Rinvoq (upadacitinib) is a prescription drug that’s used to treat certain conditions, such as rheumatoid arthritis. Rinvoq can cause side effects that range from mild to serious. Examples include nausea, cough, and serious infections.

Rinvoq is used in adults to treat:

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

The active ingredient in Rinvoq is upadacitinib. (An active ingredient is what makes a drug work.) The drug comes as a tablet that you swallow.

Keep reading to learn about the common, mild, and serious side effects that Rinvoq can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild or serious side effects during their Rinvoq treatment. Examples of a few of Rinvoq’s commonly reported side effects include:

* To learn more about this side effect, see “Side effects explained” below.

Some people taking Rinvoq may experience mild side effects. Examples of mild side effects that have been reported with Rinvoq include:

* To learn more about this side effect, see “Side effects explained” below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Rinvoq unless your doctor recommends it.

Rinvoq may cause mild side effects other than the ones listed above. See Rinvoq’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Rinvoq, visit MedWatch.

Although rare, it’s possible to develop serious side effects while taking Rinvoq. Serious side effects that have been reported with Rinvoq include:

* Rinvoq has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effects explained” below.
† An allergic reaction is possible after using Rinvoq. But this side effect wasn’t reported in studies. To learn more about this side effect, see “Side effects explained” below.

If you develop serious side effects while taking Rinvoq, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

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Get answers to some frequently asked questions about Rinvoq’s side effects.

Is hair loss a side effect of Rinvoq?

No, hair loss isn’t a side effect of taking Rinvoq. People taking the medication in studies didn’t report hair loss.

But hair loss may be a side effect of methotrexate, which is another medication used to treat rheumatoid arthritis (RA). Depending on your condition, your doctor may recommend that you take methotrexate with Rinvoq.

If you have hair loss while you’re taking Rinvoq, talk with your doctor. They’ll try to determine the cause of the hair loss and the best way to treat it.

Does Rinvoq cause weight loss or weight gain?

Rinvoq isn’t likely to cause weight loss. But weight gain is a possible side effect of the drug.

Studies of Rinvoq did not report weight loss as a side effect. But Rinvoq can raise the risk of certain types of cancers, and it can cause infections that are serious.* Weight loss is a symptom of both cancer and serious infection.

Studies did find weight gain to be a rare side effect in people taking Rinvoq for atopic dermatitis (a type of eczema). But this wasn’t a side effect reported by people taking the drug for other conditions.

In some cases, other medications for RA, such as methotrexate or corticosteroids, can cause weight gain. Some people who take Rinvoq with methotrexate or certain corticosteroids might have weight gain from the latter.

If you notice changes in your weight, talk with your doctor. They’ll try to find out what’s causing them.

* Rinvoq has a boxed warning for the risk of cancer and serious infections. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effects explained” below.

Will Rinvoq make me feel tired?

You may feel tired during Rinvoq treatment. In studies, low energy was a side effect reported by people taking the drug for Crohn’s disease or atopic dermatitis. But low energy wasn’t reported in studies of other conditions Rinvoq is used to treat.

Low energy, or fatigue, can result from some of the conditions Rinvoq is prescribed to treat. Taking Rinvoq may ease the symptoms of these conditions, including low energy.

In addition, some of Rinvoq’s known side effects may cause low energy. If you experience fatigue while taking Rinvoq, talk with your doctor. They can determine what’s causing you to feel tired and recommend treatments.

Does Rinvoq cause a weakened immune system, and can this increase my risk of side effects?

Rinvoq may weaken your immune system. This is because of how the medication works. With the conditions Rinvoq treats, your immune system attacks your body, causing certain symptoms. Rinvoq works by weakening your immune system to decrease your symptoms.

Having a weakened immune system may lead to side effects, such as an increased risk of infections.

Symptoms of a weakened immune system include getting sick frequently or having a cold or infection that won’t go away. If you have such symptoms, talk with your doctor. They can recommend ways to help strengthen your immune system. They may also recommend a different medication to treat your condition.

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

Cancer

Rinvoq has a boxed warning for an increased risk of developing certain types of cancer while taking the medication. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Since Rinvoq weakens your immune system, taking this drug may increase your risk of certain types of cancer. Examples include lymphoma and nonmelanoma skin cancer. Cancer is a rare but serious side effect of taking Rinvoq.

If you have cancer or have had it in the past, be sure to tell your doctor before you start taking Rinvoq. You may have an increased risk of your cancer worsening or coming back.

Symptoms of cancer include:

  • swollen lymph nodes in your neck
  • fever or night sweats
  • feeling very tired
  • weight loss
  • a new lump or growth on your skin
  • a sore that doesn’t heal
  • a discolored patch on your skin that doesn’t go away

What might help

If you develop any of the changes or symptoms mentioned above, tell your doctor. They can find out what’s causing your symptoms and recommend appropriate treatments.

Be sure to tell your doctor about any history of cancer that you have. They may recommend more frequent monitoring or a different medication to treat your condition.

