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Will your family have to guess your health care wishes?

2019-03-27T11:01:00

(BPT) – Imagine you are in an accident or a sudden illness leaves you unable to speak for yourself. Your loved one or caregiver may be faced with a difficult decision about whether to continue life-saving measures. How does that person know what to do?

Discuss, decide and document. These are three important steps to take to ensure your future care preferences are known and remove a burden from your family.

According to the Conversation Project, more than 90 percent of people think it’s important to have conversations about end-of-life care with their loved ones, yet less than 30 percent have done so. Planning for major injuries or sudden illness may feel awkward, but timely conversations with family members can ensure your care preferences are honored and that your caregivers don’t have to guess what you might want.

“It’s simpler than you think to get started,” said Dr. Stephanie Peterson, a senior medical director at Optum. “It doesn’t have to be perfect, and you can change it at any time.” Here are a few tips from Peterson:

1) Choose an advocate.

This should be someone who knows you well, is calm in a crisis, understands your preferences, is not afraid to ask questions of care providers and will advocate on your behalf. An advocate can be a close relative or friend, but should be someone who knows you well and someone you trust to follow your wishes.

2) Talk with your advocate and doctor about your future care preferences.

Let your advocate and doctors know what’s most important to you in life. What are the activities and abilities that make life most worth living for you? What are the things that give you comfort when you’re sick? When, if ever, should your advocate decide that it’s time to “let go”? And who else should they include in that decision?

3) Write it down.

Formalize your decisions by putting them in writing. Learn more and find links to worksheets you can fill out at www.optumcare.com/nhdd.

4) Give copies of your plan to your advocate, family members and doctors.

Make sure they are aware of your plan, and take some time to go over the document with them. Update and review the plan whenever your situation or preferences change, and have the document placed in your medical records.

“I have seen firsthand the sense of peace, calm and satisfaction families experience when they know their loved one’s wishes have been fulfilled,” Peterson said. Advance care planning improves quality of life and reduces anxiety. “Don’t make people guess what you want. Make your future care preferences known.”

April 16 is National Healthcare Decisions Day — a time to educate and empower people of all ages to create their advance care plan.


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Mom survey shows taxes a source of anxiety

2019-03-26T08:01:00

(BPT) – Considering all the tasks a mom does, it may not be surprising that more than 40 percent of mothers feel overwhelmed during tax season, according to a new survey of 1,000 moms commissioned by H&R Block. Their largest source of anxiety when it comes to the process of filing their taxes is potentially owing money on their tax return (34 percent). Lynn Ebel — tax attorney, director at The Tax Institute at H&R Block, and mother of two — shared her hard-earned advice for busy moms who still need to file their taxes.

Larger, expanded child tax credit is good news for moms anxious about owing

According to the mom survey, more than two in five moms feel overwhelmed during tax season and their largest source of anxiety about filing their taxes is owing money. The good news, according to Ebel, is that families with children under 17, especially those who claim the standard deduction, are most likely to get a refund bigger than anticipated, unless they had updated their withholding with their employer at the beginning of the year.

“That’s because the child tax credit doubled to $2,000 per child and more families will qualify for it. Fifty-one percent of moms surveyed didn’t know the child tax credit had changed, so this could be a pleasant surprise,” said Ebel.

Moms anxious about paperwork, tax return prep need help their way

Together, four in 10 moms said the largest sources of anxiety are gathering the necessary documents and filling out their actual tax return. Every year, 150 million Americans file taxes and 97 percent of them rely on some type of help. Moms’ needs evolve and so does the kind of help they need and how they get it.

“If moms want help in person, online or virtually, H&R Block is the only tax preparation company to offer complete choice on how you get the tax help you need,” said Ebel. “That could mean dropping off documents at an H&R Block office, uploading files online for a tax expert to complete, stopping in to work with one of our experienced tax professionals, or completing your return yourself with the help you need from a tax professional, whether that’s answering your questions through live chat or reviewing your return and submitting it for you.”

