What is the difference between TACROLIMUS and Tofacitinib?

TACROLIMUS is a Immunosuppressant and Tofacitinib is a JAK Inhibitor. They reach a similar treatment goal through different pharmacological mechanisms, which is why one may be tolerated by a patient who could not tolerate the other.

Can TACROLIMUS and Tofacitinib be used for the same conditions?

Both medications are prescribed for overlapping indications including 1 INDICATIONS AND USAGE Tacrolimus capsules are calcineurin-inhibitor immunosuppressant indicated for the prophylaxis of organ rejection in adult patients receiving allogeneic liver and kidney or heart transplants and pediatric patients receiving allogeneic liver transplants in combination with other immunosuppressants. ( 1.1 ) 1.1 Prophylaxis of Organ Rejection in Kidney. Always verify with your prescriber and the current FDA label before switching.

Is Tacrolimus the same as Xeljanz?

No. Tacrolimus (TACROLIMUS) and Xeljanz (Tofacitinib) are distinct medications. They are sometimes confused because of similar branding or because they treat overlapping conditions, but they have different active ingredients and different safety profiles.

Which has fewer side effects, TACROLIMUS or Tofacitinib?

Side-effect frequency varies by individual. The side-effect comparison section on this page shows FAERS-reported events for each drug side by side. FAERS is voluntary reporting, so it reflects what patients and clinicians chose to report, not absolute population risk.

Can I switch from TACROLIMUS to Tofacitinib?

Switching medications should always be done under prescriber supervision. The "patient stories" section on this page includes accounts from people who have made the switch and what their transition felt like, but those are individual experiences, not protocols.

TACROLIMUS vs Tofacitinib

Compare TACROLIMUS (Tacrolimus) and Tofacitinib (Xeljanz) — clinical data, side effects, and patient experiences.

TACROLIMUS

Tacrolimus · Immunosuppressant

How it works

12.1 Mechanism of Action Tacrolimus binds to an intracellular protein, FKBP-12. A complex of tacrolimus-FKBP-12, calcium, calmodulin, and calcineurin (a ubiquitous mammalian intrac...

Approved for

1 INDICATIONS AND USAGE Tacrolimus capsules are calcineurin-inhibitor immunosuppressant indicated for the prophylaxis of organ rejection in adult patients receiving allogeneic liver

kidney or heart transplants and pediatric patients receiving allogeneic liver transplants in combination with other immunosuppressants. ( 1.1 ) 1.1 Prophylaxis of Organ Rejection in Kidney

Liver or Heart Transplant Tacrolimus capsules are indicated for the prophylaxis of organ rejection

in adult patients receiving allogeneic kidney transplant [ see Clinical Studies (14.1) ]

OralTablet

Tofacitinib

Xeljanz · JAK Inhibitor

How it works

Inhibits Janus kinases JAK1 and JAK3, modulating the signalling of interleukins and interferons involved in immune and inflammatory pathways.

Approved for

Rheumatoid Arthritis

Psoriatic Arthritis

Ulcerative Colitis

FDA: 2012OralTablet, Extended-release tablet

Quick Comparison

TACROLIMUSTofacitinib

Drug Class

Immunosuppressant

JAK Inhibitor

Route

Oral

Half-Life

—

FDA Approved

—

2012

Side Effect Frequency Comparison

Estimated frequency (%) based on clinical trial data

Side Effects

TACROLIMUS

Drug Not Working

>10%

Diarrhea

1-10%

Fever

1-10%

Tofacitinib

Drug Not Working

>10%

Joint Pain

1-10%

Condition Worsened

1-10%

Fatigue

1-10%

Headache

1-10%

Rash

0.1-1%

General Unwellness

0.1-1%

Limb Pain

0.1-1%

FDA Warnings

TACROLIMUS

5 WARNINGS AND PRECAUTIONS Not Interchangeable with Extended Release Tacrolimus Products-Medication Errors : Instruct patients or caregivers to recognize the appearance of tacrolimus capsules
5 ) Neurotoxicity: Including risk of Posterior Reversible Encephalopathy Syndrome (PRES), monitor for neurologic abnormalities; reduce or discontinue tacrolimus
9 ) Not recommended for use with sirolimus: Not recommended in liver and heart transplant due to increased risk of serious adverse reactions
1 Lymphoma and Other Malignancies Patients receiving immunosuppressants, including tacrolimus, are at increased risk of developing lymphomas and other malignancies, particularly of the skin

Tofacitinib

Black Box: Serious infections, mortality, malignancy, MACE, thrombosis
Lymphoma risk

Clinical Trial Data

No head-to-head clinical studies found for TACROLIMUS vs Tofacitinib.

