Rinvoq (upadacitinib) is a brand-name drug prescribed for certain conditions, such as rheumatoid arthritis, in adults. Some children may take it for atopic dermatitis. As with other drugs, Rinvoq can cause side effects, such as upper respiratory tract infections, fever, and nausea.

Rinvoq is approved by the Food and Drug Administration (FDA) to treat the following conditions in certain situations:

The drug is mainly used to treat these conditions in adults. But doctors may also prescribe it to treat atopic dermatitis in children ages 12 years and older.

Rinvoq belongs to a drug class called Janus kinase inhibitors. The drug is not available in a generic version. Rinvoq comes as an extended-release oral tablet. (This type of tablet releases the drug in your body slowly over a period of time.)

Read on to learn about potential common, mild, and serious side effects of Rinvoq. For a general overview of the drug, including details about its uses, see this article.

Rinvoq can cause certain side effects, some of which are more common than others. These side effects are usually temporary, lasting for a few days or weeks. But if the side effects last for longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Some of the more common side effects of Rinvoq reported in clinical trials are:

* For more information about this side effect, see “Side effect specifics” below.

These are just a few of the more common side effects reported by people who took Rinvoq in clinical trials. Other possible side effects of the drug are discussed in the following sections.

Mild side effects can occur while taking Rinvoq. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Rinvoq’s prescribing information.

Mild side effects of Rinvoq can include:

* For more information about this side effect, see “Side effect specifics” below.

These side effects are usually temporary, lasting for a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Rinvoq and want to tell the FDA about it, visit MedWatch.

Rinvoq may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Rinvoq’s prescribing information.

If you develop serious side effects while taking Rinvoq, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects and their symptoms can include:

* For more information, see “Side effect specifics” below.
† Rinvoq has boxed warnings for these side effects. A boxed warning is a serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect specifics” below.

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Rinvoq may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Is weight gain or weight loss a side effect of Rinvoq?

It’s possible for weight gain to occur with Rinvoq. But weight loss is not a known side effect of the drug.

Weight gain was reported as a rare side effect in clinical trials of Rinvoq for treating atopic dermatitis, which is a type of eczema. However, weight gain wasn’t reported as a side effect of taking Rinvoq to treat other conditions that the drug is approved for.

Also, Rinvoq is sometimes taken with methotrexate (Trexall) to treat rheumatoid arthritis (RA). And weight gain is a possible side effect of methotrexate.

Weight loss was not a reported side effect of Rinvoq. However, weight loss is a symptom of two of the drug’s possible side effects: serious infections and increased risk of certain cancers.* If you experience unexplained weight loss while taking Rinvoq, contact your doctor. They’ll determine what’s causing the weight loss and recommend treatment options if needed.

If you have further questions about Rinvoq and your weight, talk with your doctor.

* Rinvoq has boxed warnings for these side effects. A boxed warning is a serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect specifics” below.

Does Rinvoq cause hair loss?

No, hair loss wasn’t a side effect reported in clinical trials of Rinvoq.

But hair loss is a possible side effect of methotrexate, which is sometimes taken with Rinvoq to treat RA.

If you have further questions, or if you’re concerned about hair loss while taking Rinvoq, talk with your doctor.

Does Rinvoq suppress my immune system?

Yes, Rinvoq works by suppressing (decreasing the activity of) your immune system. This is why the drug is known as an immunosuppressant.

Reducing the activity of your immune system can help reduce inflammation (damage and swelling) and relieve symptoms of your condition. But having a suppressed immune system also increases your risk for infections, including serious infections. (See “Side effect specifics” below for details about possible infections while taking Rinvoq.)

Because of this risk for infections, you’ll need to avoid getting live vaccines while taking Rinvoq. Live vaccines contain a small amount of a live germ or virus. This is unlike inactive vaccines, which don’t contain any live virus.

Examples of live vaccines that you should avoid while you’re taking Rinvoq include those for:

Before you start taking Rinvoq, talk with your doctor to see whether you need any live vaccines. You may need to delay starting treatment with Rinvoq until your vaccines are up to date.

If you have further questions about Rinvoq and how it affects your immune system, talk with your doctor.

