Rinvoq is a brand-name prescription drug that treats rheumatoid arthritis (RA) that’s moderately to severely active. It’s used in adults in the following situations:

  • if your RA hasn’t responded well to methotrexate (Otrexup, Rasuvo, Trexall)
  • if you’ve had to stop taking methotrexate because of negative side effects

Rinvoq is a disease-modifying antirheumatic drug (DMARD). It belongs to a class of medications known as Janus kinase (JAK) inhibitors.

Rinvoq comes as an extended-release tablet that’s taken by mouth. (Extended-release means the drug is released in your body slowly over a period of time.) Rinvoq tablets are available in one strength: 15 mg.

Rinvoq can be used alone, with methotrexate, or with nonbiologic DMARDs, such as hydroxychloroquine (Plaquenil) and leflunomide (Arava).

Rinvoq shouldn’t be taken with certain other drugs. These include other JAK inhibitors, such as tofacitinib (Xeljanz), and strong immunosuppressants, such as azathioprine (Azasan) and cyclosporine (Sandimmune, Neoral, Gengraf). Rinvoq also shouldn’t be taken with biologic DMARDs, such as infliximab (Remicade) or adalimumab (Humira).

FDA approval

Rinvoq was approved by the FDA in 2019 to treat RA that’s moderately to severely active.

Effectiveness

To learn about Rinvoq’s effectiveness, see the “Rinvoq uses” section.

Rinvoq is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Rinvoq can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Rinvoq. These lists don’t include all possible side effects.

For more information on the possible side effects of Rinvoq, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Rinvoq, you can do so through MedWatch.

Mild side effects

Mild side effects of Rinvoq can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Rinvoq. To learn about other mild side effects, talk with your doctor or pharmacist, or view Rinvoq’s Medication Guide.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Gastrointestinal perforation (a hole in the stomach, large intestine, or small intestine). Symptoms can include:
    • pain or tenderness in your abdomen (belly)
    • nausea and vomiting
    • chills
    • fever

Other serious side effects, explained in more detail below in “Side effect details,” include:

* Rinvoq has boxed warnings for these side effects. A boxed warning is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Rinvoq. It’s not known how often this happens.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Rinvoq. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Infections

Taking Rinvoq can cause infections in some people. The most common types of infections are upper respiratory infection (such as the common cold), pneumonia (infection of the lungs), and cellulitis (infection in the skin).

Infections aren’t common with Rinvoq use. However, studies have shown they can happen more often in people taking Rinvoq compared with those taking a placebo (a treatment with no active drug).

Serious infections

Rinvoq weakens your immune system, which could raise your risk for serious infections. These infections could lead to a hospital stay or even death. In clinical studies, serious infections were most common in people taking Rinvoq with other drugs that can weaken the immune system, such as corticosteroids or methotrexate.

Examples of serious infections that can occur with Rinvoq include:

Pneumonia, oral thrush, shingles, and herpes simplex occurred in less than 1% of people taking Rinvoq in clinical studies.

Also, in clinical studies comparing Rinvoq with a placebo:

  • out of every 100 people taking Rinvoq for 1 year, about two to five people had a serious infection
  • out of every 100 people taking a placebo for 1 year, about one to two people had a serious infection

In other clinical studies, 0.2% of people taking 15 mg of Rinvoq had TB. (See the prescribing information for more details.)

If you have a current infection or have had TB, talk with your doctor before starting Rinvoq. Your doctor may want to delay your Rinvoq treatment or prescribe you medication to take with Rinvoq.

Upper respiratory infection

Rinvoq may cause an upper respiratory infection (such as the common cold). In clinical studies:

  • 13.5% of people taking Rinvoq had an upper respiratory infection
  • 9.5% of people taking placebo had an upper respiratory infection

Symptoms of an upper respiratory infection may vary but can include cough, sore throat, sneezing, or a stuffy or runny nose.

These symptoms usually go away within about a week and can be treated with over-the-counter medications. However, talk with your doctor if your symptoms get worse or don’t go away.

Cancer

People taking Rinvoq may have a higher risk of lymphoma or other types of cancer, including nonmelanoma skin cancer. However, in clinical trials, cancer also occurred in some people taking a placebo or methotrexate.

