What is the drug Xeltin used for?

October 6, 2025 •

2 min read

As a type of Janus kinase (JAK) inhibitor, the drug Xeltin (tofacitinib) works by modulating the body's immune system to reduce inflammation in patients with specific autoimmune conditions. This medication is most commonly prescribed for adults who have not responded adequately to or cannot tolerate other, first-line treatments for their condition.

Quick Summary

Xeltin is a brand name for the prescription medication tofacitinib, a Janus kinase (JAK) inhibitor used to treat several inflammatory and autoimmune diseases. Its applications include moderate to severe rheumatoid arthritis, active psoriatic arthritis, and ulcerative colitis in adult patients, particularly when other treatments have failed. It is also approved for polyarticular juvenile idiopathic arthritis in children.

Key Points

Drug Identity: Xeltin is a brand name for tofacitinib, a medication also marketed as Xeljanz.
Primary Uses: It is used to treat moderate to severe rheumatoid arthritis, psoriatic arthritis, ulcerative colitis in adults, and polyarticular juvenile idiopathic arthritis (pcJIA) in children over 2.
Treatment Context: Xeltin is often reserved for patients who have not responded well to or tolerated other disease-modifying antirheumatic drugs (DMARDs) or TNF inhibitors.
Mechanism of Action: It functions as a Janus kinase (JAK) inhibitor, blocking specific enzymes to interrupt the inflammatory signaling pathways of the immune system.
Significant Risks: The drug carries a Boxed Warning for serious infections, cancer, cardiovascular events, blood clots, and mortality, requiring close patient monitoring.
Common Side Effects: Common adverse effects include upper respiratory infections, headaches, and diarrhea.

Understanding Xeltin: A JAK Inhibitor

Xeltin is a brand name for the active ingredient tofacitinib, also known by the U.S. brand name Xeljanz. It is a Janus kinase (JAK) inhibitor, which is a type of targeted synthetic disease-modifying antirheumatic drug (tsDMARD). JAK inhibitors work by blocking specific enzymes involved in the inflammatory signaling pathway, thereby reducing the overactive immune response in various autoimmune conditions.

Primary Indications for Xeltin

Xeltin is prescribed for chronic inflammatory conditions when patients have not responded well to or cannot tolerate other treatments. Approved uses include treating moderate to severe rheumatoid arthritis and psoriatic arthritis in adults, moderately to severely active ulcerative colitis in adults, and active polyarticular juvenile idiopathic arthritis in children.

Administration

Xeltin is an oral tablet taken with or without food. The administration schedule is determined by a healthcare professional and varies depending on the specific condition being treated and individual patient factors.

Significant Side Effects and Risks

Xeltin carries an FDA Boxed Warning due to potential serious side effects: Serious infections (bacterial, viral, fungal), including tuberculosis and shingles. Increased risk of death in patients over 50 with at least one cardiovascular risk factor. Increased risk of certain cancers, such as lymphoma, lung, and skin cancers. Higher risk of major cardiovascular events like heart attack and stroke in certain high-risk patients. Blood clots in the lungs, legs, or arteries. Rare cases of gastrointestinal perforation, especially with concurrent use of NSAIDs, corticosteroids, or methotrexate. Common, less severe side effects include headache, diarrhea, and upper respiratory tract infections.

Comparison of Xeltin (Tofacitinib) with Other DMARDs

Xeltin differs from other DMARDs in its mechanism and place in therapy. Below is a comparison:


Feature	Xeltin (Tofacitinib)	Methotrexate (Conventional DMARD)	Adalimumab (TNF Inhibitor/Biologic)
Drug Class	Janus kinase (JAK) Inhibitor	Antimetabolite/DMARD	TNF Inhibitor/Biologic
Mechanism	Targets and blocks specific Janus kinase enzymes, reducing cytokine signaling and inflammation.	Interferes with cell proliferation and modulates the immune system on a broader level.	Binds to and neutralizes tumor necrosis factor-alpha (TNF-alpha), a key inflammatory cytokine.
Formulation	Oral tablet or solution.	Oral tablet, liquid, or injectable.	Subcutaneous injection.
Typical Use	Often used after failure or intolerance of conventional DMARDs like methotrexate and biologics.	First-line therapy for many rheumatic diseases.	Used after failure of conventional DMARDs.
Risk of Infection	Increased risk of serious infections, including TB and shingles.	Increased risk of infections due to general immunosuppression.	Increased risk of serious infections, including TB.

Conclusion

Xeltin (tofacitinib) offers a targeted oral treatment option for specific autoimmune conditions, particularly when other therapies have not been effective. Its action as a JAK inhibitor helps control inflammation, but it is associated with significant risks, including serious infections, cardiovascular events, blood clots, and certain cancers. Patients and physicians must carefully consider these risks against the potential benefits. Regular monitoring is essential throughout treatment. Patients should consult their doctor to determine if Xeltin is appropriate for their individual circumstances, considering their full medical history and risk factors. Further details on tofacitinib are available on resources like MedlinePlus.

Frequently Asked Questions

Xeltin is an oral medication that comes in tablet form. The administration schedule is determined by a healthcare professional and depends on the condition being treated.

Xeltin can be used alone or in combination with nonbiologic DMARDs like methotrexate. However, it is not recommended to be combined with biologic DMARDs or other potent immunosuppressants due to an increased risk of serious infection.

If a dose is missed, it should be taken as soon as remembered. However, if it is close to the time for the next scheduled dose, the missed dose should be skipped to avoid taking a double dose. Patients should follow their healthcare provider's specific instructions.

Yes, the U.S. FDA has issued a Boxed Warning for Xeltin (tofacitinib) regarding the risk of serious infections, increased mortality, cancer, major cardiovascular events, and blood clots.

Xeltin and Xeljanz are both brand names for the active ingredient tofacitinib. The name used can vary by region. For example, Xeljanz is the U.S. brand name, while Xeltin is a brand used in other countries.

While common side effects include headache, diarrhea, and upper respiratory infections, patients should be vigilant for serious side effects. These include signs of serious infection (fever, chills), chest pain, shortness of breath, severe abdominal pain, or symptoms of a stroke.

You should not receive live vaccines while taking Xeltin. Patients should discuss their vaccination schedule with their healthcare provider before and during treatment to avoid potential complications related to the drug's immunosuppressant effects.