Ebel advises that organizing the necessary documents can make tax prep progress more smoothly, and checking the documents against last year’s return or a customized tax prep checklist can help moms make sure they aren’t missing important documents.

“You can create your own tax prep checklist at hrblock.com/checklist. Remember you’ll also need information that’s not coming in a tax information document, like SSNs for your kids and their daycare’s tax identification number,” said Ebel.

Removing surprises from tax time — including tax prep sticker shock

Taxes are a source of anxiety and stress. Ebel points out this year in particular, moms are worried about how they are impacted by tax reform and what it will mean for their tax refunds. To add to the stress, the tax industry has been slow to evolve to consumers’ needs. A stressful topic and a stodgy industry have created a bad experience for many consumers.

“H&R Block is helping remove stress by providing transparency, starting with price,” said Ebel. “We’re the first major brand to remove the mystery of pricing with our new upfront, transparent pricing. H&R Block clients can know the price before they begin, with price transparency from start to finish, no surprises.”

In an H&R Block office, consumers have three simple steps to know the price before they begin. First, they can determine the base price that matches their personal situation, with categories like W-2 income only, or are paying student loans, are a family or a homeowner. Next, they can determine if they need to file any state returns. They then review a list of what happened in their life during the year. At that point, clients will know their price to have their return prepared.

Doing their taxes may be one more anxiety-inducing item on moms’ overwhelming to-do lists, but Ebel says the upside is significant. It’s not just the chance to get the most out of their tax return, but an annual touchpoint to look at their whole financial picture and plan for the outcome they want next year.

“The key is getting the help and support you need. When you’re a mom, the same things might not work for you anymore and that’s OK. At H&R Block, we can help you how you want and need,” said Ebel.


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DIY nation: Jump-start your next project with these 5 tips

2019-03-26T08:01:00

(BPT) – If you prefer to take on your own home improvement projects instead of hiring professional craftsmen, you’re part of a growing trend.

Americans are increasingly aware of the money they can save by completing their own renovations rather than paying premium prices for the work of others. And that’s reflected in sales figures; not surprisingly, the value of the DIY market rose a full 45 percent between 2012 and 2018, from $30.2 billion to $43.7 billion.

With careful planning and budgeting, DIY projects can be fun, efficient and creatively satisfying while allowing you to customize your finished product to your own tastes.

Is there a new DIY project in your future? If so, consider these tips for forming a workable strategy that ensures you’re prepared for every step of the process.

* Create a wish list. If you’re like most people, you have a list a mile long of the updates or fixes you’d like to make to your home. That ever-evolving wish list is one of the joys (and one of the challenges) of homeownership. Create your own list, then determine which projects you can do on your own and which ones will require professional help. This will give you a starting point.

* Prioritize the projects. Once you have your list, you’ll need to prioritize and decide which projects come first. Take an objective look and assess “need” versus “want” to help you rank order. Improvements may be driven by plans to sell your home, host an upcoming social event or welcome a new family member. Consider all the variables. In a recent Coinstar survey, nearly 40 percent of homeowners’ DIY projects were initiated to increase the value of their home.

* Set budgets. Evaluate your top projects and estimate how much each one will cost. Some may be beyond your budget, some will be surprisingly affordable, and others may be achievable after you save a little money. One funding source you may not have considered is the spare change laying around your house or car. Round it up and you may be surprised how far it goes in financing your project. About half of U.S. homeowners surveyed already use spare change for DIY projects or like the idea of doing so, reports Coinstar.

* Plan time and resources. Before scheduling your DIY project, think about your free time and if your project has a deadline. To what extent are your nights and weekends open? Do you have the skills to get started on your own? Watching a YouTube video may give you that needed knowledge, or you may need the help of family or friends who can complement your skills or assist you in meeting a deadline.

*Get supplies, then jump in. Now that you’ve zeroed in on your project, identified financing and recruited helpers, you’re nearly ready to go. Next, create a supply list of the tools and materials you’ll need. To save money, check with those you know who may be willing to loan you tools or other supplies. Community groups like Nextdoor are also a great resource. When buying new, save receipts in case you purchase the wrong item, don’t like something when you get it home or buy too much.