* It’s important to note that the nasal spray flu vaccine is a live vaccine, but the flu shot is an inactive vaccine. So, it’s safe to get the injected flu vaccine during Rinvoq treatment.

Does Rinvoq make you tired?

It’s possible that Rinvoq may make you tired. In clinical trials, people taking Rinvoq for atopic dermatitis or Crohn’s disease reported fatigue as a side effect. However, people taking the drug to treat other conditions the drug is approved for did not report experiencing fatigue.

Note that fatigue can be a symptom of other side effects Rinvoq can cause. For example, feeling tired is a symptom of cancer, and Rinvoq may increase the risk of certain cancers.*

In addition, fatigue is also a symptom of some of the conditions Rinvoq treats, such as ulcerative colitis and Crohn’s disease. Taking Rinvoq may actually help ease the fatigue that such conditions cause.

After starting Rinvoq treatment, if you have fatigue that’s bothersome, let your doctor know. They can diagnose the cause and discuss ways to lessen this side effect.

* Rinvoq has a boxed warning for this side effect. A boxed warning is a serious warning from the FDA. To learn more, see “Side effect specifics” below.

Learn more about some of the side effects that Rinvoq may cause.

Upper respiratory tract infections

Upper respiratory tract infections are a possible side effect of Rinvoq. This is a type of infection that affects your throat or nasal passages. The common cold is one example of an upper respiratory tract infection.

People taking Rinvoq may be at higher risk for upper respiratory tract infections. These infections weren’t common in clinical trials of Rinvoq. But they did occur more often in people taking Rinvoq than in people who took a placebo. (A placebo is a treatment without an active drug.)

Symptoms of an upper respiratory tract infection may vary depending on the location and severity of your infection. But common symptoms can include:

  • coughing
  • discomfort in your nose or nasal passages
  • mild fever*
  • pain or pressure behind your face, either with or without nasal congestion
  • runny nose or excessive mucus production
  • scratchy or sore throat
  • sneezing

* In clinical trials, this side effect was more common in children than in adults.

What you can do

Symptoms of upper respiratory tract infections usually go away within about a week. These symptoms can usually be treated with over-the-counter medications. But if your symptoms get worse or don’t go away, talk with your doctor.

Changes in levels of cholesterol, liver enzymes, and certain blood cells

Rinvoq may cause changes in blood levels of cholesterol, liver enzymes, and certain blood cells.

Specifically, Rinvoq may cause:

These changes are usually minor and typically don’t cause any symptoms. But in rare cases, these changes may be signs of a more serious condition.

What you can do

While taking Rinvoq, you’ll have blood tests to check your levels of cholesterol, liver enzymes, and certain blood cells. This way, your doctor can ensure that the levels are staying within a healthy range.

If there are changes in these levels, your doctor may adjust your treatment. This could involve changing your Rinvoq dosage or adding another medication to treat your side effects. Or your doctor may recommend trying a medication other than Rinvoq to treat your condition.

Serious infections

Rinvoq has a boxed warning about serious infections. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Rinvoq works by reducing the activity of your immune system. This makes your immune system weaker. With a weakened immune system, you may have an increased risk for serious infections. In clinical trials, these infections sometimes required treatment in the hospital. In rare cases, they led to death.

Examples of serious infections that have been reported in people taking Rinvoq include:

Serious infections weren’t common in clinical trials of Rinvoq. People were more likely to have this side effect if they were taking other medications that also weaken the immune system, such as methotrexate (Trexall).

What you can do

Be sure to tell your doctor whether you have an active infection before taking Rinvoq. They may want to delay starting treatment until your infection goes away.

If you develop symptoms of a serious infection while taking Rinvoq, talk with your doctor right away. They may have you stop taking Rinvoq in order to treat your infection. They may also decide to have you stop Rinvoq and try a different drug for your condition.

Cancer

Rinvoq has a boxed warning about cancer. A boxed warning is a serious warning from the FDA.

People taking Rinvoq may have an increased risk for certain types of cancer. These types of cancer include lymphoma and non-melanoma skin cancer. But it’s important to note that cancer also occurred in some people who took a placebo in clinical trials of Rinvoq. (A placebo is a treatment without an active drug.)

