Rinvoq (Upadacitinib)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Rinvoq Used For?
Rinvoq contains upadacitinib, a Janus Kinase (JAK) inhibitor that helps reduce inflammation by blocking signals in your body’s immune system that cause inflammation and immune cell production.
Primary Uses
Rinvoq treats moderate to severe active rheumatoid arthritis (reducing joint pain, tenderness, stiffness and swelling), moderate to severe active psoriatic arthritis (reducing pain, stiffness, swelling in joints and spine, skin rash and tiredness), active ankylosing spondylitis (reducing back pain and spine inflammation), moderate to severe atopic dermatitis (improving skin condition, reducing itching, flares, pain, anxiety, depression and sleep disturbance), active non-radiographic axial spondyloarthritis (reducing back pain and spine inflammation), moderate to severe active ulcerative colitis (controlling inflammation, reducing bloody stools, abdominal pain and bathroom urgency), and moderate to severe active Crohn’s disease (controlling inflammation, reducing loose stools, abdominal pain and intestinal inflammation).
How It Works
JAK enzymes create signals in your body’s immune system that result in inflammation. Rinvoq works by blocking these signals, thereby reducing inflammation and the production of immune cells within your body.
Quality of Life: Rinvoq has been shown to help improve your ability to do normal daily activities, reduce fatigue, and improve your overall health-related quality of life.
How to Take Rinvoq
Take Rinvoq exactly as prescribed by your doctor. The usual dose is one tablet once daily, swallowed whole with a full glass of water, with or without food.
Dosage Instructions
For rheumatoid arthritis, psoriatic arthritis, non-radiographic axial spondyloarthritis or ankylosing spondylitis: take one 15 mg tablet once daily. For atopic dermatitis: take one 15mg or 30 mg tablet once daily as prescribed (15 mg daily if you’re 65 or older, or an adolescent 12+ years). For ulcerative colitis: start with one 45 mg tablet daily for 8 weeks (induction), then one 15 mg or 30 mg tablet daily (maintenance) – 15 mg daily if you’re 65 or older. For Crohn’s disease: start with one 45 mg tablet daily for 12 weeks (induction), then one 15 mg or 30 mg tablet daily (maintenance) – 15 mg daily if you’re 65 or older. Do not split, crush, or chew tablets. Take at the same time each day. Avoid grapefruit food or drinks during treatment.
What If You Miss a Dose?
If you miss a dose, take it as soon as you remember as long as it’s at least 10 hours before your next dose. If you forget for an entire day, skip the missed dose and take only your regular single dose the following day.
Important: Never take a double dose to make up for a missed dose. Do not stop taking or change your dose without checking with your doctor first.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Sore or scratchy throat
- Blocked or runny nose
- Flu symptoms
- Nausea
- Belly pain
- Fever
- Weight gain
- Unusual tiredness or weakness
- Anemia
- Headache
- Spinning sensation (vertigo)
- Acne
- Cold sores
- Hair follicle redness and swelling
- Hives
- Rash
- Warts
Seek immediate medical attention if you experience:
- Signs of serious infection (fever, sweating, chills, shortness of breath, tiredness, muscle aches, diarrhea, stomach pain, cough, weight loss, burning urination)
- Blood disorder signs (swollen glands in neck, armpits, groin)
- Painful skin rash with blisters
- New or changing skin spots, sores, or lesions
- Cluster of warm, red or painful skin sores or blisters
- GI perforation signs (sudden stomach pain, fever, chills, nausea, vomiting)
- Allergic reaction signs (breathing difficulty, chest tightness, wheezing, severe dizziness, face/lip/tongue/throat swelling, severe itching with rash)
- Tuberculosis signs (fever, night sweats, chills, breathing difficulty, persistent cough, bloody phlegm, weight loss)
- Blood clot signs (leg pain/tenderness, leg redness/swelling, chest pain, upper back pain, sudden shortness of breath)
- Pneumonia signs (fever, chills, cough with phlegm, tiredness, shortness of breath, chest pain)
- Heart attack signs (chest pain, lightheadedness, nausea, jaw/neck/back pain, arm/shoulder pain, shortness of breath)
- Stroke signs (speech trouble, sudden numbness/weakness/paralysis on one side, vision problems, headache, walking trouble)
Important Warnings
Rinvoq has important safety warnings, especially for people with certain medical conditions or risk factors. Your doctor has prescribed Rinvoq because they believe it’s the most suitable option for your condition.
