The Difference Between XELJANZ & XELJANZ XR

The difference is the dosage—XELJANZ XR is the once-daily formulation of XELJANZ. If you're currently taking XELJANZ for rheumatoid arthritis but are interested in a once-daily treatment, talk with your doctor about XELJANZ XR. Learn more about the two with the chart below.

Twice-daily pill Once-daily pill*
5 mg per pill 11 mg per pill
Immediate release tablet that releases medication into the bloodstream over the course of several hours Extended release tablet that releases medication into the bloodstream over the course of a day
Yes Yes

*XELJANZ XR tablets should be swallowed whole and intact. Do not crush, split, or chew.


XELJANZ/XELJANZ XR is a medication called a Janus kinase (JAK) inhibitor. It is used to treat adults with moderately to severely active rheumatoid arthritis (RA) in which methotrexate did not work well. Your healthcare provider can help determine if XELJANZ or once-daily XELJANZ XR is right for you.

For more information, see Is XELJANZ for You?

XELJANZ/XELJANZ XR is the first in a new class of treatments for moderate to severe RA called Janus kinase (JAK) inhibitors. JAK inhibitors work deep inside the cell to disrupt cellular activities that occur in signaling pathways, known as the JAK pathways.

Learn more about the different treatment options and where XELJANZ fits into the mix.

In some patients, XELJANZ can begin to work in as early as 2 weeks to help relieve joint pain and swelling. And, in clinical trials, more than half of XELJANZ patients felt an improvement in RA symptoms at 3 months. Everybody is different though, so your results may differ.

Learn more about how XELJANZ performed in Clinical Trial Results.

XELJANZ has been shown to be effective in slowing the progression of joint damage. In a clinical trial at 6 months, XELJANZ reduced joint damage progression better than methotrexate.

In the ORAL Start Study, XELJANZ patients hadn't taken methotrexate prior to the study. However, XELJANZ is only approved for use in patients for whom methotrexate did not work well. At 6 months, XELJANZ patients got worse by 0.2 units of change on the modified Total Sharp Score (mTSS) scale, while patients taking methotrexate worsened by 0.8. mTSS measures joint damage progression in selected joints of the hands and feet. The higher the amount of change in the mTSS, the more joint damage has progressed.

In the ORAL Scan Study, patients who took XELJANZ and methotrexate had less progression of joint damage after 6 months (0.1) than those who took a placebo and methotrexate (0.5). However, the possibility was high enough that the difference between treatments may have been due to chance alone and not due to XELJANZ, so the results were not considered significant.

Learn how the progression of RA causes joint damage.

The active ingredient in XELJANZ/XELJANZ XR is tofacitinib.

Your healthcare provider should do blood tests before you start receiving XELJANZ/XELJANZ XR, and while you take XELJANZ/XELJANZ XR, to check for the following side effects:

  • changes in lymphocyte counts. Lymphocytes are white blood cells that help the body fight off infections.
  • low neutrophil counts. Neutrophils are white blood cells that help the body fight off infections.
  • low red blood cell count. This may mean that you have anemia, which may make you feel weak and tired.

Your healthcare provider should routinely check certain liver tests.

You should not receive XELJANZ/XELJANZ XR if your lymphocyte count, neutrophil count, or red blood cell count is too low or your liver tests are too high. Your healthcare provider may stop your XELJANZ/XELJANZ XR treatment for a period of time if needed because of changes in these blood test results.

Your healthcare provider should do blood tests to check your cholesterol levels 4-8 weeks after you start XELJANZ/XELJANZ XR, and as needed after that.

XELJANZ/XELJANZ XR is proven to work alone—even without methotrexate. XELJANZ, a JAK inhibitor, has been shown to help reduce pain and swelling in the joints, and to slow the progression of joint damage.

No. XELJANZ/XELJANZ XR cannot be taken with a biologic treatment. Be sure to tell your healthcare provider about all the medicines you take.

For more information, see Rheumatoid Arthritis (RA) Treatment Options.

XELJANZ/XELJANZ XR is taken by mouth. XELJANZ is taken twice daily while XELJANZ XR is taken once daily. XELJANZ/XELJANZ XR can be taken with or without food.

For more information, see What is XELJANZ?

When you take XELJANZ XR, you may see something in your stool that looks like a tablet. This is the empty shell from the tablet after the medicine has been absorbed by your body.

  • Take XELJANZ/XELJANZ XR as prescribed by your healthcare provider.
  • If you take too much XELJANZ/XELJANZ XR, call your healthcare provider or go to the nearest hospital emergency room right away.

You should also take into account the following safety advice:

  • Keep XELJANZ/XELJANZ XR and all medicines out of the reach of children.
  • Do not use XELJANZ/XELJANZ XR for a condition for which it was not prescribed.
  • Do not give XELJANZ/XELJANZ XR to other people, even if they have the same symptoms you have. It may harm them.

For more information, see Safety & Side Effects.

Contact your healthcare provider if you miss a dose or forget to take XELJANZ/XELJANZ XR for an extended period of time.

Keep in mind that everybody is different. If you are not getting the results you expected, talk with your healthcare provider. Together you can determine if changing your course of treatment might be an appropriate step.

To help you determine how XELJANZ is working, see Tracking Your Progress.

  • Create daily reminders—by using your mobile phone or sticky notes—to help you stay on track. When you register for the XELJANZ+You Support Program, you’ll receive sticky notes and other helpful items like an RA-friendly water bottle as a free gift.
  • Set up alerts to remind you when it’s time to take XELJANZ/XELJANZ XR.
  • Take XELJANZ with your morning and evening meals or before or after you brush your teeth. Take once-daily XELJANZ XR only in the morning or only in the evening.

About Safety

XELJANZ/XELJANZ XR may cause serious side effects, including serious infections, cancer and immune system problems, tears (perforation) in the stomach or intestines, and changes in certain laboratory test results.

These are not all the possible side effects of XELJANZ/XELJANZ XR. To read more, see Safety & Side Effects.

The common side effects of XELJANZ/XELJANZ XR include upper respiratory tract infections (common cold, sinus infections), headache, diarrhea, nasal congestion, sore throat, and runny nose (nasopharyngitis).

These are not all the possible side effects of XELJANZ/XELJANZ XR. To read more, see Safety & Side Effects.

Tell your healthcare provider about any side effects you are experiencing.

You may report side effects to the FDA at 1-800-FDA-1088.

You may also report side effects to Pfizer at 1-800-438-1985.

Before starting XELJANZ/XELJANZ XR, be sure to talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known if XELJANZ/XELJANZ XR will harm an unborn baby. You should use effective birth control while you are taking XELJANZ/XELJANZ XR and for at least 4 weeks after you take your last dose.

Pregnancy Registry: Pfizer has a registry for pregnant women who take XELJANZ/XELJANZ XR. The purpose of this registry is to check the health of the pregnant mother and her baby. If you are pregnant or become pregnant while taking XELJANZ/XELJANZ XR, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at 1-877-311-8972 to enroll.

For more information, see Safety & Side Effects.

Before starting XELJANZ/XELJANZ XR, you and your healthcare provider should decide if you will take XELJANZ/XELJANZ XR or breastfeed. You should not do both.