Serious infections

Rinvoq has a boxed warning for serious infections, including tuberculosis (TB). A boxed warning is the most serious warning from the FDA. This helps the doctor and the patient understand the risks of taking a medication.

Because Rinvoq works by weakening your immune system, it can also increase your risk of infections. Because your immune system is weaker, it has more difficulty fighting off viruses and bacteria. In some rare cases, infections may be serious or even fatal.

Be sure to tell your doctor your full health history before you start taking Rinvoq. This will help them determine whether you have a higher risk of developing a serious infection.

Symptoms of an infection include:

What might help

Before you start taking Rinvoq, your doctor will test you for certain infections, such as TB. Sometimes TB can be latent, meaning you can have this disease but show no symptoms. If your test is positive for TB, you should receive treatment for TB before starting Rinvoq.

Your doctor will also ask about any infections you may have had that could come back, such as shingles or hepatitis.

If you have other conditions that may increase your risk of infections, such as diabetes or HIV, tell your doctor. Also tell your doctor what other medications you’re taking. Some medications, such as methotrexate or corticosteroids, may further increase your risk of serious infections. In these cases, your doctor may recommend a different medication for your condition or more frequent monitoring for infections.

If you have any current infections, your doctor will treat them before you start taking Rinvoq. If you develop any symptoms of infections while taking Rinvoq, tell your doctor right away. Treating an infection quickly decreases the likelihood that it will become serious.

Blood clots

Rinvoq has a boxed warning for developing blood clots. A boxed warning is the most serious warning from the FDA.

In rare cases, people taking Rinvoq have developed blood clots, including:

In some cases, these blood clots can be serious or even fatal.

Symptoms of a blood clot include:

  • pain, warmth in one leg, or redness or deepening of skin color
  • chest pain
  • swelling
  • trouble breathing

What might help

If you have a history of blood clots, be sure to tell your doctor. Taking Rinvoq could increase your risk of developing a blood clot again. Because of this, your doctor may recommend a different medication to treat your condition.

While you’re taking Rinvoq, keep watch for any symptoms of blood clots. If you develop symptoms, be sure to see your doctor right away. They’ll check you for a blood clot and, if you do have one, treat it as soon as possible.

Heart or blood vessel problems

Rinvoq has a boxed warning for heart or blood vessel problems. A boxed warning is the most serious warning from the FDA. This helps the doctor and the patient understand the risks of taking a medication.

Examples of heart or blood vessel problems include:

It’s possible for a heart or blood vessel problem to be fatal.

What might help

Talk with your doctor about whether you’re at risk for heart or blood vessel problems with Rinvoq. If you are at risk, your doctor may advise you not to take Rinvoq.

Tell your doctor if you have symptoms related to a heart or blood vessel problem with Rinvoq. These can include chest pain or trouble breathing. But call 911 if your symptoms feel severe or life threatening.

If you have a heart attack or stroke while taking Rinvoq, your doctor will have you stop taking the drug.

Increased risk of death

Rinvoq has a boxed warning for increased risk of death in certain people. A boxed warning is the most serious warning from the FDA. This helps the doctor and the patient understand the risks of taking a medication.

This risk was seen in people with rheumatoid arthritis who took another medication in the same drug class as Rinvoq. The risk was higher in people ages 50 years and older who had at least one cardiovascular disease risk factor.

What might help

Talk with your doctor to determine whether you’re affected by this risk with Rinvoq. Your doctor can recommend whether this drug is safe for you to take.

Nausea

You may have nausea while you’re taking Rinvoq. Nausea is one of the most common side effects that people taking Rinvoq experience.

What might help

If you have nausea while taking Rinvoq, talk with your doctor. They may recommend taking your medication with food or using other medications to treat your nausea.

If your nausea is severe, your doctor may recommend a different medication for your condition.

Allergic reaction

Like most drugs, Rinvoq can cause an allergic reaction in some people. In studies, allergic reactions occurred, but they were rare. In some cases, allergic reactions were severe.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To manage your symptoms, they may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine). Or they may recommend a product you apply to your skin, such as hydrocortisone cream.

If your doctor confirms that you had a mild allergic reaction to Rinvoq, they’ll decide whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms that you had a serious allergic reaction to Rinvoq, they may have you switch to a different treatment.

Keeping track of side effects

During your Rinvoq treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Rinvoq affects you. And your doctor can use this information to adjust your treatment plan if needed.

Rinvoq has several warnings that may affect whether it’s a good treatment option for your condition.

Boxed warnings

Rinvoq has boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings for Rinvoq include:

  • Cancer. If you have cancer or have had it in the past, be sure to tell your doctor before starting Rinvoq. You may have an increased risk of your cancer worsening or coming back.
  • Serious infections. If you have any active infections, your doctor will likely treat the infections before you start taking Rinvoq. Because Rinvoq weakens the immune system, it may cause serious infections to occur or make mild infections more serious.
  • Blood clots. If you have a history of blood clots, such as a deep vein thrombosis or a pulmonary embolism, tell your doctor before starting Rinvoq. Rinvoq can cause blood clots to occur, so taking it may increase your risk of blood clots.
  • Heart or blood vessel problems. If you have certain risk factors, you may be at increased risk of heart or blood vessel problems with Rinvoq. These problems include conditions such as heart attack and stroke. Talk with your doctor about your risk factors before starting treatment with this drug.
  • Increased risk of death. In some cases, Rinvoq may increase the risk of death in certain people. Talk with your doctor about your risk factors before starting treatment with this drug.

