Rinvoq interactions: Alcohol, medications, and other factors

Before you start treatment with Rinvoq, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Rinvoq interacts with supplements, herbs, or vitamins, see the “Rinvoq and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Rinvoq. Keep in mind that this table doesn’t include all drugs that may interact with Rinvoq. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see the “Drug interactions in depth” section below.
† For details about Rinvoq’s side effects, see this article.
‡ Rinvoq is a type of drug called a JAK inhibitor.

In some cases, factors or conditions could prevent your doctor from prescribing Rinvoq due to the risk of harm. These are known as contraindications. The contraindications of Rinvoq include:

Having had an allergic reaction to Rinvoq or any of its ingredients

If you have had an allergic reaction to Rinvoq or any of its ingredients, your doctor will likely not prescribe Rinvoq. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Rinvoq, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Rinvoq.

There aren’t any known interactions between Rinvoq and alcohol.

However, your doctor may advise you to avoid or limit alcohol consumption during Rinvoq treatment. This is because consuming large amounts of alcohol can increase the risk of GI perforation (tears in your digestive tract). Rinvoq may also cause GI tear as a side effect. This means that drinking large amounts of alcohol during Rinvoq treatment may further increase this risk.

In addition, drinking alcohol while taking the drug may worsen nausea as a side effect of Rinvoq.

If you have concerns about limiting or avoiding alcohol while you’re taking Rinvoq, talk with your doctor before starting treatment. To learn more about Rinvoq’s side effects, see this article.

Here’s a closer look at certain drug interactions of Rinvoq.

Certain antibiotics

Antibiotics are prescribed for bacterial infections.

Interaction result: Taking Rinvoq with certain antibiotics could make Rinvoq less effective. Certain antibiotics could also increase the risk of side effects from Rinvoq.

Interaction explained: Rinvoq is broken down in your body by specific enzymes. (An enzyme is a type of protein.)

Certain antibiotics, such as rifampin (Rifadin, Rimactane), speed up the activity of one of these enzymes. Taking Rinvoq with an antibiotic that has this effect could lower the level of Rinvoq in your body. This could make the drug less effective for treating your condition.

Other antibiotics, such as clarithromycin, slow the activity of one of these enzymes. As a result, taking Rinvoq with an antibiotic that has this effect could raise the level of Rinvoq in your system. This could increase your risk of side effects from Rinvoq.

Examples of antibiotic drugs: Antibiotics that may interact with Rinvoq include clarithromycin and rifampin.

Steps you or your doctor may take: If you need antibiotics during Rinvoq treatment, be sure the doctor prescribing it knows that you’re taking Rinvoq. They’ll advise you on whether the specific antibiotic you need can be taken with Rinvoq.

In some cases, such as when there aren’t other treatment options, your doctor may still prescribe an antibiotic that interacts with Rinvoq. If so, they may temporarily lower your dosage of Rinvoq while you’re taking the antibiotic. Doing so can help lower your risk of side effects from the drug. To learn about the dosage of Rinvoq, see this article.

If you have other questions about Rinvoq and certain antibiotics, talk with your doctor or pharmacist.

Corticosteroids

Corticosteroids are prescribed for inflammatory conditions. This can include the same autoimmune conditions that Rinvoq is prescribed to treat, such as Crohn’s disease and psoriatic arthritis.

Interaction result: Taking Rinvoq with a corticosteroid can increase the risk of side effects from either drug.

Interaction explained: When taken individually, Rinvoq and corticosteroids can cause GI tears as a side effect. Taking these medications together can raise your risk of this side effect.

Both Rinvoq and corticosteroids can also increase your risk of infection when taken alone. Your risk of infection may be even greater when these drugs are taken together.

In fact, Rinvoq has a boxed warning about the risk of serious infection. A boxed warning is the most serious warning from the FDA. For more information, see “Boxed warnings” at the beginning of this article.

Examples of corticosteroid drugs: Here are some corticosteroids that may interact with Rinvoq:

• prednisone (Rayos)
• methylprednisolone (Medrol)
• dexamethasone (Hemady)

Steps you or your doctor may take: Before taking Rinvoq, tell your doctor if you’re taking a corticosteroid. They can advise you on whether these medications may be taken together.

In some cases, your doctor may prescribe Rinvoq with a corticosteroid to treat your condition. If so, they’ll monitor you closely for symptoms of infection and GI tears. Symptoms of infection may include shortness of breath, cough, fever, and skin discoloration. Sudden and severe abdominal pain may be a symptom of a GI tear.

Your doctor or pharmacist can also recommend what to do if you have these side effects.

If you have other questions about Rinvoq and corticosteroids, talk with your doctor or pharmacist.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to ease pain, inflammation, and fever. Some NSAIDs are available over the counter, meaning you don’t need a prescription to purchase them.

Interaction result: Taking Rinvoq with an NSAID can increase the risk of GI tears from either drug.

Interaction explained: Both Rinvoq and NSAIDs can cause GI tears when taken alone. Your risk of this side effect may be even greater when you take these drugs together.

