Rinvoq is a brand-name prescription drug. It’s FDA-approved to treat the following conditions:

  • Rheumatoid arthritis (RA). Rinvoq treats moderate to severe RA. It’s given to adults:
    • who had to stop taking TNF blockers because of negative side effects
  • Psoriatic arthritis (PsA). Rinvoq treats PsA in adults::
    • whose PsA does not respond well to TNF blockers, or
    • who had to stop taking TNF blockers because of negative side effects
  • Atopic dermatitis. Rinvoq treats atopic dermatitis in adults and children ages 12 years and older. (Atopic dermatitis is also called eczema.) It’s used for moderate to severe eczema that:
    • isn’t well managed with certain systemic medications, including biologics*, or
    • can’t be treated with certain other medications

* Systemic drugs affect the whole body. Biologic drugs are made from living cells.

Rinvoq has certain limitations to its use for these conditions. To learn more, see the “Rinvoq uses” section below.

Drug details

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 two strengths: 15 milligrams (mg) and 30 mg.

FDA approval

Rinvoq was approved by the FDA in 2019 to treat moderate to severe RA. In 2021, it was approved to treat PsA. And in 2022, Rinvoq was approved for atopic dermatitis.

Effectiveness

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

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 prescribing information.

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 a boxed warning for these side effects. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

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. In clinical studies, allergic reaction was rare, but it did occur. In some cases, allergic reactions were severe.

Symptoms of a mild allergic reaction can include:

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 or your local emergency number 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:

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 placebo is 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 eight 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, two people taking 15 mg of Rinvoq and one person taking 30 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.

Additionally, Rinvoq can cause certain viral infections to become active (cause symptoms) if you already have the virus in your body. This includes hepatitis and herpes viruses. Your doctor may order a test to check for hepatitis before you start taking Rinvoq.

* Rinvoq has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Upper respiratory infection

Rinvoq may cause an upper respiratory infection, such as the common cold. In clinical studies of people with rheumatoid arthritis:

  • 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 a 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.

* Rinvoq has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Blood clots

It’s possible that Rinvoq may raise your risk for blood clots. Drugs that belong to the same group of medications have caused 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. Similarly, blood clots rarely 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. People with a higher risk for blood clots with Rinvoq may be advised not to take the drug.

* Rinvoq has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Cardiovascular problems

It’s possible that Rinvoq may raise your risk for cardiovascular problems. Examples of these include heart attack, stroke, and death caused by a cardiovascular issue.

A drug that belongs to the same group of medications has caused these problems. Specifically, an increased risk for cardiovascular problems is seen in people with rheumatoid arthritis who:

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

Smoking can also increase the risk of cardiovascular issues with Rinvoq.

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

If you have any symptoms of heart attack or stroke, call 911 or your local emergency number. These symptoms can include:

  • chest pain or tightness
  • shortness of breath
  • numbness on one side of your body

* Rinvoq has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Increased risk of death

It’s possible that Rinvoq may raise the risk of death in some people.*

Another drug that belongs to the same group of medications has increased this risk in certain people. Specifically, an increased risk for death has been seen in people with rheumatoid arthritis who:

  • are at least 50 years of age
  • have at least one risk factor for cardiovascular problems

This risk was increased compared with people taking a tumor necrosis factor (TNF) blocker drug.

Your doctor can help you determine if your risk is increased with Rinvoq.

* Rinvoq has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

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 having you stop treatment until the side effect is resolved. In some cases, your doctor could recommend taking 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 to treat moderate to severe rheumatoid arthritis (RA). It can be used in adults:

With RA, your immune system attacks certain joints in your body. This leads to inflammation and pain in the affected 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.

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

For RA, Rinvoq should not be taken with certain other drugs. These include:

Effectiveness for rheumatoid arthritis

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%

Rinvoq for psoriatic arthritis

Rinvoq is FDA-approved to treat psoriatic arthritis (PsA). It’s used in adults:

With PsA, you have symptoms of arthritis, such as achy or stiff joints. You also have symptoms of psoriasis, including itchy or scaly skin patches.

For PsA, Rinvoq should not be taken with certain other drugs. These include:

Effectiveness for psoriatic arthritis

In clinical studies, Rinvoq was effective in treating psoriatic arthritis in adults. To learn how the drug performed in these studies, see its prescribing information.

Rinvoq for atopic dermatitis

Rinvoq is FDA-approved to treat moderate to severe atopic dermatitis. (Atopic dermatitis is also called eczema.) With atopic dermatitis, you have areas of skin that are dry and itchy.

Rinvoq is used in adults and children ages 12 years and older whose condition either:

  • isn’t well managed with certain systemic medications, including biologics*
  • can’t be treated with certain other medications

* Systemic drugs affect the whole body. Biologic drugs are made from living cells.

