xeljanz XR, don't crush, split, or chew the tablet; swallow it whole.
There are no specific foods you routinely need to avoid; Xeljanz and Xeljanz XR can be taken with or without food.
One particularly important point: before starting any new prescription, antibiotic/antifungal, supplement, or vaccine, tell the prescriber or pharmacist that you're taking Xeljanz so they can check for interactions.
