it can reduce pain, swelling and further joint damage, even without methotrexate. xeljanz xr can lower your ability to fight infections, including tuberculosis. serious, sometimes fatal infections, lymphoma and other cancers have happened. don't start xeljanz xr if you have an infection. tears in the stomach or intestines, low blood cell counts and higher liver tests and cholesterol levels have happened. your doctor should perform blood tests before you start and while taking xeljanz xr, and monitor certain liver tests. tell your doctor if you were in a region where fungal infections are common and if you have had tb, hepatitis b or c, or are prone to infections. xeljanz xr can reduce the symptoms of ra, even without methotrexate. ask your rheumatologist about xeljanz xr.