Rinvoq (upadacitinib) is a prescription drug that’s used to treat certain conditions, such as rheumatoid arthritis and ulcerative colitis. Rinvoq comes as an oral tablet.

Rinvoq is used in adults to treat:

Rinvoq is also used in some children to treat moderate to severe atopic dermatitis.

In some cases, doctors may not prescribe this drug for these conditions. To learn more, see the “What is Rinvoq used for?” section below.

Rinvoq basics

Rinvoq comes as a tablet that you’ll swallow.

The active drug in Rinvoq is upadacitinib. Rinvoq isn’t available in a generic form. It belongs to a group of drugs called Janus kinase (JAK) inhibitors.

Like most drugs, Rinvoq may cause mild or serious side effects. The lists below describe some of the more common side effects that Rinvoq may cause. These lists don’t include all possible side effects.

To find out more about Rinvoq’s side effects, see this article. Your doctor or pharmacist can also tell you more about the drug’s side effects and suggest ways to help reduce symptoms.

Mild side effects

Here’s a short list of some of the mild side effects that Rinvoq can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Rinvoq’s prescribing information.

Mild side effects of Rinvoq can include:

* For more information on this side effect, see the “Side effect focus” section below.

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Rinvoq can occur, but they aren’t common. If you have serious side effects from Rinvoq, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects can include:

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

Side effect focus

Learn more about some of the side effects that Rinvoq may cause.

Cough

A cough is one of the most common side effects of Rinvoq.

Coughing can also be a symptom of infection. And serious infections are another possible side effect of Rinvoq.

If you have a cough while you’re taking Rinvoq, be sure to tell your doctor. They may want to check for other signs of infection.

What might help

If you have a cough while you’re taking Rinvoq, there are several natural remedies and medications that you can try.

Honey, thyme, and pineapple are a few items you might have around the house that can help relieve your cough. Also, be sure to drink plenty of water to stay hydrated and help loosen up mucus that may come with your cough.

It may also help to take over-the-counter (OTC) products that contain dextromethorphan, guaifenesin, or both. (Examples include Robitussin DM and Mucinex.) But be sure to check with your doctor or pharmacist before taking any medications or supplements with Rinvoq.

If your cough worsens or won’t go away, call your doctor.

Nausea

Nausea is another common side effect of Rinvoq.

Nausea can sometimes cause dehydration (low fluid level). This is especially true if nausea leads to vomiting.

What might help

If you feel nauseated after taking Rinvoq, try taking each dose with bland food. This can help settle your stomach and relieve your nausea.

Chewing on a small piece of ginger root can also help reduce nausea. You can use fresh ginger or crystallized or candied ginger. You could also make ginger tea by steeping ginger in hot water. Then sip the tea slowly when the temperature is right for you.

You can also try taking medications to help control your nausea. Pepto-Bismol and dimenhydrinate (Dramamine) are a couple of OTC drugs that you can try. But be sure to check with your doctor or pharmacist before taking any medications or supplements with Rinvoq.

If your nausea becomes severe or isn’t getting better, talk with your doctor.

Fever

You may have a fever while taking Rinvoq. Fever was a common side effect in people during studies of the drug.

Keep in mind that infections can also cause fever. So be sure to talk with your doctor if you get a fever while you’re taking Rinvoq. They can check to see if you have an infection.

What might help

You can usually relieve a fever with rest and by drinking fluids.

You can also try adjusting the room temperature or bathing in lukewarm water to help lower your body temperature. Taking ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can also help. But be sure to check with your doctor or pharmacist before taking any medications with Rinvoq.

If your fever doesn’t improve after 3 days or your body temperature is above 103°F (39.4°C), call your doctor right away.