In clinical studies comparing Rinvoq with a placebo:

  • out of every 100 people taking Rinvoq for 1 year, up to one person had cancer
  • out of every 100 people taking a placebo for 1 year, less than one people had cancer

In clinical studies comparing Rinvoq with methotrexate:

  • out of every 100 people taking Rinvoq for 1 year, about two people had cancer
  • out of every 100 people taking methotrexate for 1 year, less than one person had cancer

Talk with your doctor about your cancer risk before starting Rinvoq. If you have a history of cancer or are currently being treated for cancer, your doctor may prescribe an RA drug other than Rinvoq.

Blood clots

Rinvoq may raise the risk of blood clots. These include deep venous thrombosis (blood clot in a vein), arterial thrombosis (blood clot in an artery), and pulmonary embolism (blood clot in the artery of the lung). These blood clots may be serious and can even cause death.

In clinical studies, out of every 100 people taking Rinvoq for 1 year, less than one person had blood clots. It’s not known how often blood clots occurred in people taking a placebo or methotrexate.

Symptoms of a blood clot may include:

  • swelling or pain in your arms, legs, hands, or feet
  • shortness of breath
  • pain in a new area of your body

Talk with your doctor right away if you have any of these symptoms during your Rinvoq treatment.

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

In some people, taking Rinvoq can lead to changes in the levels of certain cells and substances in the body. These changes may be minor. However, major changes may occur, which could be symptoms of a serious condition caused by Rinvoq.

Rinvoq can cause effects such as:

If any of these levels change a lot, your doctor may need to adjust your treatment. This could involve changing your Rinvoq dosage or adding other medications to help relieve side effects.

Your doctor will order blood tests throughout your Rinvoq treatment to check for any changes in these levels.

The Food and Drug Administration (FDA) approves prescription drugs such as Rinvoq to treat certain conditions. Rinvoq may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Rinvoq for rheumatoid arthritis

Rinvoq is FDA-approved for use in adults with rheumatoid arthritis (RA) that’s moderately to severely active. It can be used in the following situations:

  • if your RA hasn’t responded well to methotrexate (Otrexup, Rasuvo, Trexall)
  • if you’ve had to stop taking methotrexate because of negative side effects

Rinvoq can be used alone, with methotrexate, or with nonbiologic DMARDs such as Plaquenil or Arava.

Rinvoq shouldn’t be taken with certain other drugs. These include other JAK inhibitors, such as tofacitinib (Xeljanz), and strong immunosuppressants, such as azathioprine (Azasan) and cyclosporine (Sandimmune, Neoral, Gengraf). Rinvoq also shouldn’t be taken with biologic disease-modifying antirheumatic drugs (DMARDs), such as infliximab (Remicade) or adalimumab (Humira).

Effectiveness

Several clinical studies have looked at the effectiveness of Rinvoq. These studies compared Rinvoq with a placebo (a treatment with no active drug) or with methotrexate (Otrexup, Rasuvo, Trexall). In these comparisons, Rinvoq was taken alone or with other DMARDs.

People taking Rinvoq alone or with methotrexate or another DMARD for RA that’s moderately to severely active had better results than those taking a placebo or methotrexate alone.

The studies looked at how much each drug relieved certain symptoms. These include inflammation, pain, and the number of swollen joints. They also looked at improved physical function.

Clinical studies lasting 12 or 14 weeks compared Rinvoq with methotrexate or a placebo. Rinvoq and methotrexate were either taken alone or with other DMARDs. People who received a placebo continued taking other medications for RA. Therefore, a placebo was used with either methotrexate or another DMARD, depending on which drug the person was taking before the study began.

Of the people taking Rinvoq:

  • 64% to 76% had their symptoms and physical function improve by 20%
  • 34% to 52% had their symptoms and physical function improve by 50%
  • 12% to 32% had their symptoms and physical function improve by 70%

Of the people taking methotrexate:

  • 41% to 54% had their symptoms and physical function improve by 20%
  • 15% to 28% had their symptoms and physical function improve by 50%
  • 3% to 14% had their symptoms and physical function improve by 70%

Of those taking a placebo:

  • 28% to 36% had their symptoms and physical function improve by 20%
  • 12% to 15% had their symptoms and physical function improve by 50%
  • 5% to 7% had their symptoms and physical function improve by 70%

Off-label uses for Rinvoq

In addition to the use listed above, Rinvoq may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. Below are examples of off-label uses for Rinvoq.

