If you have rheumatoid arthritis (RA), your doctor might suggest Rinvoq (upadacitinib) as a treatment option. Along with other questions you may have about the drug, you could be wondering about its side effects.
Rinvoq is a prescription medication that’s used in certain adults to treat moderate to severe RA.
This medication, which comes as a tablet that you take by mouth, helps decrease symptoms of RA. If Rinvoq works for you, your doctor may recommend that you take it as a long-term treatment.
For more information about Rinvoq, see this in-depth article on the drug.
Like other drugs, Rinvoq can cause mild or serious side effects. Keep reading to learn more.
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 the Rinvoq medication guide 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:
- serious infections*
- blood clots*
- gastrointestinal perforation (a tear in the stomach or intestines)
- allergic reaction†
- changes in blood levels of certain substances, such as red blood cells, white blood cells, liver enzymes, or cholesterol
* Rinvoq has a
† 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.
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. In studies, people taking the medication didn’t have 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 gain?
No, Rinvoq shouldn’t cause weight gain. This wasn’t a side effect seen during studies of the drug.
But 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.
Does Rinvoq cause a weakened immune system, and can this increase my risk for side effects?
Rinvoq may weaken your immune system. This is because of how the medication works. With RA, your immune system attacks your own body, causing pain and damage to your joints. 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 RA.
Learn more about some of the side effects Rinvoq may cause.
Rinvoq has a
Since Rinvoq weakens your immune system, taking this drug may increase your risk for 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 for 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 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 RA.
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 treats RA by weakening your immune system, it can also increase your risk for 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 if you have a higher risk for 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, which means that you can have this disease but show no symptoms. If you test positive for TB, you should receive treatment for it before starting Rinvoq.
If you have other conditions that may increase your risk for 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 for serious infections. In these cases, your doctor may recommend a different medication for your RA 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.
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:
- deep vein thrombosis (blood clots in the veins of the legs)
- pulmonary embolism (blood clots in the lungs)
- arterial thrombosis (blood clots in the arteries)
In some cases, these blood clots can be serious or even fatal.
Symptoms of a blood clot include:
What might help
If you have a history of blood clots, be sure to tell your doctor. Taking Rinvoq could increase your risk for developing a blood clot again. Because of this, your doctor may recommend a different medication to treat your RA.
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. This way they can check you for a blood clot and treat it as soon as possible.
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 RA.
Like most drugs, Rinvoq can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies.
Symptoms can be mild or serious and can include:
- skin rash
- 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 antihistamine you take by mouth, 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 rheumatoid arthritis (RA).
- Cancer. If you have cancer or have had it in the past, be sure to tell your doctor before starting Rinvoq. It’s possible that Rinvoq may further increase your risk for developing cancer.
- 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 for blood clots.
To learn more about these boxed warnings, see “Side effects explained” above.
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 cause this problem to get worse. 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.
Diverticulitis. If you have diverticulitis, you may have an increased risk for developing a gastrointestinal perforation from taking Rinvoq. (Diverticulitis is inflammation of the intestines, and a gastrointestinal perforation is a tear in the stomach or intestines.) Before starting Rinvoq treatment, tell your doctor about any other conditions you have besides RA.
High cholesterol. Rinvoq may cause high cholesterol. If you already have high cholesterol, taking Rinvoq may make your cholesterol levels even higher. Before you start taking Rinvoq, tell your doctor about any conditions that you may have.
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 for 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 if 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 not known if Rinvoq may be safe to use while breastfeeding. It’s also not known if Rinvoq passes into breastmilk or what effect the drug may have on a breastfed child.
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 rheumatoid arthritis (RA). 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?
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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.