Allergic reaction

Some people may have an allergic reaction to Rinvoq. Symptoms of a mild allergic reaction can include:

  • rash
  • itchiness
  • flushing (warmth, swelling, redness, or deepening of color in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Rinvoq. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Doctors may prescribe Rinvoq to treat the following in certain situations:

  • Moderate to severe rheumatoid arthritis (RA). Rinvoq is used in adults with RA. This condition can cause pain and damage to the joints throughout the body.
  • Psoriatic arthritis. Rinvoq is used in adults with psoriatic arthritis. This condition causes arthritis in the joints as well as psoriasis lesions on the skin. You may have patches of skin that are scaly, itchy, or discolored.
  • Moderate to severe ulcerative colitis (UC). Rinvoq is used in adults to treat UC. This condition is a type of inflammatory bowel disease (IBD). It can cause inflammation (swelling and damage) that affects the large intestine or rectum. Symptoms of UC include abdominal or rectal pain and diarrhea.
  • Moderate to severe Crohn’s disease. For treating Crohn’s disease, Rinvoq is used in adults. Like UC, Crohn’s disease is a type of IBD. But it can affect any part of your digestive system, not just the large intestine or rectum. Symptoms include abdominal pain and diarrhea.
  • Moderate to severe atopic dermatitis. Doctors prescribe Rinvoq for adults and children ages 12 years and older with atopic dermatitis, which is a type of eczema. Atopic dermatitis causes irritated skin that’s often dry, itchy, and rough.
  • Ankylosing spondylitis. For treating ankylosing spondylitis, Rinvoq is used in adults. This is a form of arthritis that affects the spine. This may result in pain, stiffness, and limited range of motion in the back.
  • Non-radiographic axial spondyloarthritis. Rinvoq is used to treat non-radiographic axial spondyloarthritis in adults. This type of arthritis is similar to ankylosing spondylitis in that it affects the spine and causes some of the same symptoms.

Rinvoq belongs to a group of drugs called Janus kinase (JAK) inhibitors. JAK inhibitors slow down the activity of your immune system. This can help relieve some symptoms of your condition, such as damage to your joints.

Who can take Rinvoq

For the conditions that Rinvoq treats (except atopic dermatitis), doctors only prescribe Rinvoq for people who have tried a type of drug called a tumor necrosis factor (TNF) blocker in the past. But either:

  • their condition didn’t improve with the TNF blocker, or
  • they had bothersome effects from the TNF blocker

For atopic dermatitis, doctors only prescribe Rinvoq for people:

  • whose condition did not improve with treatments affecting their whole body, including biologic treatments (treatments made with living cells), or
  • who are not able to take certain other medications for their condition

This drug isn’t meant to be used with certain other drugs that work on your immune system. Your doctor can tell you which drugs may or may not be used with Rinvoq.

Your doctor will recommend the dosage of Rinvoq that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form

Rinvoq comes as a tablet that you’ll swallow.

Recommended dosages

The recommended dosages of Rinvoq for the conditions it treats are discussed below. For more information about this drug’s dosages, talk with your doctor or pharmacist.

Dosage for rheumatoid arthritis

The typical dosage of Rinvoq is 15 mg, taken once per day.

Dosage for psoriatic arthritis

The typical dosage of Rinvoq is 15 mg, taken once per day.

Dosage for ulcerative colitis

The typical starting dosage of Rinvoq is 45 mg once per day for 8 weeks.

After 8 weeks, the recommended dosage is either 15 mg or 30 mg once per day. If your condition is severe, your doctor may prescribe the higher dosage.

Dosage for Crohn’s disease

The typical starting dosage of Rinvoq is 45 mg once per day for 12 weeks.

After 12 weeks, the recommended dosage is either 15 mg or 30 mg once per day. If your condition is severe, your doctor may prescribe the higher dosage.

Dosage for atopic dermatitis

For adults, the typical starting dosage of Rinvoq is 15 mg once per day. This is also the recommended ongoing dosage for adults ages 65 years and older. For adults younger than 65 years, the daily dosage may be increased to 30 mg if needed. If their condition doesn’t improve with this dosage, their doctor may recommend stopping treatment with Rinvoq.

For children ages 12 years and older who weigh at least 40 kilograms (about 88 pounds), the typical starting dosage of Rinvoq is 15 mg, taken once per day. A doctor may increase a child’s daily dosage to 30 mg per day if needed. If their condition doesn’t improve with 30 mg daily, their doctor may recommend stopping treatment with Rinvoq.

It’s not known whether Rinvoq is safe and effective for children under 12 years of age or under 40 kilograms. Talk with your doctor if you have questions about whether Rinvoq is an option for your child.

Dosage for ankylosing spondylitis

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

Dosage for non-radiographic axial spondyloarthritis

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

Questions about Rinvoq’s dosage

Here are answers to some questions you may have about Rinvoq’s dosage.

