Description
DK
Dr. Daria Kwaśniewska
ESMO Certified Consultant Medical Oncologist
Reviewed June 2026
⚠ Prescription required. For informational purposes only. Meds For Cancer is a Named Patient Program facilitator — not a retail pharmacy. A valid physician prescription is mandatory before any order is processed.
Is Tofanib 5 mg right for your situation?
Review these criteria with your doctor before enquiring✔ You may be a candidate if
- ✓Moderate-to-severe rheumatoid arthritis (RA) with inadequate response to methotrexate or other DMARDs
- ✓Active psoriatic arthritis after inadequate response to at least one DMARD
- ✓Moderate-to-severe active ulcerative colitis (UC) with inadequate response to TNF inhibitor therapy
- ✓Need a WHO-GMP generic alternative to Xeljanz® (Pfizer)
✖ May NOT be suitable if
- ✗Active serious infection, including tuberculosis (TB screening required before starting)
- ✗Age 65+ or history of cardiovascular disease, malignancy, or thrombosis (increased risk warnings)
- ✗Pregnant, planning pregnancy, or breastfeeding
- ✗Severe liver or kidney impairment without dose adjustment
Check Availability & Pricing
Prescription required · Named Patient Program · Worldwide shipping
🛡 WHO-GMP Certified · Prescription verified · Express dispatch
What is Tofanib 5 mg?
Tofanib 5 mg is a generic formulation of Tofacitinib — a first-generation oral JAK (Janus kinase) inhibitor — manufactured by Globe Pharmaceuticals Ltd. under WHO-GMP certified conditions in Bangladesh. Each tablet contains 5 mg of tofacitinib, the same active molecule found in Xeljanz® (Pfizer), and is dispensed under the Named Patient Program for patients with inflammatory autoimmune conditions.
Tofacitinib was the first oral JAK inhibitor approved by the FDA for rheumatoid arthritis, representing a significant shift from injectable biologics to oral targeted therapy for autoimmune disease.
| Generic name | Tofacitinib (citrate) |
| Reference brand | Xeljanz® (Pfizer) |
| Manufacturer | Globe Pharmaceuticals Ltd. |
| Standard | WHO-GMP Certified |
| Drug class | JAK Inhibitor (JAK1/JAK3) |
| Dosage form | Tablet — 5 mg |
| Pack size | 30 tablets per pack |
| Route | Oral · twice daily (RA/PsA) or as directed |
| Prescription | Required — physician only |
How Tofacitinib Works
In autoimmune conditions like RA, the immune system is overactivated — producing excessive inflammatory cytokines (chemical messengers like IL-6, IL-2, interferons) that drive joint inflammation and damage. These cytokines signal through JAK proteins to activate immune cells.
Tofacitinib selectively inhibits JAK1 and JAK3 — key enzymes in the intracellular signalling cascade that translates cytokine signals into inflammatory action. By blocking these enzymes, tofacitinib reduces the production and activity of multiple pro-inflammatory cytokines simultaneously, providing broad immunomodulatory effect without the need for injections. It is indicated for use as monotherapy or in combination with methotrexate, and NCCN guidelines include it for relevant inflammatory indications. View ACR RA Guidelines →
What to Expect: First 30 Days
Tofacitinib typically begins showing symptomatic benefit within 2–4 weeks, faster than many conventional DMARDs.
- Before starting: TB screening, hepatitis B/C testing, and a complete blood count are required. Vaccinations should be updated — live vaccines cannot be given during treatment.
- Weeks 1–2: Some patients notice reduced joint stiffness and pain fairly quickly. Mild side effects like headache or upper respiratory infections may emerge early.
- Weeks 3–4: Haematological monitoring (neutrophils, lymphocytes, haemoglobin) begins. Most patients experience a meaningful reduction in inflammatory markers (CRP, ESR) by the end of the first month.
Side Effects
Tofacitinib carries FDA boxed warnings for serious infections, malignancy, major cardiovascular events (MACE), and thrombosis — particularly in patients aged 50+ with cardiovascular risk factors.
Common · Usually Manageable
- Upper respiratory tract infections
- Headache
- Diarrhoea
- Nasopharyngitis
- Elevated cholesterol
- Hypertension
Serious · Report Immediately
- Serious infections (bacterial, viral, fungal, opportunistic)
- Malignancies (lymphoma, lung cancer, other)
- Major cardiovascular events (MACE)
- Deep vein thrombosis / pulmonary embolism
- Gastrointestinal perforation
⚠ Call your doctor immediately if you experience:
- Fever, chills, or signs of serious infection not resolving normally
- Sudden leg swelling/pain, chest pain, or breathlessness (possible clot)
- Severe abdominal pain (possible GI perforation)
How to Take Tofanib 5 mg
Standard dose: 5 mg twice daily for RA and PsA (10 mg twice daily for UC induction, then reducing). Some RA patients aged 65+ or with risk factors may use 5 mg once daily. Always follow your prescribed regimen.