TACROLIMUS vs Tofacitinib: What You Should Know

Key Differences

TACROLIMUS is a Immunosuppressant, while Tofacitinib belongs to the JAK Inhibitor class. This means they work through different pharmacological mechanisms, which may influence both efficacy and side effect profiles.

Safety Considerations

TACROLIMUS carries 4 FDA warnings. Tofacitinib carries 2 FDA warnings. Patients should discuss all warnings and contraindications with their healthcare provider before starting or switching medications..

This comparison is for informational purposes only. Always consult a qualified healthcare professional before making medication decisions.

Related Comparisons

EVEROLIMUS vs TACROLIMUS→SIROLIMUS vs TACROLIMUS→CYCLOSPORINE OPHTHALMIC SOLUTION vs TACROLIMUS→CYCLOSPORINE vs TACROLIMUS→MYCOPHENILIC ACID vs TACROLIMUS→AZATHIOPRINE vs TACROLIMUS→

Primary sources

Every figure on this comparison links back to its primary source. See data sources and methodology for the full provenance trail.

TACROLIMUS: DailyMed label · FAERS adverse events · ClinicalTrials.gov
Tofacitinib: DailyMed label · FAERS adverse events · ClinicalTrials.gov

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TACROLIMUS vs Tofacitinib

Compare TACROLIMUS (Tacrolimus) and Tofacitinib (Xeljanz) — clinical data, side effects, and patient experiences.

TACROLIMUS

Tacrolimus · Immunosuppressant

How it works

12.1 Mechanism of Action Tacrolimus binds to an intracellular protein, FKBP-12. A complex of tacrolimus-FKBP-12, calcium, calmodulin, and calcineurin (a ubiquitous mammalian intrac...

Approved for

1 INDICATIONS AND USAGE Tacrolimus capsules are calcineurin-inhibitor immunosuppressant indicated for the prophylaxis of organ rejection in adult patients receiving allogeneic liver

kidney or heart transplants and pediatric patients receiving allogeneic liver transplants in combination with other immunosuppressants. ( 1.1 ) 1.1 Prophylaxis of Organ Rejection in Kidney

Liver or Heart Transplant Tacrolimus capsules are indicated for the prophylaxis of organ rejection

in adult patients receiving allogeneic kidney transplant [ see Clinical Studies (14.1) ]

OralTablet

Tofacitinib

Xeljanz · JAK Inhibitor

How it works

Inhibits Janus kinases JAK1 and JAK3, modulating the signalling of interleukins and interferons involved in immune and inflammatory pathways.

Approved for

Rheumatoid Arthritis

Psoriatic Arthritis

Ulcerative Colitis

FDA: 2012OralTablet, Extended-release tablet

Quick Comparison

TACROLIMUSTofacitinib

Drug Class

Immunosuppressant

JAK Inhibitor

Route

Oral

Half-Life

—

FDA Approved

—

2012

Side Effect Frequency Comparison

Estimated frequency (%) based on clinical trial data

Side Effects

TACROLIMUS

Drug Not Working

>10%

Diarrhea

1-10%

Fever

1-10%

Tofacitinib

Drug Not Working

>10%

Joint Pain

1-10%

Condition Worsened

1-10%

Fatigue

1-10%

Headache

1-10%

Rash

0.1-1%

General Unwellness

0.1-1%

Limb Pain

0.1-1%

FDA Warnings

TACROLIMUS

5 WARNINGS AND PRECAUTIONS Not Interchangeable with Extended Release Tacrolimus Products-Medication Errors : Instruct patients or caregivers to recognize the appearance of tacrolimus capsules
5 ) Neurotoxicity: Including risk of Posterior Reversible Encephalopathy Syndrome (PRES), monitor for neurologic abnormalities; reduce or discontinue tacrolimus
9 ) Not recommended for use with sirolimus: Not recommended in liver and heart transplant due to increased risk of serious adverse reactions
1 Lymphoma and Other Malignancies Patients receiving immunosuppressants, including tacrolimus, are at increased risk of developing lymphomas and other malignancies, particularly of the skin

Tofacitinib

Black Box: Serious infections, mortality, malignancy, MACE, thrombosis
Lymphoma risk

Clinical Trial Data

No head-to-head clinical studies found for TACROLIMUS vs Tofacitinib.

TACROLIMUS vs Tofacitinib: What You Should Know

Key Differences

Safety Considerations

This comparison is for informational purposes only. Always consult a qualified healthcare professional before making medication decisions.