  • What if I miss a dose of Rinvoq? You should take your missed dose as soon as you remember. But if it’s almost time for your next dose, you can skip your missed dose and pick up on your regular dosing schedule. If you have any questions about a missed dose, call your doctor.
  • Will I need to use Rinvoq long term? Yes, you’ll probably use Rinvoq long term. Be sure to talk with your doctor about the treatment plan that’s right for you.
  • How long does Rinvoq take to work? You’ll probably take Rinvoq for several weeks before you notice an improvement in your symptoms.

Your doctor will explain how you should take Rinvoq. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Rinvoq

Rinvoq comes as a tablet that you’ll swallow.

Taking Rinvoq with other drugs

Your doctor may prescribe Rinvoq alone or together with certain other drugs. But this depends on your condition.

For instance, Rinvoq may be prescribed with methotrexate or other disease modifying antirheumatic drugs (DMARDs) that aren’t considered biologics. (Biologics are drugs made from living cells.) Examples of these biologics include leflunomide (Arava) and sulfasalazine (Azulfidine).

Talk with your doctor about whether you’ll need to take other drugs with Rinvoq. And be sure to check with them before taking any drugs with Rinvoq.

Questions about taking Rinvoq

Below are some questions you may have about taking Rinvoq.

  • Can Rinvoq be chewed, crushed, or split? No, you should not chew, crush, or split Rinvoq tablets. If you have trouble swallowing pills, talk with your doctor or pharmacist.
  • Should I take Rinvoq with food? No, you don’t have to take Rinvoq with food. You can take the drug with or without it.

Other drugs are available to treat the conditions Rinvoq treats. To learn more about other treatment options for some of the conditions Rinvoq is prescribed for, check out these articles:

If you’d like to know how Rinvoq compares with the alternative drug Humira, see this article. For a detailed comparison of Rinvoq and Xeljanz, see this article.

Using medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Rinvoq, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions that these items may cause with Rinvoq.

Interactions with drugs or supplements

Rinvoq can interact with certain medications from several groups of drugs. Examples of these drug groups include:

This list doesn’t contain all types of drugs that may interact with Rinvoq. Your doctor or pharmacist can tell you more about these interactions and any others that may occur when using Rinvoq.

Other interactions

It’s best to avoid grapefruit while taking Rinvoq. Eating grapefruit or drinking grapefruit juice while taking this drug can affect how it works for you.

It’s also recommended that you avoid getting live vaccines while taking Rinvoq. When you get a live vaccine, you’re injected with a small amount of a live virus. A healthy immune system then learns how to fight the virus to protect against infection from that virus.

But Rinvoq can weaken your immune system. This lowers the likelihood that your body will respond properly to the vaccine. So, getting a live vaccine while taking Rinvoq can raise your risk of contracting the virus instead of becoming protected from it.

If you’re taking Rinvoq, be sure to talk with your doctor or pharmacist before getting any vaccines.

Rinvoq has some precautions for its use. Read below to learn more. And be sure to talk with your doctor about whether this drug is right for you.

Boxed warnings

Rinvoq has boxed warnings about certain conditions.

Boxed warnings are serious warnings from the Food and Drug Administration (FDA) about drug effects that may be dangerous.These warnings are described below:

  • Increased risk of serious infections. Some people who take Rinvoq get serious infections, such as tuberculosis. Tell your doctor right away if you have any symptoms of infection while taking this drug.
  • Increased risk of cancer. Taking Rinvoq might increase your likelihood of getting certain cancers, such as lymphoma (a type of cancer that affects your lymphatic system). If you’re concerned about your risk for cancer while taking this drug, talk with your doctor.
  • Increased risk of blood clots. Blood clots can occur in some people who take Rinvoq. These clots may occur in your legs, lungs, or arteries. Be sure to tell your doctor about any past blood clots that you’ve had. And ask them about possible symptoms of blood clots and your risk for developing a clot.
  • Increased risk of heart or blood vessel problems. Heart or blood vessel problems may occur in certain people taking Rinvoq. These problems include stroke, heart attack, and death caused by a heart or blood vessel issue. If you have risks for cardiovascular problems with Rinvoq, your doctor may recommend that you do not take this drug.
  • Increased risk of death in some people. It’s possible that Rinvoq may raise the risk of death in certain people. Your doctor can help advise if you have an increased risk of death with this drug.