Rinvoq for atopic dermatitis

Rinvoq isn’t FDA-approved to treat atopic dermatitis (a type of eczema). However, some people may use Rinvoq for this purpose.

Atopic dermatitis is a chronic (long-term) skin condition that can make your skin swollen, dry, and itchy. Rinvoq has been studied in people with moderate to severe atopic dermatitis. One study showed that Rinvoq improved symptoms of atopic dermatitis compared to a placebo (a treatment with no active drug).

Talk with your doctor if you’re interested in taking Rinvoq for atopic dermatitis.

Rinvoq for other inflammatory conditions

Ongoing research is looking at Rinvoq as a treatment for several inflammatory conditions. These include:

Research has shown that Rinvoq and other JAK inhibitors can be effective in treating certain types of inflammatory bowel disease (including Crohn’s disease and ulcerative colitis).

Two ongoing clinical studies are testing Rinvoq as a treatment for psoriatic arthritis in people who haven’t responded well to other DMARDs.

Rinvoq and children

Rinvoq isn’t approved for use in children. Its safety and effectiveness haven’t been proven in children.

Rinvoq is sometimes taken alone, but it’s often used along with other medications.

Rinvoq shouldn’t be taken with certain other drugs. These include other JAK inhibitors, such as tofacitinib (Xeljanz), and strong immunosuppressants, such as azathioprine (Azasan) and cyclosporine (Sandimmune, Neoral, Gengraf). Rinvoq also shouldn’t be taken with biologic DMARDs, such as infliximab (Remicade) or adalimumab (Humira).

Talk with your doctor if you have questions about adding Rinvoq to your treatment plan to help improve your rheumatoid arthritis (RA).

The following information describes the dosage that is commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Rinvoq comes as a tablet that’s available in one strength: 15 mg.

Dosage for rheumatoid arthritis

The typical Rinvoq dosage for rheumatoid arthritis is 15 mg taken once a day.

What if I miss a dose?

If you miss a dose of Rinvoq, take it as soon as you remember. However, if it’s close to the time for your next dose, skip your missed dose and take your next dose as scheduled. Never take a double dose to make up for a missed dose. This could raise your risk for side effects.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Rinvoq is meant to be used as a long-term treatment. If you and your doctor determine that Rinvoq is safe and effective for you, you’ll likely take it long term.

Rinvoq is FDA-approved to treat rheumatoid arthritis (RA) in adults. It’s used to treat RA in the following situations:

  • if your RA hasn’t responded well to methotrexate (Otrexup, Rasuvo, Trexall)
  • if you’ve had to stop taking methotrexate because of negative side effects

What happens with rheumatoid arthritis

RA is a chronic (long-term) condition in which your immune system attacks your joints. This can cause inflammation (swelling), pain, and stiffness in your joints.

RA usually affects your hands, wrists, and feet. However, it may also affect your shoulders, elbows, knees, or ankles. Over time, untreated RA can cause your joints to become deformed.

What Rinvoq does

Rinvoq is a disease-modifying antirheumatic drug (DMARD). It belongs to a class of medications called Janus kinase (JAK) inhibitors. It works by decreasing the activity of your immune system cells. This can reduce inflammation and relieve symptoms of rheumatoid arthritis, such as pain and swelling in your joints.

How long does it take to work?

Rinvoq begins working in your body after the first dose. However, it may take several weeks for you to notice an improvement in your symptoms.

There are no known interactions between Rinvoq and alcohol.

However, alcohol may make certain side effects of Rinvoq worse or more likely to occur. Examples of these side effects include nausea and liver problems.

If you drink alcohol, talk with your doctor about how much is safe to drink during your Rinvoq treatment.

Rinvoq can interact with live vaccines. It can also interact with other medications, certain supplements, and certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Rinvoq and live vaccines

You shouldn’t get live vaccines during your Rinvoq treatment. For live vaccines, you’re injected with a small amount of a virus so your body can learn to fight it.