Examples of NSAIDs: Here are some NSAIDs that may interact with Rinvoq:

• meloxicam
• ibuprofen (Advil, Motrin)
• naproxen (Aleve, Anaprox DS, others)

Steps you or your doctor may take: Talk with your doctor or pharmacist before taking any NSAIDs with Rinvoq. They can tell you whether it’s safe to take these drugs together.

If your doctor or pharmacist recommends taking an NSAID with Rinvoq, they’ll have you watch for sudden and severe abdominal pain. These may be symptoms of a GI tear. Your doctor or pharmacist can also recommend what to do if you have these symptoms.

If you have other questions about Rinvoq and NSAIDs, talk with your doctor or pharmacist.

Rinvoq may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Rinvoq.

Rinvoq interactions with supplements

Before you start treatment with Rinvoq, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Rinvoq interactions with herbs

Rinvoq may interact with St. John’s wort, which is an herbal supplement used to treat depression and other conditions.

St. John’s wort may speed up the breakdown of Rinvoq in your body. This may lead to a low level of Rinvoq in your system. As a result, Rinvoq may not work as well to treat your condition.

Due to this risk, your doctor may recommend avoiding St. John’s wort while you’re taking Rinvoq. They can suggest a treatment option other than St. John’s wort.

Rinvoq and vitamins

There are no reports of vitamins interacting with Rinvoq. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Rinvoq.

Rinvoq interactions with food

Rinvoq may interact with grapefruit and grapefruit juice. This is because grapefruit products can slow the breakdown of Rinvoq in your body. This may lead to a high level of Rinvoq in your system, increasing your risk of side effects from the drug.

Due to this risk, your doctor may recommend avoiding grapefruit products while you’re taking Rinvoq.

Rinvoq interactions with vaccines

Rinvoq may interact with live vaccines. A live vaccine contains weakened pieces of the virus or bacterium it’s meant to defend against. Live vaccines usually won’t cause infection for people with healthy immune systems.

However, Rinvoq may lower the activity of your immune system. As a result, your immune system may not be able to fight the weakened virus or bacterium in a live vaccine. This may cause you to develop symptoms of the illness the vaccine is meant to prevent.

Examples of live vaccines that may interact with Rinvoq include:

• measles, mumps, rubella (MMR) vaccine
• chickenpox vaccine
• nasal spray flu vaccine (FluMist)

Before starting Rinvoq, talk with your doctor or pharmacist about any vaccines you may need. They can advise you on the timing of the vaccines and when it’s safe to begin Rinvoq treatment.

Rinvoq and lab tests

Rinvoq isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

RINVOQ AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been reported to interact with Rinvoq. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Rinvoq. The impact of cannabis may affect how well you stick to your Rinvoq treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Rinvoq. Before you take this drug, be sure to talk with your doctor about your health history. Rinvoq may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Rinvoq include:

• Risks of serious infections, cancer, blood clots, cardiovascular problems, and death: Rinvoq has boxed warnings about these risks. A boxed warning is the strongest warning from the FDA. For details, see “Boxed warnings” at the beginning of this article. Before starting Rinvoq, talk with your doctor about your personal risk of serious infections, cancer, blood clots, cardiovascular problems, and even death with Rinvoq. They’ll recommend whether Rinvoq is safe for you to take.
• Liver or kidney problems: If you have a liver or kidney problem, such as liver failure or kidney failure, tell your doctor before taking Rinvoq. They may prescribe a lower dosage of the drug to help reduce your risk of side effects. To learn about the dosage of Rinvoq, see this article.
• Digestive system problems: Taking Rinvoq may cause GI tears. This risk may be greater for people with certain digestive system problems, such as diverticulitis. In addition, pieces of Rinvoq tablet may appear in the stool. This could be a sign that your body is not breaking down the drug as well as it should. This effect may occur more often in people who’ve had certain procedures, such as a colostomy or ileostomy. Before taking Rinvoq, tell your doctor about any digestive system issues you have. They can recommend whether Rinvoq is a safe treatment option.
• Allergic reaction: If you’ve had an allergic reaction to Rinvoq or any of its ingredients, your doctor will likely not prescribe Rinvoq. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: Rinvoq may not be safe to take while breastfeeding. The drug may cause side effects in a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before starting Rinvoq. They may advise you not to breastfeed during Rinvoq treatment and for at least 6 days after your last dose. Your doctor can also talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Rinvoq is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Rinvoq. They may advise you not to become pregnant while taking the drug and for at least 4 weeks after your last dose. Your doctor can also recommend an alternative treatment plan for you.

You can take certain steps to help prevent interactions with Rinvoq. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Rinvoq label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Rinvoq doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Rinvoq by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Rinvoq. These resources might help:

• Overview of Rinvoq: For a general overview of Rinvoq, you can see this article.
• Side effects: If you’re interested in the side effects of Rinvoq, see this article. Another option is to refer to the Rinvoq prescribing information.
• Dosage specifics: To learn about the dosage of Rinvoq, see this article.
• Cost: If you’d like to learn about Rinvoq and cost, see this article.
• Facts about your condition: To learn more about some of the conditions Rinvoq treats, check out our hubs for:
  • rheumatoid arthritis
  • inflammatory bowel disease
  • eczema

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.