For atopic dermatitis, Rinvoq should not be taken with certain other drugs. These include:

Effectiveness for atopic dermatitis

In clinical studies, Rinvoq was effective in treating atopic dermatitis in adults and children. To learn how the drug performed in these studies, see its prescribing information.

Off-label uses for Rinvoq

In addition to the uses 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 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).

Rinvoq and children

Rinvoq is approved for use in certain children with atopic dermatitis. For more information, see the “Rinvoq for atopic dermatitis” section above.

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

For rheumatoid arthritis and psoriatic arthritis, Rinvoq may be prescribed in addition to another medication when the initial drug isn’t treating the condition well enough. Adding Rinvoq to a treatment plan can bring better results. For these conditions, Rinvoq can be taken with:

For atopic dermatitis, Rinvoq may be prescribed in combination with another medication when the initial drug isn’t treating the condition well enough. Rinvoq can be used with topical corticosteroids, such as triamcinolone acetonide 0.1% cream or fluocinolone acetonide 0.025% ointment (Synalar).

It’s important to note that Rinvoq should not be taken with certain other drugs. These include:

  • other JAK inhibitors, such as tofacitinib (Xeljanz)
  • depending on the condition being treated, other immunosuppressants such as:
    • azathioprine (Azasan)
    • cyclosporine (Sandimmune, Neoral, Gengraf)

Talk with your doctor if you have questions about adding Rinvoq to your treatment plan to help improve your condition.

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.

In some cases, your doctor may recommend a dosage of Rinvoq that’s different from those listed below. They may recommend this if you have liver or kidney problems and are taking the drug for certain conditions.

Drug forms and strengths

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 two strengths: 15 milligrams (mg) and 30 mg.

Dosage for rheumatoid arthritis

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

Dosage for psoriatic arthritis

The typical Rinvoq dosage for psoriatic arthritis is 15 mg taken once per day.

Dosage for atopic dermatitis

The typical starting dosage of Rinvoq for adults with atopic dermatitis is 15 mg taken once per day.

In adults ages 65 years and older, this is also the recommended ongoing dosage.

In adults younger than 65 years, the daily dosage may be increased to 30 mg if needed. If their atopic dermatitis doesn’t improve with 30 mg daily, their doctor may recommend stopping treatment with Rinvoq.

Children’s dosage

The typical starting dosage of Rinvoq for children with atopic dermatitis is 15 mg taken once per day. This is for children ages 12 years and older who weigh at least 40 kilograms, which is about 88 pounds.

Their daily dosage may be increased to 30 mg per day if needed. If their atopic dermatitis doesn’t improve with 30 mg daily, their doctor may recommend stopping treatment with Rinvoq.

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 approved to treat the following conditions in certain situations:

What happens with these conditions

RA, PsA, and atopic dermatitis are chronic (long-term) conditions in which your immune system attacks certain parts of your body.

With RA and PsA, your joints are affected, causing inflammation, pain, and stiffness. With PsA and atopic dermatitis, your skin is affected, leading to inflammation and skin changes.

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 your condition.

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 should not 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 should not get these vaccines while using Rinvoq because the drug may weaken your immune system. If this happens, your body can’t properly respond to 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:

  • antiretrovirals, such as ritonavir (Norvir) or darunavir (Prezista)
  • 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 condition.

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
  • antiretrovirals, such as efavirenz (Sustiva) or nevirapine (Viramune, Viramune XR)

Talk with your doctor if you’re taking any of these drugs. Your doctor may prescribe a different drug to treat your condition,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. To find current prices for Rinvoq in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. 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 include:

Alternatives for psoriatic arthritis

Examples of other drugs that may be used to treat psoriatic arthritis include:

Alternatives for atopic dermatitis

Examples of other drugs that may be used to treat atopic dermatitis include:

  • topical corticosteroids, such as
    • fluocinolone (Synalar)
    • triamcinolone
    • betamethasone
  • topical calcineurin inhibitors, such as
    • tacrolimus (Protopic)
    • pimecrolimus (Elidel)
  • biologic drugs, such as
    • dupilumab (Dupixent)

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 approved to treat moderate to severe rheumatoid arthritis (RA). They can be used in adults:

These drugs are also both used to treat psoriatic arthritis (PsA) in adults:

  • whose PsA did not respond well to a TNF blocker, or
  • who had to stop taking TNF blockers because of negative side effects

Rinvoq is also approved to treat atopic dermatitis in adults and some children. (Atopic dermatitis is also called eczema.)

Xeljanz is also 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. This medication also comes as a solution that’s taken by mouth.

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 Rinvoq:
    • cardiovascular problems*
    • increased risk of death*
  • Can occur with Xeljanz:
    • increased risk of death, including sudden death, in older people with heart problems*
  • Can occur with both Rinvoq and Xeljanz:
    • 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. For more information about Rinvoq’s boxed warnings, see “FDA warnings” at the beginning of this article.