You shouldn’t get these vaccines while using Rinvoq because the drug may weaken your immune system. If this happens, your body can’t properly fight the vaccine. This could make you sick.

Live vaccines you should avoid during your Rinvoq treatment include:

Before you start taking Rinvoq, talk with your doctor about whether you need any live vaccines. You and your doctor may decide to delay your Rinvoq treatment until after you’ve received any live vaccines you need.

Rinvoq and other medications

Below is a list of medications that can interact with Rinvoq. This list doesn’t contain all drugs that may interact with Rinvoq.

Before taking Rinvoq, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

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

Rinvoq and strong CYP3A4 inhibitors

Taking Rinvoq with drugs that inhibit (slow down) the activity of an enzyme called CYP3A4 can increase the amount of Rinvoq in your body. CYP3A4 helps your body break down drugs. When this process is slowed down, it raises your risk for side effects from Rinvoq.

Examples of CYP3A4 inhibitors include:

  • antivirals, such as ritonavir (Norvir) or elvitegravir
  • antifungals, such as ketoconazole or itraconazole (Sporanox)
  • antibiotics, such as clarithromycin or erythromycin (Ery-Tab)
  • calcium channel blockers, such as diltiazem (Cardizem CD, Cartia XT) or verapamil (Verelan, Calan SR)

Talk with your doctor if you’re taking any of these medications. Your doctor may choose to prescribe a drug other than Rinvoq to treat your rheumatoid arthritis.

Rinvoq and strong CYP3A4 inducers

Taking Rinvoq with medications that induce (speed up) the activity of an enzyme called CYP3A4 can decrease the amount of Rinvoq in your body. CYP3A4 helps your body break down drugs. When this process is sped up, Rinvoq may not be as effective.

Examples of CYP3A4 inducers:

  • antibiotics, such as rifampin (Rifadin) or rifabutin (Mycobutin)
  • anticonvulsants, such as carbamazepine (Carbatrol, Tegretol), oxcarbazepine (Trileptal), or phenytoin (Dilantin)
  • corticosteroids, such as dexamethasone
  • antivirals, such as efavirenz (Sustiva) or nevirapine (Viramune)

Talk with your doctor if you’re taking any of these drugs. Your doctor may prescribe a different drug to treat your rheumatoid arthritis,or they may adjust your dosage for your other medications.

Rinvoq and herbs and supplements

Avoid taking Rinvoq with an herbal supplement called St. John’s wort. Taking these together can decrease the level of Rinvoq in your body. This can make Rinvoq less effective.

Talk with your doctor if you take St. John’s wort. They may have you stop taking it during your Rinvoq treatment.

Check with your doctor or pharmacist before using any other herbs or supplements while taking Rinvoq.

Rinvoq and foods

Eating grapefruit or drinking grapefruit juice may increase the amount of Rinvoq in your body. This can make side effects of the drug worse. You should avoid grapefruit or grapefruit juice while taking Rinvoq.

As with all medications, the cost of Rinvoq can vary.

The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you may have to get Rinvoq at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before approving coverage for Rinvoq. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Rinvoq, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Rinvoq, or if you need help understanding your insurance coverage, help is available.

AbbVie, the manufacturer of Rinvoq, offers a program called Rinvoq Complete. If you have commercial insurance, you may also qualify for the Rinvoq Complete Savings Card to help lower the cost of the drug.

For more information and to find out if you’re eligible for support, call 800-274-6867 or visit the program website.

Generic version

Rinvoq isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Rinvoq, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat this specific condition. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for rheumatoid arthritis

Examples of other drugs that may be used to treat rheumatoid arthritis (RA) include:

You may wonder how Rinvoq compares with other medications that are prescribed for similar uses. Here we look at how Rinvoq and Xeljanz are alike and different.

Ingredients

The active ingredient in Rinvoq is upadacitinib. The active ingredient in Xeljanz is tofacitinib.

