Rinvoq is a brand-name oral tablet that’s prescribed for rheumatoid arthritis and other conditions. Rinvoq contains the active ingredient upadacitinib and is a type of disease-modifying antirheumatic drug.

Rinvoq is FDA approved to treat the following conditions in certain adults:

Doctors may also prescribe the drug to treat moderate to severe atopic dermatitis in certain children ages 12 years and older.

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

Drug details

You’ll find key information about Rinvoq below.

  • Drug class: Janus kinase (JAK) inhibitor*
  • Drug form: extended-release oral tablet†
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2019

* JAK inhibitors are a type of disease-modifying antirheumatic drug (DMARD). DMARDS help ease inflammation and pain caused by certain conditions.
† Extended release means the drug is released in your body slowly over a period of time.

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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. For more information about Rinvoq’s cost, you can refer to this article.

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 use them 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 whether the drug will be covered.

If you’re unsure whether 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 800-2RINVOQ (800-274-6867) or visit the program website.

Generic version

Rinvoq isn’t available in a generic form. See the “Rinvoq generic” section below for more information.

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, see this article. Or talk with your doctor or pharmacist. In addition to side effect details, they can give you tips on how to manage side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has 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 do not 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.
† For more on this side effect, see “Side effect details” below.

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
    • 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. Boxed warnings alert doctors and patients about drug effects that may be dangerous. See “Side effect details” below for more information.

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 trials, 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 are not common with Rinvoq use. However, clinical trials have shown they can happen more often in people taking Rinvoq than in 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 of serious infections.* These infections could lead to a hospital stay or even be fatal. In clinical trials, 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 less often than other infections in people taking Rinvoq in clinical trials.

Although serious infections resulting from Rinvoq use are rare, taking a higher dosage of the drug may increase your risk of this side effect.

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.

Symptoms of an upper respiratory infection may vary but can include a cough, sore throat, sneezing, and 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.

Talk with your doctor about your cancer risk before starting Rinvoq. If you have a history of cancer or are currently receiving treatment 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 of 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.

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. If you have a higher risk of blood clots with Rinvoq, your doctor may advise you 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 of 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 of 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 of cardiovascular problems with this type of medication, your doctor might advise you not to 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 a 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 of 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 determine whether 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 adjusting 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. Doctors may also prescribe Rinvoq 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 who:

  • have RA that did not respond well to medications called tumor necrosis factor (TNF) blockers, or
  • had to stop taking TNF blockers because of negative side effects

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 misshapen.

For details about this condition, you can refer to our rheumatoid arthritis hub.

Rinvoq can be taken alone, with methotrexate, or with nonbiologic disease-modifying antirheumatic drugs (DMARDs),* such as hydroxychloroquine (Plaquenil) or leflunomide (Arava).

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

* DMARDS help ease inflammation and pain caused by certain conditions.

Effectiveness for rheumatoid arthritis

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

Rinvoq for psoriatic arthritis

Rinvoq is FDA approved to treat psoriatic arthritis (PsA) in adults who:

  • have PsA that did not respond well to medications called TNF blockers, or
  • had to stop taking TNF blockers because of negative side effects

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 details about this condition, you can refer to our psoriasis hub and our arthritis hub.

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

  • other JAK inhibitors, such as tofacitinib
  • strong immunosuppressants, such as azathioprine and cyclosporine
  • biologic DMARDs, such as infliximab and adalimumab

Effectiveness for psoriatic arthritis

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

Rinvoq for atopic dermatitis

Rinvoq is FDA approved to treat moderate to severe atopic dermatitis. (Atopic dermatitis is a type of eczema.) With atopic dermatitis, you have areas of skin that are dry and itchy. For details about this condition, you can refer to our eczema hub.

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,* or
  • cannot 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:

  • other JAK inhibitors, such as tofacitinib
  • any immunosuppressants
  • biologic DMARDs, such as infliximab and adalimumab

Effectiveness for atopic dermatitis

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

Rinvoq for ulcerative colitis

Rinvoq is FDA approved to treat moderate to severe ulcerative colitis (UC). It’s used in adults who:

  • have UC that did not respond well to medications called TNF blockers, or
  • had to stop taking TNF blockers because of negative side effects

With UC, you have long-term inflammation in your colon. This can cause diarrhea, abdominal pain, and severe urges to have a bowel movement. For details about this condition, you can refer to our inflammatory bowel disease hub.