With cancer, cells in your body divide uncontrollably. This can result in the formation of a tumor.

Symptoms of cancer may include weight loss, fatigue, skin changes, or a persistent cough. But the symptoms may vary depending on the type of cancer you have. If you have any persistent or worrisome symptoms, you should talk with your doctor.

What you can do

Before you take Rinvoq, tell your doctor whether you have a history of cancer or are currently receiving treatment for cancer. They may recommend that you try a different medication to treat your condition.

Blood clots

Rinvoq has a boxed warning about blood clots. A boxed warning is a serious warning from the FDA.

With blood clots, your blood turns from a liquid to a gel and stops flowing. Blood clots are important to help your body stop bleeding, such as when you get a cut. But when blood doesn’t clot properly, serious health problems can occur.

Some types of blood clots are particularly severe. These include:

Rarely, Rinvoq may cause these types of clots and, in severe cases, death. Symptoms of a blood clot may include pain in a new area of your body, shortness of breath, and swelling or pain. Swelling or pain may affect one or both of your arms, legs, hands, or feet.

What you can do

If you develop symptoms of a blood clot while taking Rinvoq, talk with your doctor right away. They may have you stop taking Rinvoq and try a different medication to treat your condition.

Cardiovascular problems

Rinvoq has a boxed warning about cardiovascular problems. A boxed warning is a serious warning from the FDA.

Rinvoq may raise your risk for cardiovascular problems. Examples include:

A similar drug has caused these problems in people with rheumatoid arthritis who:

  • are ages 50 years and older
  • have at least one risk factor for cardiovascular problems
  • are taking a type of medication known as a Janus kinase (JAK) inhibitor

Keep in mind that smoking can also increase the risk of cardiovascular problems during Rinvoq treatment.

What you can do

While taking Rinvoq, watch for any symptoms of cardiovascular issues. Examples include feeling short of breath or having chest pain. You may also feel numbness or weakness on one side of your body. Call your doctor if you have any of these symptoms. But call 911 or your local emergency number if your symptoms feel severe.

If you’re at risk for cardiovascular problems with Rinvoq, your doctor may recommend that you do not take the drug. If you have a stroke or heart attack while taking Rinvoq, your doctor will recommend that you stop taking this medication.

Increased risk of death

Rinvoq has a boxed warning about an increased risk of death in certain people. A boxed warning is a serious warning from the FDA.

It’s possible that Rinvoq may raise the risk of death in some people. Another similar drug has increased this risk in certain people with rheumatoid arthritis who:

  • are ages 50 years and older
  • have at least one risk factor for cardiovascular problems

What you can do

Ask your doctor about your risk for complications with Rinvoq. Your doctor can help you determine whether you have a higher risk for death with this drug.

Allergic reaction

As with most drugs, Rinvoq can cause an allergic reaction in some people. In clinical trials, allergic reactions were rare. However, in some cases, allergic reactions were severe.

Symptoms can be mild or serious and may include:

  • rash
  • itching
  • flushing
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether or not you should keep taking Rinvoq. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Rinvoq may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Rinvoq. Factors to consider include those in the list below.

Boxed warnings

Rinvoq has boxed warnings about serious infections, cancer, and blood clots. These are serious warnings from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

  • Serious infections. Rinvoq can weaken your immune system and increase your risk for serious infections, such as pneumonia.
  • Cancer. Rinvoq may increase your risk for lymphoma or certain other types of cancer.
  • Blood clots. Rinvoq may increase your risk for blood clots, including deep vein thrombosis and pulmonary embolism.
  • Cardiovascular problems. Rinvoq may increase your risk for cardiovascular problems such as stroke, heart attack, and death caused by a cardiovascular issue.
  • Increased risk of death. It’s possible that Rinvoq may increase the risk of death in certain people.

For more information about Rinvoq’s boxed warnings, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Rinvoq. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Blood disorders. If you have a history of blood disorders, be sure to tell your doctor before you start taking Rinvoq. Examples of blood disorders include anemia, lymphopenia, and neutropenia. Rinvoq can decrease the levels of certain blood cells. For this reason, your doctor may order more lab tests than usual during your Rinvoq treatment. Or they may prescribe a drug other than Rinvoq for you.