Uses

Rinvoq and Xeljanz are both FDA-approved for use in adults with rheumatoid arthritis (RA) that’s moderately to severely active. They can be used in the following situations:

  • if your RA hasn’t responded well to methotrexate (Otrexup, Rasuvo, Trexall)
  • if you’ve had to stop taking methotrexate because of negative side effects

Xeljanz is also FDA-approved to treat:

Drug forms and administration

Rinvoq comes as an extended-release tablet that’s taken by mouth. (Extended-release means the drug is released slowly over a certain period of time.) Xeljanz also comes as a tablet that’s taken by mouth. It’s available in immediate-release and extended-release forms.

Side effects and risks

Rinvoq and Xeljanz have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Rinvoq, with Xeljanz, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Xeljanz or with both drugs (when taken individually).

  • Can occur with Xeljanz:
    • increased risk for death, including sudden death, in older people with heart problems*
  • Can occur with both Rinvoq and Xeljanz:
    • changes to levels of certain blood cells, lipids, and liver enzymes
    • serious infections**
    • cancer**
    • blood clots**
    • changes to your levels of liver enzymes, cholesterol, and certain blood cells

* Xeljanz has a boxed warning for sudden death in older people with heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

** Both Rinvoq and Xeljanz have boxed warnings for serious infections, cancer, and blood clots.

Effectiveness

The only condition both Rinvoq and Xeljanz are used to treat is RA that’s moderately to severely active.

A review compared separate studies of the two drugs. These studies involved people whose RA didn’t respond well to DMARD treatment alone.

The review of studies found that Rinvoq plus methotrexate (Otrexup, Rasuvo, Trexall) was more effective than Xeljanz plus methotrexate at improving people’s symptoms and physical function by 20%.

Costs

Rinvoq and Xeljanz are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Rinvoq and Xeljanz generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Rinvoq and Humira are prescribed for similar uses. Here we look at how these drugs are alike and different.

Ingredients

The active ingredient in Rinvoq is upadacitinib. The active ingredient in Humira is adalimumab.

Uses

Both Rinvoq and Humira are FDA-approved to treat rheumatoid arthritis (RA) that’s moderately to severely active.

Humira is also approved to treat the following conditions:

Drug forms and administration

Rinvoq comes as a tablet that’s taken by mouth. Humira is given as a subcutaneous injection (under the skin). Humira comes in three forms: a single-dose pen, a single-dose prefilled syringe, and a single-dose vial of liquid solution.

Side effects and risks

Rinvoq and Humira have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Rinvoq, with Humira, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Rinvoq, with Humira, or with both drugs (when taken individually).

* Rinvoq has a boxed warning for blood clots. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warnings” at the beginning of this article.

** Both Rinvoq and Humira have boxed warnings for cancer and serious infections.

Effectiveness

The only condition both Rinvoq and Humira are used to treat is RA that’s moderately to severely active.

The use of Rinvoq and Humira in treating RA has been directly compared in a clinical study. The study included people with RA whose condition hadn’t responded well to treatment with methotrexate (Otrexup, Rasuvo, Trexall) alone.

People in the study continued to take methotrexate, in addition to either Rinvoq, Humira, or a placebo (a treatment with no active drug). The results showed that Rinvoq was more effective than Humira or a placebo at relieving symptoms and improving physical function.

In the study, at 12 weeks:

  • 71% of people taking Rinvoq had their symptoms and physical function improve by 20%.
  • 63% of people taking Humira had their symptoms and physical function improve by 20%.
  • 36% of people taking a placebo had their symptoms and physical function improve by 20%.

Costs

Rinvoq and Humira are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Rinvoq may be slightly less expensive than Humira. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You should take Rinvoq according to your doctor’s or healthcare provider’s instructions.

When to take

You can take Rinvoq at any time of day, but it’s best to take it at the same time each day.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Rinvoq with food

Rinvoq can be taken with or without food.

Can Rinvoq be crushed, split, or chewed?

No, Rinvoq tablets shouldn’t be crushed, split, or chewed. Each tablet should be swallowed whole with some water.

Rinvoq use isn’t recommended during pregnancy. Based on animal studies, it’s possible that Rinvoq could cause harm to a fetus. However, animal studies don’t always predict what will happen in humans.

Women who can become pregnant should use birth control during their Rinvoq treatment and for at least 4 weeks after their last dose.