With a little planning, DIY projects can be cost-effective, fun and truly rewarding to complete. When it comes to financing, don’t forget to cash in spare change at your neighborhood Coinstar kiosk. It’s easy to use and you’ll have the option of getting cash or putting funds onto a no-fee e-gift card for retailers like Amazon.com or Home Depot.


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Simple ways to curb carbs when eating on the go

2019-03-26T07:01:00

(BPT) – Whether you are trying to reduce carbs or eat more protein, eating well on the go can be a challenge.

Quality carbohydrates like whole-grain breads, milk, yogurt, fruits and legumes are an important part of a balanced diet, especially for children and teens. For adults, reducing the amount of empty carbs you eat can be a great way to meet your personal wellness goals. It’s important to replace those carbs with lean meats, healthy fats and nutrient-dense vegetables.

Here are a few simple suggestions to eat on the go while still following your current diet.

Keto-style

A ketogenic diet, also known as keto, is a popular diet that balances protein, fat and carbs roughly in the following breakdown:

* 10 percent or less of their calories from carbs

* 70 to 80 percent of their calories from fat

* 10 to 20 percent of their calories from protein

One good way to follow a ketogenic diet is with a salad starting with a lean meat such as rotisserie-style chicken, turkey breast, steak or roast beef. Add in some veggies like lettuce, spinach and onions. Then top it all off with a dressing that has less than 2 grams of carbs like ranch, savory Caesar, oil and vinegar or Chipotle Southwest.

Carb-conscious

If keto sounds too ambitious for you, there are other simple ways to reduce carbs in your diet, like asking for a lettuce wrap instead of a sandwich. You can make any Subway sandwich into a nutritious salad with five servings of veggies.

Visit subway.com and use the nutrition chart to see how your favorite salad stacks up, or try these favorites:

* “Spicy” Steak Salad: Order a steak salad with your favorite veggies plus jalapenos, shredded Monterey Cheddar and Chipotle Southwest sauce. This has 380 calories, 17 grams of carbs and 21 grams of protein.

* “Cobb-style” Oven Roasted Chicken Salad: Try a salad with oven roasted chicken, guacamole, your favorite veggies and top it off with ranch dressing. This has 420 calories, 20 grams of carbs and 21 grams of protein. You could also add a strip of bacon for an additional 35 calories.

If you’re in the mood for a sub but would like to cut down on carbs, you can always ask to have your bread scooped out.

Quality carbs

Trying to improve the overall nutrition quality in your diet, but don’t want to cut carbs? Try these easy swaps:

* Swap white bread for wheat. Select whole grain-certified 9-Grain Wheat

* Swap sweet sauce for savory. Try mustard, oil and vinegar or mayo

* Swap sweet drinks for water. Choose bottled water or unsweetened fountain drinks


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Professionals today are enrolling in law school to further their careers … not to become lawyers

2019-03-25T08:01:00

(BPT) – A broad range of working professionals today are enrolling in online law schools while simultaneously holding their current positions. They’re pursuing law degrees — in addition to other degrees they’ve already earned — to widen their skills and better understand legal issues impacting their companies.

This recent trend mostly includes professionals who do not want to practice law but want to gain insight into the legal complexities involved in business transactions, regulated industries such as health care or education or in the public sector. They want to broaden perspectives in their own professional lives and benefit the companies where they work.

The American Bar Association reported that in 2018 more than 14 percent of all law students in the U.S. were pursuing master’s degrees or certificate programs in law, rather than the J.D., which means they want to gain legal expertise without practicing law.

