For patients · Medication guide

JAK inhibitors

tofacitinib, baricitinib, upadacitinib, filgotinib, JAKi

Are you a clinician? See the clinical version of this page.

The short versionJAK inhibitors are targeted tablets. They block specific signals inside immune cells that drive inflammation. They are used in rheumatoid arthritis, psoriatic arthritis, and some other conditions, usually when other treatments have not worked well enough.
How you take it

These are targeted tablets (not biologics) taken by mouth that block JAK signals inside cells to reduce inflammation. They often work within a couple of weeks. Because of important safety concerns, your team will review your risk factors and do blood tests first.

Tests while you take it

You will have blood tests before and during treatment (blood counts, liver, and cholesterol). Because of heart, blood-clot, and cancer risks seen mainly in older people with heart-disease risk factors, your team will weigh the risks and watch for warning signs.

What to know

Common side effects

These medicines can make some infections more likely, including shingles. They can also change some blood test results, such as cholesterol and blood counts, which is why regular tests are done.

Tests and monitoring

Before you start, your team checks for hidden infections such as tuberculosis, and does baseline blood tests including blood counts, cholesterol, and liver tests. It helps to be up to date with recommended vaccines beforehand, and if you are 50 or older your team may suggest the shingles vaccine before you start. Live vaccines are usually avoided while you are on treatment. Blood tests continue during treatment.

Important cautions

There are important safety points with this group of medicines. In some people, especially older people and those with heart or clot risks, they can raise the risk of blood clots, heart problems, and certain cancers. Your team weighs these with you before choosing one, and they are not right for everyone. Tell your team before any live vaccine.

+Planning a pregnancy? This medicine has separate, reviewed reproductive-health guidance. See the pregnancy guide for this medicine.
iThis page helps you prepare a conversation with your care team. It does not replace individual medical advice. Always confirm your own plan with your rheumatology team.
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What to watch for