Diverticulitis. Rinvoq treatment may increase your risk for gastrointestinal perforation. You may be at higher risk for this side effect if you have a history of diverticulitis. Be sure to discuss your medical history with your doctor before starting Rinvoq treatment.

Use of nonsteroidal anti-inflammatory drugs (NSAIDs) or certain other medications. Rinvoq treatment may increase your risk for gastrointestinal perforation. Your risk for this side effect may increase further if you take certain medications. Examples include NSAIDs, such as ibuprofen (Motrin, Advil) and naproxen (Aleve). Methotrexate (Trexall) and corticosteroids, such as prednisone (Rayos), can also increase this risk.

If you take any of these medications, be sure to tell your doctor. Your doctor may adjust your Rinvoq treatment to make sure the drug is safe for you to take.

High cholesterol. Rinvoq can increase cholesterol levels. If you currently have high cholesterol, or if you have a history of high cholesterol, make your doctor aware of this before you start taking Rinvoq. They may monitor you more closely than usual during treatment.

Conditions that decrease digestion time. Pieces of Rinvoq oral tablet may appear in stool. This can happen more often when substances move quicker than usual through the digestive system. Decreased digestion time can occur in people who’ve had certain digestive system procedures, such as a colostomy or a bowel resection. If you have a condition that decreases digestion time, tell your doctor. Also let them know if you regularly see the medication in your stool. This could indicate that your body is not breaking down the drug effectively. In this case, your doctor may recommend a treatment other than Rinvoq for your condition.

Liver problems. Rinvoq may cause increased levels of certain enzymes (a type of protein) made in the liver. These enzymes are called alanine aminotransferase and aspartate aminotransferase. A large increase in these enzyme levels is sometimes a sign of liver damage. If you have liver problems or a history of liver problems, make sure to tell your doctor. They may monitor you more closely than usual during your Rinvoq treatment. Or, they may prescribe a drug other than Rinvoq to treat your condition.

Allergic reaction. If you’ve had an allergic reaction to Rinvoq or any of its ingredients, you should not take this drug. Ask your doctor about which other medications are better options for you.

Alcohol with Rinvoq

There aren’t any known interactions between alcohol and Rinvoq. But drinking alcohol could increase your risk for certain side effects from Rinvoq. These side effects include nausea and liver problems.

If you drink alcohol, talk with your doctor about whether it’s safe for you to drink it while taking Rinvoq.

Pregnancy and breastfeeding while taking Rinvoq

Taking Rinvoq during pregnancy isn’t recommended. Based on animal studies, it’s thought that Rinvoq could cause harm to a fetus.

If you can become pregnant, you should use birth control while taking Rinvoq. And you should continue to use birth control for 4 weeks after your last dose of Rinvoq.

You should not breastfeed while taking Rinvoq or for at least 6 days after your last dose of the drug. This is because animal studies have shown Rinvoq can pass into breast milk. So it’s likely that the drug can pass into human breast milk and may cause side effects in a child who’s breastfed.

If you’re pregnant, planning to become pregnant, breastfeeding, or thinking about breastfeeding, talk with your doctor. They may recommend treatment options other than Rinvoq.

Side effects can occur while taking Rinvoq, but they’re usually mild. Most mild side effects of the drug go away with time and don’t require medical attention.

It’s important to note that your doctor may recommend taking Rinvoq on its own to treat your condition. Or you may take it in combination with other drugs, such as methotrexate (Trexall). Some side effects of other drugs and Rinvoq overlap, but the drugs may cause different side effects as well. Your doctor or pharmacist can help explain the similarities and differences in side effects that each drug can cause.

You should talk with your doctor if you experience any symptoms of:

These side effects could be serious and may require medical attention. See the “Side effect specifics” section above for more information.

You should also contact your doctor right away if you get pregnant while taking Rinvoq.

If you have more questions about Rinvoq, or if you have any concerns about side effects of the drug, talk with your doctor or pharmacist.

Besides talking with your doctor, you can do some research on your own. These articles might help:

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.