- 1Twice daily, approximately 12 hours apart — consistency helps maintain stable drug levels and reduces fluctuations in immune suppression.
- 2Can be taken with or without food — food does not significantly affect absorption.
- 3Swallow tablets whole with water. Do not crush or chew.
- 4Do not start tofacitinib during an active infection — contact your doctor if you develop any infection symptoms and discuss whether to pause treatment.
- 5Storage: at room temperature, away from moisture and light, out of reach of children.
Caregiver Guidance
- ♥Watch for infection signs closely — immune suppression means infections can progress more rapidly. Fever, worsening cough, or unusual symptoms warrant prompt medical attention rather than a “wait and see” approach.
- ♥Ensure regular blood monitoring appointments — complete blood counts and lipid panels are required periodically throughout treatment, especially in the first year.
- ♥Keep an updated medication list — tofacitinib interacts with immunosuppressants, certain antifungals, and strong CYP3A4 inhibitors. Any new prescription or supplement should be checked with the treating physician.
If the Medicine Stops Working
Loss of response to tofacitinib can occur over time through poorly understood mechanisms that may involve upregulation of alternative inflammatory pathways. If disease activity worsens despite adequate dosing, your rheumatologist will typically reassess disease activity scores and may switch to a different JAK inhibitor (such as baricitinib or upadacitinib), a biologic DMARD (anti-TNF, IL-6 inhibitor, etc.), or a different therapeutic class depending on your specific disease pattern and prior treatment history.
Frequently Asked Questions
What is the FDA boxed warning on tofacitinib?
The FDA added boxed warnings for serious infections, malignancies, major cardiovascular events (MACE), and thrombosis based on a post-marketing safety study (ORAL Surveillance) that compared tofacitinib with TNF inhibitors in RA patients aged 50+ with cardiovascular risk factors. These risks were higher with tofacitinib in that population. Your physician will weigh these risks against the benefits based on your specific age, cardiovascular history, and disease status before prescribing.
How does tofacitinib compare to baricitinib or upadacitinib?
All three are oral JAK inhibitors used for RA, but they differ in selectivity, dosing frequency, and indications. Tofacitinib (JAK1/JAK3) was first to market and uses twice-daily dosing. Baricitinib (JAK1/JAK2) is once-daily with additional indications including alopecia areata and COVID-19. Upadacitinib (JAK1-selective) is once-daily with the broadest approved indication set including RA, psoriatic arthritis, ankylosing spondylitis, atopic dermatitis, UC, and Crohn’s. The best choice depends on your specific condition, risk profile, and treatment history.
Do I need to stop tofacitinib before surgery?
This is a clinical decision for your physician and surgeon. Generally, tofacitinib is held before elective surgery due to infection and wound healing risk. The timing of interruption depends on the procedure and your disease status. Discuss this with your care team well in advance of any planned procedure.
Can I receive vaccines while taking tofacitinib?
Live vaccines (e.g., MMR, shingles live vaccine, yellow fever) are contraindicated during tofacitinib treatment. Inactivated vaccines (influenza, pneumococcal, COVID-19) are generally recommended and may be administered during treatment, though immune response may be reduced. Aim to complete recommended vaccinations before starting tofacitinib where possible.
Who manufactures Tofanib?
Tofanib is manufactured by Globe Pharmaceuticals Ltd., a Bangladeshi pharmaceutical company operating under WHO-GMP compliant conditions. Globe Pharmaceuticals exports to multiple markets across Asia and Africa under Named Patient Program and similar frameworks.
How do I order Tofanib through Meds For Cancer?
Contact us via WhatsApp (+880 130 449 8958) or email (info@medsforcancer.com) with your physician’s prescription specifying your diagnosis and the prescribed dose. Our team will verify the prescription, confirm availability and pricing for your country, and arrange secure international shipping under the Named Patient Program.
🛡 Named Patient Program — Regulatory Framework
Meds For Cancer operates as a Named Patient Program (NPP) facilitator. Under this framework, WHO-GMP certified medicines are made available to individual patients with a confirmed medical need and a valid prescription, in countries where the branded product is unavailable or unaffordable.
This service does not constitute retail pharmacy dispensing. A prescription review is mandatory before any order is processed.
Clinical References
- Fleischmann R, et al. Tofacitinib as monotherapy in patients with active rheumatoid arthritis (ORAL Solo). Arthritis Rheum 2012;64:2836–2846.
- Ytterberg SR, et al. Cardiovascular outcomes with tofacitinib in RA (ORAL Surveillance). NEJM 2022;386:316–326.
- ACR Clinical Practice Guidelines: Management of Rheumatoid Arthritis. Arthritis Rheumatol 2021;73:1108–1123.
- FDA Prescribing Information: Xeljanz (tofacitinib). Pfizer, 2023.