For instance, Alex Bauer, an experienced CPA and CFO at Sansum Clinic in Santa Barbara, California, found that the high volume of regulatory and contract issues he faced every day often required legal input that was not readily available. Because legal decisions are essential to his work, waiting for advice from outside counsel slowed down his progress and hampered his efficiency. Bauer considered the option of traditional brick-and-mortar law schools near where he worked but realized he would have to attend classes on a full-time basis. Ultimately, he decided to obtain an online Executive Juris Doctor (EJD) from Concord Law School, part of Purdue University Global, because it offered him the flexibility and accessibility to continue his full-time work along with the legal expertise he was seeking.*

While Bauer doesn’t want to practice law, he did see the value in earning an EJD from Concord to build a solid legal foundation. “Now I know how attorneys think,” said Bauer. By understanding the fundamentals of law, Bauer could speak the same language as attorneys when negotiating with vendors or dealing with regulatory problems and save the company time, he said. “If I encounter some bizarre clause in our negotiations, now I know what that clause means.”

Chris Wojtowicz is another professional who recognized the value of an online EJD. Wojtowicz, who manages international trade compliance at Rice Lake Weighing Systems in Rice Lake, Wisconsin, said that the degree he earned from Concord allows him “to anticipate legal problems before they become problems.”

“I speak attorney,” said Wojtowicz, a licensed customs broker who deals with complex trade and regulatory issues and meets regularly with attorneys representing clients, business partners and government agencies.

These two executives said they could not have attended law school while working full time without the convenience and flexibility of an online option. In fact, they were able to take live courses online, speak with law professors and complete exams online — often at home — while they continued their demanding professions. If they missed a live class, they were able to access a recording. Both professionals feel their legal training clearly enhanced their own efficiency and value to their companies.

For Kevin Marshall, manager of Logistics and Wojtowicz’s supervisor at Rice Lake, Wojtowicz’s legal training has augmented his value as a key professional at the company. “In large part due to his legal training, Chris has been able to expand on his original role to become a very helpful resource for several groups within the company,” Marshall said. “With increasing frequency, we are running into complicated regulations and laws within our global trade and marketing efforts and have found Chris to be an excellent colleague to help us understand and interpret legal language.”

Marshall noted that, over the last year or two, Wojtowicz has helped Rice Lake’s marketing department understand the legal language contained in new data privacy laws such as Canada’s Anti-Spam Legislation and the European General Data Protection Regulation. The company is looking forward to using Wojtowicz’s legal skills in additional areas as opportunities arise, Marshall said.

Concord Law School at Purdue University Global

For those considering pursuit of an executive juris doctor degree, go to www.concordlawschool.edu for more information on their online law degree programs.

For comprehensive consumer information, visit www.ConcordLawSchool.edu/About-Concord-Law-School/Accreditation. Concord Law School cannot guarantee employment or career advancement. These testimonials were obtained by Concord Law School. The views and opinions expressed are those of the individual; student experiences may vary.

* Note that EJD graduates do not qualify to take the bar exam or to be admitted to practice law in any jurisdiction without additional experience, education or petition.


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Celebrate spring with sweet and festive projects for your kids

2019-03-25T08:01:00

(BPT) – Get your kids excited about spring’s arrival and its festive holidays by making fun crafts and sweet treats together. Creating decorations and enjoying fun desserts together is one of the best ways to create lasting family memories. Why not start some new family traditions with your children this spring?

1. Decorate the house for spring

Cut out easy-to-make flower or Easter bunny patterns from colorful construction paper with your kids. Then hang or tape them in your windows for a festive spring look. Make construction or crepe paper chains in bright spring colors together. Stretch them across doorways or along the walls to decorate your porch or the kids’ bedrooms or playroom.

2. Create fun first-day-of-spring and Easter baskets together

Let kids participate in assembling festive Easter baskets to give to other family members, homebound relatives or friends. Supply your children with simple baskets, an assortment of delicious, colorful candies, festive eggs, decorative flowers and other art materials like colored paper to make spring decorations. Encourage them to let their imaginations go wild!

3. Bake spring treats together

Photo courtesy of Love From the Oven.

Nothing is more fun than baking together with your children. Make your favorite sugar cookies, a special cake or a couple of different flavors of cupcakes with different colors of icing. Even the youngest child in the family can help decorate your baked creations with their favorite spring candies for a fun treat to snack on and share with friends. Find unique recipes and loads of candy topping ideas at www.brachs.com.