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

  • other JAK inhibitors, such as tofacitinib
  • strong immunosuppressants, such as azathioprine and cyclosporine
  • biologic drugs for UC, such as infliximab and adalimumab

Effectiveness for ulcerative colitis

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

Rinvoq for Crohn’s disease

Rinvoq is FDA approved to treat moderate to severe Crohn’s disease. It’s used in adults who:

  • have Crohn’s disease that did not respond well to medications called TNF blockers, or
  • had to stop taking TNF blockers because of negative side effects

With Crohn’s disease, you have long-term inflammation in any part of your digestive tract, including your stomach or intestines. This can cause mouth sores, diarrhea, and abdominal pain. For details about this condition, you can refer to our inflammatory bowel disease hub.

For Crohn’s disease, Rinvoq should not be taken with certain other drugs. These include:

  • other JAK inhibitors, such as tofacitinib
  • strong immunosuppressants, such as azathioprine and cyclosporine
  • biologic drugs for Crohn’s disease, such as infliximab and adalimumab

Effectiveness for Crohn’s disease

In clinical trials, Rinvoq was effective in treating Crohn’s in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for ankylosing spondylitis

Rinvoq is FDA approved to treat ankylosing spondylitis that’s active (causing symptoms) in adults who:

  • have ankylosing spondylitis that did not respond well to medications called TNF blockers, or
  • had to stop taking TNF blockers because of negative side effects

With ankylosing spondylitis, you have inflammation in and around the joints of your spine. This can cause stiffness, pain, and limited range of motion in your back, particularly in the lower back. For details about this condition, you can refer to our arthritis hub.

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

  • other JAK inhibitors, such as tofacitinib
  • strong immunosuppressants, such as azathioprine and cyclosporine
  • biologic DMARDs, such as infliximab and adalimumab

Effectiveness for ankylosing spondylitis

In clinical trials, Rinvoq was effective in treating ankylosing spondylitis in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for non-radiographic axial spondyloarthritis

Rinvoq is FDA approved to treat non-radiographic axial spondyloarthritis (nr-AxSpA) that’s active (causing symptoms) in adults who:

  • have nr-AxSpA that did not respond well to medications called TNF blockers, or
  • had to stop taking TNF blockers because of negative side effects

With nr-AxSpA, you have inflammation in and around your spinal joints. This can cause stiffness, pain, and limited movement in your back, especially your lower back.

The difference between this condition and ankylosing spondylitis (which Rinvoq also treats) is that with nr-AxSpA, there is no visible joint damage on X-rays. To learn more, you can refer to our arthritis hub.

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

  • other JAK inhibitors, such as tofacitinib
  • strong immunosuppressants, such as azathioprine and cyclosporine
  • biologic DMARDs, such as infliximab and adalimumab

Effectiveness for non-radiographic axial spondyloarthritis

In clinical trials, Rinvoq was effective in treating nr-AxSpA in adults. To learn how the drug performed in these trials, see its prescribing information.

Off-label uses for Rinvoq

In addition to the uses listed above, doctors may prescribe Rinvoq off-label for other purposes. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition. Below are examples of off-label uses for Rinvoq.

Rinvoq for autoimmune conditions

Ongoing research is looking at Rinvoq as a treatment for several autoimmune conditions. (With autoimmune conditions, your immune system mistakenly attacks healthy tissue in your body.) These include:

To learn more about possible off-label uses of Rinvoq, talk with your doctor or pharmacist.

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 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 is sometimes taken by itself, but it’s often taken in combination with other medications.

For rheumatoid arthritis and psoriatic arthritis, doctors may prescribe Rinvoq 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, doctors may prescribe Rinvoq in combination with another medication when the initial drug isn’t treating the condition well enough. Rinvoq can be taken with topical corticosteroids, such as triamcinolone acetonide 0.1% cream or fluocinolone acetonide 0.025% ointment (Synalar).

For Crohn’s disease, doctors may prescribe Rinvoq 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:

  • methotrexate
  • aminosalicylates, such as sulfasalazine or mesalamine

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

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 differs 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 you take by mouth. (Extended release means the drug is released in your body slowly over a period of time.)

Rinvoq tablets are available in three strengths: 15 milligrams (mg), 30 mg, and 45 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.

This is also the recommended ongoing dosage for adults ages 65 years and older.

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.

