Indications of Tofacent 5 mg
Rheumatoid Arthritis: Tofacent 5 mg is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate. It may be used as monotherapy or in combination with methotrexate or other nonbiologic ... Read moreRheumatoid Arthritis: Tofacent 5 mg is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate. It may be used as monotherapy or in combination with methotrexate or other nonbiologic disease-modifying antirheumatic drugs (DMARDs).Psoriatic Arthritis: Tofacent 5 mg is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).Ulcerative Colitis: Tofacent 5 mg is indicated for the treatment of adult patients with moderately to severely active ulcerative colitis (UC).
Theropeutic Class
Immunosuppressant
Pharmacology
Rheumatoid arthritis is an autoimmune disease characterized by a dysregulation of pro-inflammatory cytokines including IL7, IL15, IL21, IL6, IFN-alpha, and IFN-beta. (3) Cytokines signalling results in tissue inflammation and joint damage by stimulating the recruitment and activation of immune cells via the janus kinase signalling pathway.Tofacent 5 mg is a partial and reversible janus kinase (JAK) inihibitor that will prevent the body from responding to cytokine signals. By inhibiting JAKs, Tofacent 5 mg prevents the phosphorylation and activation of STATs. The JAK-STAT signalling pathway is involved in the transcription of cells involved in hematopoiesis, and immune cell function. Tofacent 5 mg works therapeutically by inhibiting the JAK-STAT pathway to decrease the inflammatory response. However, there is evidence to suggest that it may also achieve efficacy via other pathways as well.
Dosage & Administration of Tofacent 5 mg
Rheumatoid Arthritis: Tofacent 5 mg 5 mg twice daily or Tofacent 5 mg 11 mg once daily. Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacent 5 mg 5 mg once daily.Psoriatic Arthritis (in combination with nonbiologic DMARDs): Tofacent 5 mg 5 mg twice daily or Tofacent 5 mg 11 mg once daily. Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacent 5 mg 5 mg once daily.Ulcerative Colitis: Tofacent 5 mg 10 mg twice daily for at least 8 weeks; then 5 or 10 mg twice daily. Discontinue after 16 weeks of 10 mg twice daily, if adequate therapeutic benefit is not achieved. Use the lowest effective dose to maintain response.
Dosage of Tofacent 5 mg
Rheumatoid Arthritis: Tofacent 5 mg 5 mg twice daily or Tofacent 5 mg 11 mg once daily. Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacent 5 mg 5 mg once daily.Psoriatic Arthritis (in combination with nonbiologic DMARDs): Tofacent 5 mg 5 mg twice daily or Tofacent 5 mg 11 mg once daily. Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacent 5 mg 5 mg once daily.Ulcerative Colitis: Tofacent 5 mg 10 mg twice daily for at least 8 weeks; then 5 or 10 mg twice daily. Discontinue after 16 weeks of 10 mg twice daily, if adequate therapeutic benefit is not achieved. Use the lowest effective dose to maintain response.
Interaction of Tofacent 5 mg
Potent inhibitors of Cytochrome P450 3A4 (CYP3A4) (e.g., Ketoconazole)
Recommended dose is Tofacent 5 mg 5 mg once daily: One or more concomitant medications that result in both moderate inhibition of CYP3A4 and potent inhibition of CYP2C19 (e.g., fluconazole)
Recommended dose is Tofacent 5 mg 5 mg once daily Potent CYP inducers (e.g.Rifampin): May result in loss of or reduced clinical response.
Side Effects of Tofacent 5 mg
The most commonly reported adverse reactions during the first 3 months in controlled clinical trials (occurring in greater than or equal to 2% of patients treated with Tofacent 5 mg monotherapy or in combination with DMARDs) were upper respiratory tract infections, headache, diarrhea and nasopharyngitis.
Pregnancy & Lactation
Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Tofacent 5 mg should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.It is not known whether Tofacent 5 mg is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Tofacent 5 mg, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug for the mother
Precautions & Warnings
Serious Infections: Avoid use of Tofacent 5 mg during an active serious infection, including localized infections.
Gastrointestinal Perforations: Use with caution in patients that may be at increased risk.
Laboratory Monitoring: Recommended due to potential changes in lymphocytes, neutrophils, hemoglobin, liver enzymes and lipids.
Immunizations: Live vaccines: Avoid use with Tofacent 5 mg.
Do not initiate Tofacent 5 mg if absolute lymphocyte count <500 cells/mm3, an absolute neutrophil count (ANC) <1000 cells/mm3 or hemoglobin <9 gm/dL.
Storage Conditions
Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.
Use In Special Populations
Pediatric Use: The safety and effectiveness of Tofacent 5 mg in pediatric patients have not been established.Geriatric Use: The frequency of serious infection among Tofacent 5 mg-treated subjects 65 years of age and older was higher than among those under the age of 65. As there is a higher incidence of infections in the elderly population in general, caution should be used when treating the elderly.Moderate and severe renal impairment or moderate hepatic impairment: half the total daily dosage recommended for patients with normal renal and hepatic function.
Drug Classes
Immunosuppressant
Mode Of Action
Rheumatoid arthritis is an autoimmune disease characterized by a dysregulation of pro-inflammatory cytokines including IL7, IL15, IL21, IL6, IFN-alpha, and IFN-beta. (3) Cytokines signalling results in tissue inflammation and joint damage by stimulating the recruitment and activation of immune cells via the janus kinase signalling pathway.Tofacent 5 mg is a partial and reversible janus kinase (JAK) inihibitor that will prevent the body from responding to cytokine signals. By inhibiting JAKs, Tofacent 5 mg prevents the phosphorylation and activation of STATs. The JAK-STAT signalling pathway is involved in the transcription of cells involved in hematopoiesis, and immune cell function. Tofacent 5 mg works therapeutically by inhibiting the JAK-STAT pathway to decrease the inflammatory response. However, there is evidence to suggest that it may also achieve efficacy via other pathways as well.
Pregnancy
Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Tofacent 5 mg should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.It is not known whether Tofacent 5 mg is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Tofacent 5 mg, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug for the mother
Pediatric Uses
Pediatric Use: The safety and effectiveness of Tofacent 5 mg in pediatric patients have not been established.Geriatric Use: The frequency of serious infection among Tofacent 5 mg-treated subjects 65 years of age and older was higher than among those under the age of 65. As there is a higher incidence of infections in the elderly population in general, caution should be used when treating the elderly.Moderate and severe renal impairment or moderate hepatic impairment: half the total daily dosage recommended for patients with normal renal and hepatic function.