ngi, or viruses that can spread throughout the body. Some people have died from these infections.
•Your healthcare provider should test you for TB before starting XELJANZ.
•Your healthcare provider should monitor you closely for signs and symptoms of TB infection during treatment with XELJANZ.
You should not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay.
Before starting XELJANZ, tell your healthcare provider if you:
•think you have an infection or have symptoms of an infection such as:
◦fever, sweating, or chills
◦muscle aches
◦cough
◦shortness of breath
◦blood in phlegm
◦weight loss
◦warm, red, or painful skin or sores on your body
◦diarrhea or stomach pain
◦burning when you urinate or urinating more often than normal
◦feeling very tired
•are being treated for an infection
•get a lot of infections or have infections that keep coming back
•have diabetes, HIV, or a weak immune system. People with these conditions have a higher chance for infections.
•have TB, or have been in close contact with someone with TB
•live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis). These infections may happen or become more severe if you use XELJANZ. Ask your healthcare provider if you do not know if you have lived in an area where these infections are common.
•have or have had hepatitis B or C
After starting XELJANZ, call your healthcare provider right away if you have any symptoms of an infection. XELJANZ can make you more likely to get infections or make worse any infection that you have.
2. Cancer and immune system problems.
XELJANZ may increase your risk of certain cancers by changing the way your immune system works.
•Lymphoma and other cancers can happen in patients taking XELJANZ. Tell your healthcare provider if you have ever had any type of cancer.
•Some people who have taken XELJANZ with certain other medicines to prevent kidney transplant rejection have had a problem with certain white blood cells growing out of control (Epstein Barr Virus-associated post transplant lymphoproliferative disorder).
3. Tears (perforation) in the stomach or intestines.
•Tell your healthcare provider if you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking XELJANZ get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.
•Tell your healthcare provider right away if you have fever and stomach-area pain that does not go away, and a change in your bowel habits.
4. Changes in certain laboratory test results. Your healthcare provider should do blood tests before you start receiving XELJANZ and while you take XELJANZ to check for the following side effects:
• changes in lymphocyte counts. Lymphocytes are white blood cells that help the body fight off infections.
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