Dosage for ulcerative colitis

The typical induction (starting) Rinvoq dosage for ulcerative colitis (UC) is 45 mg once daily for 8 weeks.

After this, the recommended maintenance (ongoing) dosage is either 15 mg or 30 mg once daily. If your condition is severe, your doctor may prescribe the higher 30-mg daily dosage. They’ll ultimately prescribe the lowest dosage that’s effective for you.

Dosage for Crohn’s disease

The typical induction (starting) Rinvoq dosage for Crohn’s disease is 45 mg once daily for 12 weeks.

After this, the recommended maintenance (ongoing) dosage is either 15 mg or 30 mg once daily. If your condition is severe, your doctor may prescribe the higher 30-mg daily dosage. They’ll ultimately prescribe the lowest dosage that’s effective for you.

Dosage for ankylosing spondylitis

The typical Rinvoq dosage for ankylosing spondylitis is 15 mg, taken once per day.

Dosage for non-radiographic axial spondyloarthritis

The typical Rinvoq dosage for non-radiographic axial spondyloarthritis is 15 mg, taken once per day.

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 doctor may increase their daily dosage to 30 mg per day if needed. If a child’s 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 of 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

Each of the conditions Rinvoq is approved to treat is a chronic (long-term) condition in which your immune system attacks certain parts of your body.

RA, PsA, ankylosing spondylitis, and nr-AxSpA affect your joints. These conditions cause inflammation, pain, and stiffness.

PsA and atopic dermatitis affect your skin, leading to inflammation and skin changes.

UC affects your colon. This can lead to diarrhea, abdominal pain, and other gastrointestinal symptoms.

Crohn’s disease may affect any part of your digestive tract, including your stomach or intestines. This can cause mouth sores, diarrhea, and other gastrointestinal symptoms.

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.

* DMARDS help ease inflammation and pain caused by certain conditions.

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.

Alcohol may also worsen certain conditions that Rinvoq treats. For example, drinking alcohol can worsen ulcerative colitis symptoms.

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.

Learn more about Rinvoq interactions below or see this article for detailed information.

Rinvoq and live vaccines

You should not get live vaccines during your Rinvoq treatment. With live vaccines, you’re injected with a small amount of a virus or bacterium 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 respond to the vaccine properly. 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 are examples of medications that can interact with Rinvoq. This section does not list 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 of side effects from Rinvoq.

Examples of CYP3A4 inhibitors include:

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 be less effective.

Examples of CYP3A4 include:

  • 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 the dosage of 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 and grapefruit juice while taking Rinvoq.

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 the condition they are listed under. 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:

  • DMARDs, such as:
    • methotrexate (Otrexup, Rasuvo, Trexall)
    • leflunomide (Arava)
    • apremilast (Otezla)
    • sulfasalazine (Azulfidine)
    • tofacitinib (Xeljanz)
  • biologic drugs, such as:
    • abatacept (Orencia)
    • adalimumab (Humira)
    • certolizumab (Cimzia)
    • infliximab (Remicade)

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
  • biologic drugs, such as
    • tralokinumab-ldrm (Adbry)

Alternatives for ulcerative colitis

Examples of other drugs that may be used to treat ulcerative colitis include:

  • aminosalicylates, such as:
    • balsalazide (Colazal)
    • olsalazine (Dipentum)
    • sulfasalazine (Azulfidine)
  • immunomodulators, such as:
    • azathioprine (Imuran, Azasan)
    • 6-mercaptopurine (6-MP)
  • biologics, such as:
    • adalimumab (Humira)

Alternatives for Crohn’s disease

Examples of other drugs that may be used to treat Crohn’s disease include:

  • aminosalicylates, such as:
    • balsalazide (Colazal)
    • olsalazine (Dipentum)
    • sulfasalazine (Azulfidine)
    • mesalamine (Asacol HD, Lialda, Delzicol)
  • immunomodulators, such as:
    • azathioprine (Imuran, Azasan)
    • 6-mercaptopurine (6-MP)
  • biologics, such as:
    • adalimumab (Humira)
    • infliximab (Inflectra, Remicade, Renflexis)
    • golimumab (Simponi)
    • vedolizumab (Entyvio)

Alternatives for ankylosing spondylitis

Examples of other drugs that may be used to treat ankylosing spondylitis include:

