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Rinvoq (upadacitinib)

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Rinvoq® (upadacitinib) is used to treat certain adults with moderately to severely active rheumatoid arthritis (RA).1

Before starting Rinvoq, users must have tried at least 1 tumor necrosis factor (TNF) blocker. If it did not work or the user could not tolerate it, they can start using Rinvoq. TNF blockers are a different type of drug that may be used to treat RA.1

Rinvoq is approved to treat other conditions, such as inflammatory bowel disease and eczema (atopic dermatitis).1

What are the ingredients in Rinvoq?

The active ingredient in Rinvoq is upadacitinib.1

How does Rinvoq work?

Rinvoq is a type of drug called a Janus kinase (JAK) inhibitor. Kinase inhibitors are a very common type of medicine that treat many different conditions. They work by targeting certain kinases, which are a type of protein that cells use for many different functions.1

Rinvoq works by targeting JAK. This kinase has a role in signaling the body’s inflammation response. By targeting JAK, Rinvoq interrupts the signal. This can reduce inflammation caused by conditions like RA.1

What are the possible side effects?

The most common side effects of Rinvoq include:1

  • Common cold or sinus infections
  • Shingles (herpes zoster)
  • Cold sores (herpes simplex)
  • Bronchitis
  • Nausea
  • Cough
  • Fever
  • Acne
  • Headache

Rinvoq has a boxed warning, the strictest warning from the US Food and Drug Administration. It has this warning because it may cause severe and life-threatening side effects, including increased risk of:1

  • Serious infections, including tuberculosis (TB)
  • Heart attack, stroke, or death in people over 50 with RA who also have heart problems
  • Certain cancers, including lymphoma
  • Blood clots

Rinvoq impacts the immune system. This can make you more likely to get infections. Call your doctor right away if you have any signs of infections while taking Rinvoq, such as:1

  • Fever or chills
  • Shortness of breath
  • Unusual tiredness
  • Cough
  • Muscle aches

These are not all the possible side effects of Rinvoq. Talk to your doctor about what to expect when taking Rinvoq. You also should call your doctor if you have any changes that concern you when taking Rinvoq.

Other things to know

Your doctor should test you for TB before starting treatment with Rinvoq. You should also be monitored for signs and symptoms of TB during treatment.1

You should not take Rinvoq if you have any kind of infection unless your doctor tells you to.1

Before starting Rinvoq, tell your doctor if you:1

  • Are being treated for an infection or have had an infection that does not go away or keeps coming back
  • Have diabetes, chronic lung disease, HIV, or a weak immune system
  • Have had a heart attack, other heart problems, or stroke
  • Have liver or kidney problems
  • Have TB or have been in close contact with someone with TB
  • Have had shingles
  • Have or have had hepatitis B or C
  • Have unexplained stomach pain, have a history of diverticulitis or ulcers in your stomach or intestine, or are taking non-steroidal anti-inflammatories (NSAIDs)
  • Have low red or white blood cell counts
  • Have recently received or are scheduled to receive any vaccines
  • Live, have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valley and the Southwest) where there is an increased risk of getting certain kinds of fungal infections
  • Think you have an infection or have symptoms of an infection

Rinvoq can harm an unborn baby. If you can become pregnant, you should use birth control during treatment and for some time after the last dose of Rinvoq. You should also not breastfeed during treatment with Rinvoq and for some time after the last dose. Talk to your doctor about your options for birth control and breastfeeding while taking Rinvoq.1

Before beginning treatment for RA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs. You may have side effects if you take Rinvoq along with other drugs, including medicines:1

  • For fungal or bacterial infections
  • For neurological disorders
  • That affect your immune system

For more information, read the full prescribing information of Rinvoq.

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