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Avoid extreme pulling or lifting motions (such as placing your arm over your head without bending at the elbow)

Decrease dose if: Experiencing consistent side effects (headaches, fatigue, GI disturbance), achieving satisfactory results at current dose with no need for escalation, or cost considerations favor using minimum effective dose

However, after such a long time period, it is to be expected, that inflammation has already stopped and fibrosis has taken over

Hematologic: Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia

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465,466 Treatment with tofacitinib has been shown to significantly improve constipation and rectal bleeding