Effectiveness

Both Rinvoq and Xeljanz are approved to treat RA and psoriatic arthritis.

A review compared separate studies of the two drugs in treating RA. 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%.

These drugs haven’t been in any studies directly comparing them as a treatment for psoriatic arthritis.

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 approved to treat the following conditions in adults:

Rinvoq is also approved to treat atopic dermatitis, which is also called eczema.

Humira is also approved to treat:

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

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 this side effect. 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

Both Rinvoq and Humira are approved to treat RA and psoriatic arthritis.

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%.

The use of Rinvoq and Humira in treating psoriatic arthritis was directly compared in a clinical study. The study included people with psoriatic arthritis:

  • whose condition didn’t respond well to treatment with a drug such as methotrexate (Otrexup, Rasuvo, Trexall)
  • who couldn’t tolerate side effects of a drug such as methotrexate

More people had their symptoms reduced and physical function improved by 20% with Rinvoq compared with a placebo. (A placebo is a treatment with no active drug.)

When compared with Humira, the 30-mg dose of Rinvoq was more effective in improving symptoms of psoriatic arthritis. However, there was no difference in effectiveness between Humira and the 15-mg dose of Rinvoq.

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 another healthcare professional’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 should not be crushed, split, or chewed. Each tablet should be swallowed whole with some water.

Rinvoq use is not 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.

People who can become pregnant should use birth control during 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 condition.

Rinvoq is not 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.

People who can become pregnant should use birth control during 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 is not recommended during Rinvoq treatment or for at least 6 days after your last dose. Animal studies show that the drug may pass into breast milk. 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 you’re taking Rinvoq. These vaccines don’t have any live germs in them. However, you should avoid getting live vaccines during treatment.

With live vaccines, you’re injected with a small amount of a live germ so that your body can learn to fight it. You should not get these vaccines while using Rinvoq because the drug weakens your immune system. If this happens, your body won’t be able to properly respond to 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.)

Instead, 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 help reduce symptoms of the conditions Rinvoq is used to treat.

Some biologics are also used for the conditions Rinvoq treats. To view examples of biologic drugs, see the “Alternatives to Rinvoq” section above.

Talk with your doctor if you’re interested in taking a biologic drug for your condition.

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. It’s possible that Rinvoq may raise your risk for blood clots. Drugs that belong to the same group of medications have caused 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. People with a higher risk for blood clots with this type of medication may be advised not to take Rinvoq.
  • Cardiovascular problems. It’s possible that Rinvoq may raise your risk for cardiovascular problems. A drug that belongs to the same group of medications has caused these problems in certain people. Examples include heart attack, stroke, and death caused by a cardiovascular issue. People with a higher risk for cardiovascular problems with this type of medication may be advised not to take Rinvoq.
  • Increased risk of death. It’s possible that Rinvoq may raise the risk of death in certain people. A drug that belongs to the same group of medications has increased this risk in some people. Your doctor can help you determine if you have a higher risk for death with this type of medication.

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 (Advil, Motrin) or naproxen (Aleve), and in people who are taking corticosteroids (such as 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 level. 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 should not take Rinvoq. Talk with your doctor about your treatment options.
  • Pregnancy. Rinvoq use is not recommended during pregnancy. For more information, see the “Rinvoq and pregnancy” section above.
  • Breastfeeding. Breastfeeding is not 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.

Do not 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 FDA-approved indications for the treatment of:

  • moderate to severe rheumatoid arthritis in adults when the condition hasn’t responded well to one or more tumor necrosis factor (TNF) blockers or when these drugs have not been tolerated well.
  • psoriatic arthritis in adults when the condition hasn’t responded well to one or more tumor necrosis factor (TNF) blockers or when these drugs have not been tolerated well.
  • moderate to severe atopic dermatitis in adults and children ages 12 years and older when the condition hasn’t responded well to systemic drugs, including biologic medications, or when these other drugs cannot be used.

Rinvoq should not be prescribed with certain other drugs, including:

  • other JAK inhibitors, such as tofacitinib (Xeljanz)
  • depending on the condition being treated, other immunosuppressants such as:
    • azathioprine (Azasan)
    • cyclosporine (Sandimmune, Neoral, Gengraf)
  • biologic DMARDs, such as infliximab (Remicade) or adalimumab (Humira)

Administration

For rheumatoid arthritis or psoriatic arthritis, Rinvoq is usually prescribed as 15 mg taken once daily by mouth, with or without food.

For atopic dermatitis, the typical starting dosage is 15 mg taken once daily. In certain individuals, the maintenance dosage may be as high as 30 mg daily, based on their condition’s response to treatment.

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, psoriatic arthritis, and atopic dermatitis.

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

Rinvoq is contraindicated in people who have experienced a hypersensitivity reaction in the past to this drug. Additionally, the drug has boxed warnings and multiple precautions. See the “FDA warnings” section 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 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.