To learn more about these boxed warnings, see “Side effects explained” above.

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. The list below includes factors to consider.

Active infections. Before you start taking Rinvoq, your doctor will recommend treating any active infections you may have. Rinvoq can weaken your immune system, which can cause your infection to worsen. If you have any current infections, tell your doctor. They’ll likely treat your infection before you start taking Rinvoq.

Liver problems. Rinvoq may increase liver enzyme levels, which can indicate how well your liver is working. If you already have a liver problem, taking Rinvoq may worsen this problem. Be sure to tell your doctor about any other conditions that you may have before you start taking Rinvoq.

Blood disorders, such as low white or red blood cell levels. Rinvoq may decrease the amount of certain blood cells, such as red blood cells and white blood cells. If you already have low red or white blood cell levels, Rinvoq may not be the best treatment choice for you. The same is true if you have any bleeding disorders that affect your blood cells. Before you start taking Rinvoq, tell your doctor about any conditions that you have.

Recent vaccination. You should not receive certain vaccines, called live vaccines, while you’re taking Rinvoq. (Live vaccines contain a small, altered piece of a virus.) Rinvoq may weaken your immune system. As a result, getting a live vaccine may cause you to get sick. Before you start taking Rinvoq, tell your doctor about any vaccines you’ve had recently or are planning to have.

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

Conditions or medications that increase risk of gastrointestinal perforation. Certain conditions, such as diverticulitis, may increase the risk of developing a gastrointestinal perforation while taking Rinvoq. (Diverticulitis is inflammation of the intestines, and a gastrointestinal perforation is a tear in the stomach or intestines.) Taking certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, with Rinvoq may also increase this risk. Before starting Rinvoq, tell your doctor about any conditions you have and any medications you take.

High cholesterol. Rinvoq may cause high cholesterol. If you already have high cholesterol, taking Rinvoq may increase your cholesterol levels further. Before you start taking Rinvoq, tell your doctor about any conditions that you may have.

Condition that causes faster digestion. Parts of Rinvoq tablets may show up in a person’s stool. This can occur more frequently in a person whose digestive system moves substances faster than usual through the body. (For instance, people who’ve had certain procedures, such as a colostomy, may have shorter digestion times.) If pieces of Rinvoq tablets are appearing in your stool regularly, this may mean the drug isn’t being digested properly. In this case, your doctor may recommend a treatment other than Rinvoq for your condition.

Alcohol use and Rinvoq

There are no known interactions between alcohol and Rinvoq. But Rinvoq may cause certain side effects, such as liver problems and nausea. Alcohol can also cause these side effects. So consuming alcohol while taking Rinvoq may increase your risk of these side effects.

If you consume alcohol, talk with your doctor about how much is safe for you to drink while taking Rinvoq.

Pregnancy and breastfeeding while taking Rinvoq

There haven’t been enough studies to determine whether Rinvoq is safe to take during pregnancy. But Rinvoq may lead to decreased birth weight or problems with an infant’s developing bones or heart.

If you’re pregnant, your doctor will likely recommend a treatment other than Rinvoq. If you can become pregnant, you should use birth control during Rinvoq treatment and for at least 4 weeks after your last dose.

It’s unknown if Rinvoq is safe to use while breastfeeding. It’s also unknown if Rinvoq passes into breast milk or how it may affect a breastfed child. You should not use Rinvoq while breastfeeding and for at least 6 days after you stop taking the drug.

If you’re breastfeeding or planning to breastfeed, tell your doctor before starting Rinvoq. They may recommend a different treatment option for you.

Rinvoq is used to treat the following conditions in certain situations:

It may cause certain side effects, some of which can be serious. But in most cases, Rinvoq’s side effects tend to be mild.

If you have specific questions about the side effects that Rinvoq may cause, discuss them with your doctor or pharmacist. Here are some questions you may wish to ask:

  • If I develop side effects from Rinvoq, what can I do to treat them?
  • What happens if I become pregnant while taking Rinvoq?
  • What side effect symptoms should I look out for 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:

If I’m taking Rinvoq with methotrexate or other medications for my rheumatoid arthritis (RA), am I at an increased risk of side effects?

Anonymous

A:

Yes. Any time you take additional medications, you have an increased risk of side effects. Methotrexate and corticosteroids are both widely used to treat RA. Both have many of their own side effects and possible drug reactions. And taking either with Rinvoq increases your risk of serious infections.

If you have questions about an increased risk of side effects when taking Rinvoq with another medication, talk with your doctor or pharmacist.

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.