  • DMARDs, such as:
    • methotrexate (Otrexup, Rasuvo, Trexall)
    • sulfasalazine (Azulfidine)
    • tofacitinib (Xeljanz)
  • biologics, such as:

Alternatives for non-radiographic axial spondyloarthritis

Examples of other drugs that may be used to treat non-radiographic axial spondyloarthritis include:

  • DMARDs, such as:
    • methotrexate (Otrexup, Rasuvo, Trexall)
    • sulfasalazine (Azulfidine)
  • biologics, such as:
    • certolizumab (Cimzia)
    • secukinumab (Cosentyx)
    • ixekizumab (Taltz)

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

The active ingredient in Rinvoq is upadacitinib. The active ingredient in Dupixent is dupilumab.

Uses

These drugs are both approved to treat atopic dermatitis in certain adults and children. For this use, Rinvoq can be given to children ages 12 years and older, and Dupixent can be given to children ages 6 months and older.

In addition to atopic dermatitis, Rinvoq is approved to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, Crohn’s disease, ankylosing spondylitis, and non-radiographic axial spondyloarthritis. For these uses, Rinvoq is prescribed only to adults.

Dupixent is also approved to treat asthma, chronic (long-term) rhinosinusitis with nasal polyps (noncancerous growths), eosinophilic esophagitis, and prurigo nodularis (a skin condition that causes itchy bumps). For these uses, Dupixent is prescribed to adults. For eosinophilic esophagitis, Dupixent is also prescribed to children ages 12 months and older. For asthma, Dupixent is also prescribed to children ages 6 years and older.

Forms

Rinvoq comes as an extended-release tablet that you take by mouth. (Extended release means the drug is released in your body slowly over a period of time.) Dupixent is given as a subcutaneous injection using single-dose prefilled syringes and pens.

Side effects

Rinvoq and Dupixent tend to cause different side effects. For more information, see the “Rinvoq side effects” section above and this article on Dupixent’s side effects. You can also refer to the prescribing information for Rinvoq and Dupixent, or talk with your doctor for details. It’s important to note that Rinvoq has several boxed warnings,* but Dupixent doesn’t come with any boxed warnings.

* Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). See “Rinvoq side effects” above for details.

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 who:

  • have RA that did not respond well to medications called tumor necrosis factor (TNF) blockers, or
  • had to stop taking TNF blockers because of negative side effects

These drugs are also both used to treat psoriatic arthritis (PsA), ulcerative colitis (UC), and ankylosing spondylitis in adults who:

  • have PsA, UC, or ankylosing spondylitis that did not respond well to a TNF blocker, or
  • had to stop taking TNF blockers because of negative side effects

Rinvoq is also approved to treat Crohn’s disease and non-radiographic axial spondyloarthritis in certain adults and atopic dermatitis in certain adults and children ages 12 years and older. (Atopic dermatitis is a type of eczema.)

Xeljanz is also approved to treat polyarticular juvenile idiopathic arthritis, a type of arthritis in children that affects at least five joints. For this purpose, Xeljanz is prescribed to children ages 2 years and older.

Drug forms and administration

Rinvoq comes as an extended-release oral tablet. (Extended release means the drug is released slowly over a certain period of time.)

Xeljanz comes as an oral tablet. It’s available in immediate-release and extended-release forms. This medication also comes as a solution that you take 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 both drugs (when taken individually).

  • Can occur with both Rinvoq and Xeljanz:
    • increased risk of death*
    • cardiovascular problems*
    • serious infections*
    • cancer*
    • blood clots*
    • changes to your levels of liver enzymes, cholesterol, and certain blood cells

* Both Rinvoq and Xeljanz have boxed warnings for cardiovascular problems, increased risk of death, serious infections, cancer, and blood clots. For more information about Rinvoq’s boxed warnings, see the “Rinvoq side effects” section above.

Effectiveness

Both Rinvoq and Xeljanz are approved to treat some of the same conditions, including RA and PsA.

A review compared separate studies of the two drugs in treating RA. These studies involved people whose RA didn’t respond well to disease-modifying antirheumatic drug (DMARD) treatment alone.

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

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

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.

The actual price you’ll pay for either Rinvoq or Xeljanz depends on your insurance plan, your location, and the pharmacy you use.

Doctors prescribe Rinvoq and Humira 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:

In addition, Humira is approved to treat UC in children ages 5 years and older and Crohn’s disease in children ages 6 years and older.