Your doctor may ask you to take a pregnancy test before starting Rinvoq treatment. Talk with your doctor if you’re pregnant or are planning to become pregnant during your treatment. They may suggest a different treatment to treat your rheumatoid arthritis.

Rinvoq isn’t recommended for use during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Rinvoq.

Women who can become pregnant should use birth control during their Rinvoq treatment and for at least 4 weeks after their last dose.

For more information about taking Rinvoq during pregnancy, see the “Rinvoq and pregnancy” section above.

Breastfeeding isn’t recommended during Rinvoq treatment or for at least 6 days after your last dose. Animal studies show that the drug may pass into breastmilk. However, animal studies don’t always predict what will happen in humans.

If you’re currently breastfeeding, talk with your doctor about the best way to feed your child during your Rinvoq treatment.

Here are answers to some frequently asked questions about Rinvoq.

Will Rinvoq cure my rheumatoid arthritis?

No, Rinvoq won’t cure your condition. There is currently no cure for rheumatoid arthritis (RA). However, Rinvoq can help slow down the progression (worsening) of RA and relieve symptoms such as swelling and pain.

Talk with your doctor if you have questions about how Rinvoq can treat your RA.

Is Rinvoq an immunosuppressant?

Yes, Rinvoq is an immunosuppressant drug. It works by decreasing the activity of your immune system. This can reduce inflammation (swelling) and relieve symptoms of RA, such as pain and swelling in your joints.

Rinvoq is a disease-modifying antirheumatic drug (DMARD). It belongs to a class of medications known as Janus kinase (JAK) inhibitors.

By weakening your immune system, Rinvoq can raise your risk for serious infections. (See the “FDA warnings” section to learn more.)

Because of how Rinvoq affects your immune system, you should avoid getting live vaccines during your treatment. (See the next question for more information.)

Can I get vaccines while I’m taking Rinvoq?

You can get inactive vaccines while taking Rinvoq. These vaccines don’t have any live viruses in them. However, you should avoid getting live vaccines during treatment.

With live vaccines, you’re injected with a small amount of a virus so that your body can learn to fight it. You shouldn’t get these vaccines while using Rinvoq because the drug weakens your immune system. If this happens, your body won’t be able to properly fight the vaccine, and it may make you sick.

Examples of live vaccines that you should avoid during treatment include:

Examples of inactive vaccines that you can get during Rinvoq treatment include:

Before you begin taking Rinvoq, talk with your doctor about whether you may need any live vaccines. You and your doctor may decide to delay your treatment until after you’ve received any live vaccines you need.

Is Rinvoq a biologic?

No, Rinvoq isn’t a biologic drug. (Biologics are medications made from living organisms rather than chemicals.)

Rinvoq is a disease-modifying antirheumatic drug (DMARD). It belongs to a class of drugs called Janus kinase (JAK) inhibitors. Rinvoq works by decreasing the activity of your immune system cells. This can reduce inflammation and relieve symptoms of rheumatoid arthritis, such as pain and swelling in your joints

Some biologics are used to treat RA. (See the “Alternatives to Rinvoq” section above for a list of biologics that treat this condition.) Talk with your doctor if you’re interested in taking a biologic drug for your RA.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

  • Serious infections. Rinvoq can raise your risk for serious infections. If you currently have an infection, talk with your doctor before taking Rinvoq. Also tell your doctor if you have a history of serious infections, including tuberculosis (TB), shingles, or other fungal or viral infections. You should be tested for TB before starting Rinvoq. This risk for serious infections may be higher in people who take immunosuppressants with Rinvoq. Your Rinvoq treatment should be stopped if you get a serious infection.
  • Cancer. Rinvoq may raise your risk for lymphoma or other types of cancer. Talk with your doctor about your cancer risk before starting Rinvoq. If you have a history of cancer or are currently being treated for cancer, your doctor may prescribe an RA drug other than Rinvoq.
  • Blood clots. Rinvoq may raise your risk for blood clots. These include deep venous thrombosis (blood clot in a vein), arterial thrombosis (blood clot in an artery), and pulmonary embolism (blood clot in the artery of the lung). These blood clots may be serious and can even cause death.