4. Host a spring party

Invite your friends or family over to celebrate the changing seasons together. Have the kids help you set up easy-to-fix snacks and party games. Fill large plastic eggs with classic, tasty jelly beans such as BRACH’S Classic Jelly Bird Eggs and an assortment of playful and colorful candies, such as SweeTARTS Sour Jelly Beans, then hide them around the house or yard (weather permitting) for your own special Easter egg hunt.

5. Make a spring candy garden

Cover a tray with foil and then let your kids design their own festive spring garden out of green royal icing for the ground and blue icing for lakes or ponds. Use rice cereal treats, graham crackers or other cookies to make walls or other structures, then create candy “flowers” to fill out the garden.

Spring is a wonderful time to celebrate the warmer weather, the return of birds and blooming flowers, and all the fun you can have together, inside and out. Enjoy the season by letting your children be creative and bringing all the sweetness of spring into your home.


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Don’t be left behind – 3 tips to prep for spring

2019-03-25T07:01:00

(BPT) – Warmer weather means not only saying goodbye to the tough winter conditions your car or truck has endured, but also getting your vehicles — and outdoor power equipment — ready for the changing seasons. This is a great opportunity to get outside and tend to the vital cleaning and maintenance that the machines you rely on need to function well year-round.

1. Clean it. Whether we’re talking about your car, truck or outdoor power equipment, like your lawnmower, it could use a thorough cleaning if it endured winter elements or was stuck in your garage.

For your vehicles, this means a complete wash, and making sure to thoroughly clean out the accumulated road salt from your undercarriage and the entire outer surface of your vehicles, plus the interior.

If you ran out of time last fall and did not properly store your lawnmower or other outdoor power equipment, you’re going to have to take extra care getting your equipment out of storage for the first time this year. Clean the dirt, grass or other debris from your machinery before the first use. While cleaning, check for damage or needed repairs that can range from wear on the cord to tightening up nuts or getting the blades sharpened. It’s easier to assess the condition of any vehicle or piece of outdoor power equipment once you’ve gotten the basic cleaning finished.

To clean the insides of any gasoline engines, including vehicles and outdoor power equipment, use STA-BIL 360 Protection at each fill-up to help keep fuel fresh for up to 12 months and to increase your engine’s power and fuel efficiency. STA-BIL 360 Protection prevents corrosion caused by moisture and today’s ethanol blended fuels.

2. Maintain it. Every vehicle and piece of outdoor power equipment you own needs regular maintenance to keep it running smoothly and to prevent problems down the road.

Vehicles require regular maintenance, including oil changes, tire rotations and checking all your fluids — from coolant and power steering to transmission and brake fluid. Test your wiper blades and replace them if winter usage has worn them out. Finally, to reduce the chance of being stuck on the roadside, examine your tires to make sure they not only have enough air, but also have the appropriate amount of tread left.

As for your lawnmower, it requires much of the same maintenance that your car does, although most forget it until it’s too late. First, review the basics. Start by making sure your oil is full and has been changed recently. Check your air filter, because it may have become clogged with leaves from fall’s final mowing. Examine the spark plug, which needs to be changed from time to time. While the spark plug is still disconnected, be sure to look at your blade, because a sharp blade not only cuts better but helps promote a healthy lawn by cutting the grass properly and not tearing it. Lastly, there are few additional things to be aware of if your mower has them — items like drive belts, on both riding mowers and self-propelled mowers, and fuel filters on some models — that can experience wear and may need to be changed.

3. Protect it. UV protection is not just for your skin. While one third of respondents in a recent survey believed that vehicles did not experience UV damage, the sun’s rays can in fact damage any of your vehicle’s rubber, vinyl or plastic surfaces. The truth is, protecting surfaces like your vehicle’s dashboard from sun damage on a regular basis can result in a better-looking, longer-lasting vehicle. This is even more crucial for convertibles and jeeps. 303 Automotive Protectant keeps surfaces appearing newer and prevents cracking and fading.

