Table 3.
Tofacitinib dose adjustments in special conditions.
| Condition | Value | Recommendation |
|---|---|---|
| Low absolute lymphocyte count (ALC) | ALC ⩾ 750 ALC 500–750 ALC < 500 |
Maintain Reduce to 5 mg twice daily Discontinue |
| Low absolute neutrophil count (ANC) | ANC ⩾ 1000 ANC 500–1000 ANC < 500 |
Maintain Reduce to 5 mg twice daily Discontinue |
| Low hemoglobin value | Decrease ⩽ 2 g/dl and Hb ⩾ 9.0 g/dl Decrease > 2 g/dl or Hb < 8.0 g/dl |
Maintain Interrupt until Hb normalizes |
| Hepatic impairment | Child Pugh A | No dose adjustment |
| Child Pugh B | Reduce to 5 mg once daily if 5 mg twice daily is the indicated dose in the absence of hepatic impairment Reduce to 5 mg twice daily if 10 mg twice daily is the indicated dose in the absence of hepatic impairment |
|
| Child Pugh C | Contraindicated | |
| Renal impairment | Mild: Cr. clearance 50–80 ml/min | No dose adjustment |
| Moderate: Cr. clearance 30–49 ml/min | No dose adjustment | |
| Severe: Cr. clearance < 30 ml/min | Reduce to 5 mg once daily when the indicated dose in the presence of normal renal function is 5 mg twice daily Reduce to 5 mg twice daily when the indicated dose in the presence of normal renal function is 10 mg twice daily Patients with severe renal impairment should remain on a reduced dose even after hemodialysis |
Hb, Hemoglobin; Cr., creatinine.