Who Should Not Take Rinvoq
Do not take Rinvoq if you’re already using biological medicines (like etanercept, adalimumab), taking medicines that strongly suppress your immune system (like azathioprine, ciclosporin, tacrolimus), or if you’re allergic to upadacitinib or any ingredients in Rinvoq.
Medical Conditions to Discuss
Tell your doctor if you have: any infections or recurring infections, tuberculosis exposure or travel to TB-endemic areas, shingles or chicken pox history, hepatitis B or C, recent vaccinations or scheduled immunizations, blood clots or increased clotting risk, smoking history, cancer including skin cancer or lymphomas, abnormal blood cell counts, heart problems/high blood pressure/high cholesterol, kidney or liver problems, stomach problems including diverticulitis or ulcers, diabetes (especially if 65+ years), or if you see tablet pieces in your stool.
Pregnancy and Breastfeeding
Do not take Rinvoq during pregnancy as it may harm your unborn baby. Use effective contraception while taking Rinvoq and for at least 4 weeks after your last dose. Do not take Rinvoq while breastfeeding as it’s unknown if the medicine passes into breast milk.
High-Risk Patients: Patients 65+ years may have increased risk of infections, heart problems including heart attack and stroke, and some cancers. Current or past long-time smokers and those with cardiovascular disease history need special consideration.
Drug Interactions
Some medicines may interfere with how Rinvoq works, or Rinvoq may affect how other medicines work. Always tell your doctor about all medicines you’re taking.
Grapefruit interaction: Avoid food or drinks containing grapefruit during treatment as these may increase the risk of side effects.
- Biological medicines (avoid completely)
- Antifungal medicines (ketoconazole, itraconazole, posaconazole, voriconazole) – may increase Rinvoq effects
- Antibiotics (clarithromycin) – may increase Rinvoq effects
- Tuberculosis medicines (rifampicin) – may reduce Rinvoq effects
- Neurological disorder medicines (phenytoin) – may reduce Rinvoq effects
- Other JAK inhibitors (tofacitinib, baricitinib) – may increase infection risk
- Immune suppressing medicines (azathioprine, ciclosporin, tacrolimus) – may increase infection risk
- NSAIDs, opioids, corticosteroids – may increase GI perforation risk
- Diabetes medicines – Rinvoq may affect blood sugar levels
Alcohol & Driving
Be cautious with activities that require alertness if you experience side effects, and there’s limited information about alcohol interactions.
Alcohol
There is no specific information available about the effects of taking Rinvoq with alcohol. Discuss alcohol use with your doctor.
Driving and Operating Machinery
Do not drive or use machines if you experience a spinning sensation (vertigo) when taking Rinvoq until it resolves.
Storage
Store Rinvoq in a cool, dry place below 30°C, away from moisture, heat, and sunlight. Do not store in the bathroom, near a sink, in the car, or on windowsills. Keep tablets in their original pack until it’s time to take them. Keep out of reach of children. Do not use after the expiry date.
Overdose Information
If you take too much Rinvoq, immediately phone the Poisons Information Centre in Australia (13 11 26), in New Zealand (0800 POISON or 0800 764 766), contact your doctor, or go to the nearest hospital Emergency Department. Do this even if you feel fine or have no symptoms of poisoning.
Frequently Asked Questions
The timeframe varies by condition. For ulcerative colitis and Crohn’s disease, you’ll start with a higher induction dose for 8-16 weeks, then switch to a maintenance dose. Your doctor will monitor your progress and may adjust your dose depending on how well the medicine is working.
Yes, you can take Rinvoq with or without food. Swallow the tablet whole with a full glass of water, but avoid grapefruit food or drinks during treatment as these may increase the risk of side effects.
Do not stop taking Rinvoq or change the dose without checking with your doctor first. Follow your doctor’s instructions and continue taking Rinvoq until they tell you to stop.
There is no specific information available about the effects of taking Rinvoq with alcohol. You should discuss alcohol use with your doctor to determine what’s safe for your situation.
Weight gain is listed as a possible less serious side effect of Rinvoq. If you experience weight gain that worries you, speak to your doctor about it.
Patients 65 years and older may be at increased risk of infections, heart problems including heart attack and stroke, and some types of cancer. For most conditions, the recommended dose for elderly patients is 15 mg daily rather than higher doses.
If you miss a dose, take it as soon as you remember as long as it’s at least 10 hours before your next dose. If you forget for an entire day, skip the missed dose and take only your regular single dose the following day. Never take a double dose to make up for a missed dose.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.