Other warnings

Rinvoq may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Rinvoq. Factors to consider include those mentioned below.

Diverticulitis. Before taking Rinvoq, tell your doctor if you have a history of a condition called diverticulitis. Having diverticulitis can raise your risk for having a tear in your stomach, small intestine, or large intestine while taking Rinvoq.

Allergic reaction. If you’ve had an allergic reaction to Rinvoq or any of its ingredients, you should not take this drug. Ask your doctor about which other medications are better options for you.

Use of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. Using NSAIDs or corticosteroids may raise your risk of having a tear in your stomach or intestines while taking Rinvoq. Be sure to tell your doctor about all medications you’re taking before starting Rinvoq.

Condition that shortens digestion time. Undigested parts of Rinvoq tablets may show up in stool. This can occur more frequently in people whose digestive system takes less time to move substances through the body. (An example is a person who has had a colostomy.) If parts of Rinvoq tablets are appearing in your stool regularly, let your doctor know. Your body may not be digesting the tablet properly. In this case, your doctor may recommend a treatment other than Rinvoq for your condition.

Drinking alcohol while taking Rinvoq isn’t thought to be harmful. But if you do drink alcohol, it’s important to talk with your doctor first. They can tell you how much alcohol, if any, is safe to drink while you’re taking Rinvoq.

Taking Rinvoq during pregnancy may be harmful to a developing fetus. For this reason, you should not use Rinvoq during pregnancy. Also, you should try to avoid becoming pregnant until at least 4 weeks after taking your last dose of Rinvoq.

Rinvoq can pass into breast milk, so breastfeeding while taking Rinvoq is also not recommended. You should wait for at least 6 days after your last dose of the drug before breastfeeding.

Be sure to talk with your doctor before taking this drug during pregnancy or while breastfeeding.

Find answers to some commonly asked questions about Rinvoq.

Can I take Rinvoq if I haven’t tried other rheumatoid arthritis treatments in the past?

No, probably not. Rinvoq is used in adults whose rheumatoid arthritis (RA) hasn’t improved with past use of drugs called tumor necrosis factor (TNF) blockers. For this reason, your doctor likely won’t prescribe Rinvoq unless you’re taking a TNF blocker or have taken one in the past.

If you have questions about other RA treatments, talk with your doctor.

Will Rinvoq affect my cholesterol?

Yes, Rinvoq might affect your cholesterol. Rinvoq may cause high cholesterol in some people.

After you’ve taken the drug for several weeks, your doctor will likely order a cholesterol test for you. If the test shows that you have high cholesterol, your doctor might prescribe a cholesterol-lowering drug.

If you’d like, ask your doctor about diet tips for a healthy cholesterol level.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

For more information about Rinvoq and cost, see this article. If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the manufacturer’s website to see if it has options for lowering the cost of the drug.

Do not take more Rinvoq than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Rinvoq

Call your doctor if you think you’ve taken too much Rinvoq. You can also call 800-222-1222 to reach American’s Poison Centers, or you can use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

There are other medications available for the conditions Rinvoq treats. If you have questions about which treatment option is right for you, talk with your doctor or pharmacist.

You might also want to ask your doctor a few questions about Rinvoq, such as:

  • Will Rinvoq cure my condition?
  • How is Rinvoq different from other drugs used to treat my condition?
  • Which vaccines are safe for me to get while I’m taking Rinvoq?

To learn more about Rinvoq, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

Can I take Rinvoq with other rheumatoid arthritis treatments?

Anonymous

A:

Yes. If your doctor thinks it’s right for you, they may prescribe Rinvoq with certain other rheumatoid arthritis treatments.

Your doctor may give you Rinvoq alone. Or, they may prescribe it with either methotrexate or another treatment, such as sulfasalazine (Azulfidine) or hydroxychloroquine (Plaquenil).

But they won’t give you Rinvoq with certain other drugs called biologics, which work on your immune system. (Biologics are drugs made from living cells.) Rinvoq also won’t be given to you with other drugs that work in a similar way. These include tofacitinib (Xeljanz) and immunosuppressants such as azathioprine (Azasan).

Your doctor can tell you which drugs may or may not be used with Rinvoq.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Disclaimer: Healthline 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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