The majority (52 percent) of people surveyed said they waxed or detailed their vehicle only twice per year, while about 29 percent said they waxed their car monthly. Surprisingly, residents of the Midwest — where extreme weather and road salt can really take its toll on vehicles — are noticeably less likely than people in other regions to detail or wax their cars, with nearly one third of people claiming to do it less than once a year or never. This may be due to the time it takes to get your vehicle waxed. But now there’s an easier solution — 303 Touchless Sealant lasts up to two times longer than traditional wax, and you simply spray it on and rinse for superior water beading and protection against paint fading in minutes.

Spring is all about gearing up for outdoor activities with friends and family. Take a little time to prep your vehicles and outdoor power equipment before warmer weather arrives, and you’ll have a worry-free spring and summer doing all the things you enjoy.


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Tips that may help manage life with a chronic illness

2019-03-24T23:31:00

(BPT) – Content sponsored and provided by Pfizer.

Janet H., a wife and mother from Alabama, had many things to celebrate in her life – two beautiful children, a wonderful husband, her dog Falco, and a rewarding career. She was proud that even with all of this, she was able to achieve her personal goal of staying active. However, she was diagnosed with a chronic disease the week before her 40th birthday.

Janet enjoyed moderate exercise, so when she began to have persistent joint pain and swelling in her knees, she suspected it was from an old injury. After initial visits with an orthopedic specialist, she was referred to a rheumatologist who diagnosed her with moderate to severe rheumatoid arthritis (RA) – a chronic, autoimmune disease of the joints.[i]

“I remember thinking that if this is what 40 is like, I don’t know if I can handle 50,” she says. “I wasn’t sure how RA would affect my life.”

Unfortunately, this story is all too common, as RA impacts approximately 1.3-1.5 million adults in the United States.[ii],[iii] Many living with a chronic condition like RA experience challenges while trying to manage their symptoms, doctor’s appointments, and the daily demands of life. Working toward personal goals can be put on the backburner.

With her rheumatologist, Janet was motivated to find a treatment plan that could help manage her RA symptoms. She was prescribed XELJANZ® (tofacitinib) 5 mg twice daily tablets, an oral medication for adults with moderate to severe RA in whom methotrexate did not work well enough. Janet’s rheumatologist reviewed the side effects of XELJANZ and explained that it is taken twice daily and has a BOXED WARNING for serious infections and malignancies.

XELJANZ/XELJANZ XR can lower the ability of your immune system to fight infections. Some people can have serious infections while taking XELJANZ/XELJANZ XR, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Read more about the Important Safety Information and Indication below.

Within three to six months, Janet felt improvement in her RA symptoms and found herself thinking about ways to become more active. She spoke with her rheumatologist and, together, they came up with exercise goals including yoga classes, cycling, and walking her dog with her husband and children. She also says one of her biggest milestones was walking her daughter down the aisle and gaining a new son-in-law. Eventually, Janet worked with her rheumatologist to switch to a once-a-day version of XELJANZ, called XELJANZ XR extended-release tablets.

Here are some of Janet’s tips to help someone living with a chronic inflammatory illness work toward their personal goals:

  • Plan ahead: Living with a chronic condition can be challenging. Plan ahead when it comes to things like travel or big life events to allow ample time for adjustments and preparation.
  • Partner up: Find a significant other, friend, or sibling who can join you on your journey toward reaching your goals. Sometimes living with a chronic condition requires extra support from others, so having a partner to plan with can help make that support seamless.
  • Consult your doctor: Before considering any new travel or physical activity, make sure to consult your doctor. Discuss your plans and how you and your doctor can work together.

By following these tips, Janet says that she has been able to manage her RA and have time to focus on her family, friends, and herself.

“I hope my story can help other adults who are living with moderate to severe rheumatoid arthritis and inspire them to share their stories,” she says.