Other precautions

Before taking Rinvoq, talk with your doctor about your health history. Rinvoq may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Diverticulitis or NSAID use. Taking Rinvoq may increase your risk for gastrointestinal tears. This may be more likely in people with a history of diverticulitis. It may also be more likely in those taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) or naproxen (Aleve), and in people who are taking corticosteroids (like prednisone) or methotrexate. Tell your doctor if you have a history of diverticulitis or currently take NSAIDs, corticosteroids, or methotrexate. They may choose to adjust your treatment approach to make it as safe as possible for you.
  • High cholesterol. Taking Rinvoq can raise your cholesterol levels. Talk with your doctor if you have high cholesterol or a history of high cholesterol. They may monitor you more closely during your Rinvoq treatment.
  • Liver problems. Rinvoq may cause increased levels of liver enzymes called aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Large increases in these enzyme levels can be a sign of liver damage. Tell your doctor if you have a history of liver problems or current liver problems. Your doctor may monitor you more closely during your Rinvoq treatment or prescribe a different drug to treat your condition.
  • Blood disorders. Taking Rinvoq may lower your levels of certain blood cells. Talk with your doctor if you have a history of blood disorders (such as neutropenia, lymphopenia, or anemia). They may monitor you more closely during your Rinvoq treatment or prescribe a different drug to treat your RA.
  • Allergic reaction. If you’ve had an allergic reaction to Rinvoq or any of its ingredients, you shouldn’t take Rinvoq. Talk with your doctor about your treatment options.
  • Pregnancy. Rinvoq use isn’t recommended during pregnancy. For more information, see the “Rinvoq and pregnancy” section above.
  • Breastfeeding. Breastfeeding isn’t recommended during Rinvoq treatment or for at least 6 days after your last dose. For more information, see the “Rinvoq and breastfeeding” section above.

Note: For more information about the potential negative effects of Rinvoq, see the “Rinvoq side effects” section above.

Don’t use more Rinvoq than your doctor recommends. For some drugs, doing so can lead to unwanted side effects or overdose.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Rinvoq from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Rinvoq tablets should be stored at a temperature of 36˚F to 77˚F (2˚C to 25˚C). Store Rinvoq in the original bottle to protect it from moisture. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Rinvoq and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Rinvoq has an FDA-approved indication for the treatment of rheumatoid arthritis when the condition hasn’t responded well to methotrexate (Otrexup, Rasuvo, Trexall) treatment alone or when the methotrexate treatment has not been tolerated well. It’s approved for use in adults but not children under age 18, as safety and effectiveness in this group haven’t been established.

Rinvoq can be used alone or in addition to methotrexate or other nonbiologic DMARDs, such as hydroxychloroquine (Plaquenil) or leflunomide (Arava)). It’s not recommended for use with other Janus kinase (JAK) inhibitors (Xeljanz), biologic DMARDs (examples include Remicade and Humira), or potent immunosuppressants such as azathioprine (Azasan) and cyclosporine (Sandimmune, Neoral, Gengraf).

Administration

Rinvoq is usually prescribed as 15 mg taken once daily by mouth, with or without food. The prescribing information in the medication’s package insert provides guidance regarding treatment interruption for certain laboratory parameters. These include neutrophil count, lymphocyte count, hemoglobin level, and hepatic transaminases.

Mechanism of action

Rinvoq is a JAK inhibitor that modulates the activity of the immune system by interrupting signaling pathways. Through this modulation, it decreases inflammation associated with rheumatoid arthritis.

Pharmacokinetics and metabolism

Steady-state concentrations of Rinvoq are achieved within about 4 days. Rinvoq is metabolized primarily through CYP3A4, with minor contribution from CYP2D6. The parent drug is primarily responsible for the pharmacological activity of the drug. Rinvoq is eliminated mostly as parent drug, through both urine and feces.

Contraindications

There are no specific contraindications for Rinvoq. However, there are boxed warnings and multiple precautions. See the “FDA warnings” and “Rinvoq Precautions” sections above for additional details.

Storage

Rinvoq tablets should be stored at a temperature of 36˚F to 77˚F (2˚C to 25˚C). Store Rinvoq in the original bottle to protect it from moisture.

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 other 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.