Rinvoq is also approved to treat:

Humira is also approved to treat:

Drug forms and administration

Rinvoq comes as a tablet that you take by mouth. Humira is given as a subcutaneous injection. 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 this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Rinvoq side effects” above.
† Both Rinvoq and Humira have boxed warnings for cancer and serious infections.

Effectiveness

Both Rinvoq and Humira are approved to treat some of the same conditions, including RA and PsA.

A clinical trial directly compared the use of Rinvoq and Humira in treating RA. The study included people with RA whose condition had not 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.

A clinical trial directly compared the use of Rinvoq and Humira in treating PsA. The study included people with PsA who:

  • have PSA that did not respond well to treatment with a drug such as methotrexate (Otrexup, Rasuvo, Trexall)
  • could not tolerate side effects of a drug such as methotrexate

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

In the trial, the 30-mg dose of Rinvoq was more effective at reducing symptoms of PsA compared with Humira. However, the 15-mg dose of Rinvoq and Humira were similarly effective.

Costs

Rinvoq and Humira are both brand-name drugs. There is currently no generic form of Rinvoq available.

Humira is a biologic drug, which is made from living cells. It’s not possible to copy biologics exactly. So instead of a generic version, a biologic may have a biosimilar version. A biosimilar is similar to the parent drug and considered to be just as safe and effective. Several biosimilars are available for Humira, including Amjevita, Hadlima, and Hyrimoz.

Generic and biosimilar medications tend to cost less than their brand-name versions.

The actual price you’ll pay for either Rinvoq or Humira 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. It comes as a tablet that you swallow whole.

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.

Note that with some extended-release* tablets such as Rinvoq, you may occasionally see pieces of the tablet in your stool. This is not unusual for extended-release tablets.

But let your doctor know if you’re seeing the drug in your stool regularly. This could be a sign that the drug is not breaking down properly in your body. In this case, your doctor may recommend switching treatments for your condition.

* Extended release means the drug is released in your body slowly over a period of time.

Taking Rinvoq with food

You can take Rinvoq with or without food.

Can Rinvoq be crushed, split, or chewed?

No, you should not crush, split, or chew Rinvoq tablets. You should swallow each tablet whole with some water.

If you can become pregnant, are breastfeeding, or are using birth control, it’s important to consider whether Rinvoq is a safe choice for you.

You can also refer to this article for information. If you have additional questions, talk with your doctor.

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 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 of serious infections. (See the “Rinvoq side effects” section above 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 respond to the vaccine properly, 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 need any live vaccines. You and your doctor may decide to delay your treatment until 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 DMARD. It belongs to a class of drugs called 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 of 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 bacterial, fungal, or viral infections. You should be tested for TB before starting Rinvoq. This risk of serious infections may be higher in people who take immunosuppressants with Rinvoq. If you get a serious infection, your doctor will likely have you stop taking Rinvoq.
  • Cancer. Rinvoq may raise your risk of 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 a drug other than Rinvoq for your condition.
  • Blood clots. It’s possible that Rinvoq may raise your risk of 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. If you have a higher risk of blood clots with this type of medication, your doctor might advise you not to take Rinvoq.
  • Cardiovascular problems. It’s possible that Rinvoq may raise your risk of 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 due to a cardiovascular issue. If you have a higher risk of cardiovascular problems with this type of medication, your doctor might advise you 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 will determine whether you have a higher risk of death with this type of medication.

For more details about these boxed warnings, you can refer to the “Rinvoq side effects” section above.

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 of 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 taking corticosteroids (such as prednisone) or methotrexate. Tell your doctor if you have had 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.
  • Conditions that shorten digestion time. Pieces of Rinvoq tablet may appear in stool, especially when substances move more quickly through the digestive system than usual. This can occur more frequently in people who’ve had certain digestive system procedures, such as an ileostomy or colostomy. If you have a condition that shortens digestion time, let your doctor know. Also let them know if you see the medication in your stool regularly. This could indicate that your body is not breaking down the drug effectively. Your doctor may recommend a treatment other than Rinvoq for your condition.
  • 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, breastfeeding, and birth control” 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 pregnancy, breastfeeding, and birth control” 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 America’s Poison Centers at 800-222-1222 or use its 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 indicates how long the medication remains effective. 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, ask your pharmacist how to dispose of it correctly.

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 36–77˚F (2–25˚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.

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.

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