To learn more about XELJANZ and hear from others who are living with RA, visit RA.XELJANZ.com.

What is XELJANZ/XELJANZ XR?

XELJANZ/XELJANZ XR (tofacitinib) is a prescription medicine called a Janus kinase (JAK) inhibitor used to treat:

  • Adults with moderately to severely active rheumatoid arthritis in whom methotrexate did not work well
  • Adults with active psoriatic arthritis in which methotrexate or other similar medicines called nonbiologic disease-modifying antirheumatic drugs (DMARDs) did not work well

It is not known if XELJANZ/XELJANZ XR is safe and effective in children or in people with Hepatitis B or C.

XELJANZ/XELJANZ XR is not recommended for people with severe liver problems.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about XELJANZ/XELJANZ XR?

XELJANZ/XELJANZ XR may cause serious side effects, including:

Serious infections. XELJANZ/XELJANZ XR can lower the ability of your immune system to fight infections. Some people can have serious infections while taking XELJANZ/XELJANZ XR, including tuberculosis (TB), and infections caused by bacteria, fungi, 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 and during XELJANZ/XELJANZ XR treatment, and monitor you closely for signs and symptoms of TB infection during treatment.

You should not start taking XELJANZ/XELJANZ XR if you have any kind of infection unless your healthcare provider tells you it is okay. You may be at a higher risk of developing shingles (herpes zoster). People taking the higher dose (10 mg twice daily) of XELJANZ have a higher risk of serious infections and shingles.

Before starting XELJANZ/XELJANZ XR, tell your healthcare provider if you:

  • think you have an infection or have symptoms of an infection, such as fever, sweating, or chills; cough; blood in phlegm; warm, red, or painful skin or sores on your body; burning when you urinate or urinating more often than normal; muscle aches; shortness of breath; weight loss; diarrhea or stomach pain; or feeling very tired
  • are being treated for an infection
  • get a lot of infections or have infections that keep coming back
  • have diabetes, chronic lung disease, 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 in, 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/XELJANZ XR. 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/XELJANZ XR, call your healthcare provider right away if you have any symptoms of an infection. XELJANZ/XELJANZ XR can make you more likely to get infections or make worse any infection that you have.

Cancer and immune system problems. XELJANZ/XELJANZ XR may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers, including skin cancers, can happen in patients taking XELJANZ/XELJANZ XR. People taking the higher dose (10 mg twice daily) of XELJANZ have a higher risk of skin cancers. 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).

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/XELJANZ XR can 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.

Serious allergic reactions have happened in patients taking XELJANZ/XELJANZ XR. If you have swelling of your lips, tongue, throat, or get hives, stop XELJANZ/XELJANZ XR and call your healthcare provider right away.

Changes in certain lab test results. Your healthcare provider should do blood tests before you start receiving XELJANZ/XELJANZ XR, and while you take XELJANZ/XELJANZ XR, to check for the following side effects:

  • Changes in lymphocyte counts. Lymphocytes are white blood cells that help the body fight off infections.
  • Low neutrophil counts. Neutrophils are white blood cells that help the body fight off infections.
  • Low red blood cell count. This may mean that you have anemia, which may make you feel weak and tired.

Your healthcare provider should routinely check certain liver tests.

You should not receive XELJANZ/XELJANZ XR if your lymphocyte count, neutrophil count, or red blood cell count is too low or your liver tests are too high. Your healthcare provider may stop your XELJANZ/XELJANZ XR treatment for a period of time if needed because of changes in these blood test results.

You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests to check your cholesterol levels 4 to 8 weeks after you start XELJANZ/XELJANZ XR, and as needed after that.

What should I tell my healthcare provider before taking XELJANZ/XELJANZ XR?

Before taking XELJANZ/XELJANZ XR, tell your healthcare provider about all of your medical conditions, including if you:

  • have an infection
  • have liver problems
  • have kidney problems
  • have any stomach area (abdominal) pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines
  • have had a reaction to tofacitinib or any of the ingredients in XELJANZ/XELJANZ XR
  • have recently received or are scheduled to receive a vaccine. People taking XELJANZ/XELJANZ XR should not receive live vaccines but can receive non-live vaccines
  • plan to become pregnant or are pregnant. XELJANZ/XELJANZ XR may affect the ability of females to get pregnant. It is not known if this will change after stopping XELJANZ/XELJANZ XR. It is not known if XELJANZ/XELJANZ XR will harm an unborn baby.
    • Pregnancy Registry: Pfizer has a registry for pregnant women who take XELJANZ/XELJANZ XR. The purpose of this registry is to check the health of the pregnant mother and her baby. If you are pregnant or become pregnant while taking XELJANZ/XELJANZ XR, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at 1-877-311-8972 to enroll
  • plan to breastfeed or are breastfeeding. You and your healthcare provider should decide if you will take XELJANZ/XELJANZ XR or breastfeed. You should not do both. After you stop your treatment with XELJANZ/XELJANZ XR do not start breastfeeding again until 18 hours after your last dose of XELJANZ or 36 hours after your last dose of XELJANZ XR.
  • Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take any other medicines to treat your rheumatoid arthritis or psoriatic arthritis. You should not take tocilizumab (Actemra®), etanercept (Enbrel®), adalimumab (Humira®), infliximab (Remicade®), rituximab (Rituxan®), abatacept (Orencia®), anakinra (Kineret®), certolizumab (Cimzia®), golimumab (Simponi®), ustekinumab (Stelara®), secukinumab (Cosentyx®), vedolizumab (Entyvio®), azathioprine, cyclosporine, or other immunosuppressive drugs while you are taking XELJANZ or XELJANZ XR. Taking XELJANZ or XELJANZ XR with these medicines may increase your risk of infection.
  • Tell your healthcare provider if you are taking medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.

Taking XELJANZ/XELJANZ XR

  • Take XELJANZ 2 times a day with or without food.
  • Take XELJANZ XR 1 time a day with or without food for rheumatoid or psoriatic arthritis. Do not take XELJANZ XR for ulcerative colitis.
  • When you take XELJANZ XR, you may see something in your stool that looks like a tablet. This is the empty shell from the tablet after the medicine has been absorbed by your body.
  • For the treatment of psoriatic arthritis, take XELJANZ/XELJANZ XR in combination with methotrexate, sulfasalazine or leflunomide as instructed by your healthcare provider.

What are other possible side effects of XELJANZ/XELJANZ XR?

XELJANZ/XELJANZ XR may cause serious side effects, including Hepatitis B or C activation infection in people who carry the virus in their blood. If you are a carrier of the Hepatitis B or C virus (viruses that affect the liver), the virus may become active while you use XELJANZ/XELJANZ XR. Your healthcare provider may do blood tests before you start treatment with XELJANZ/XELJANZ XR and while you are using XELJANZ/XELJANZ XR. Tell your healthcare provider if you have any of the following symptoms of a possible Hepatitis B or C infection: feel very tired, little or no appetite, clay-colored bowel movements, chills, muscle aches, skin rash, skin or eyes look yellow, vomiting, fevers, stomach discomfort, or dark urine.

Common side effects of XELJANZ/XELJANZ XR in rheumatoid arthritis and psoriatic arthritis patients include upper respiratory tract infections (common cold, sinus infections), headache, diarrhea, nasal congestion, sore throat, and runny nose (nasopharyngitis), and high blood pressure (hypertension).

Please see full Prescribing Information including Boxed WARNING and Medication Guide.

PP-XEL-USA-4218


[i] National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). National Institutes of Health, Department of Health and Human Services. Handout on health: rheumatoid arthritis. August 2014. http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp. Accessed February 14, 2019.

[ii] Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004-2014. Rheumatol Int. 2017;37(9):1551-1557.

[iii] Arthritis Foundation. Arthritis by the numbers. https://www.arthritis.org/Documents/Sections/About-Arthritis/arthritis-facts-stats-figures.pdf. Accessed February 14, 2019.