Rinvoq (upadacitinib)

Rinvoq cost and savings

As with all medications, the cost of Rinvoq can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you may have to get Rinvoq at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to use them safely and effectively.

Your insurance plan may require you to get prior authorization before approving coverage for Rinvoq. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re unsure whether you’ll need to get prior authorization for Rinvoq, contact your insurance company.

Financial and insurance assistance

Here are a few tips for saving on the price of Rinvoq:

• Comparing pharmacies: The price of Rinvoq may vary depending on which pharmacy you use, so it can help to compare prices across pharmacies to find the lowest cost.
• Drug coupons: You may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits, but the discounted price may be lower than what you would pay through insurance.
• Financial assistance: Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
  • Medicine Assistance Tool
  • NeedyMeds

Generic version

Rinvoq is not available in a generic form. A generic drug contains the same active ingredient as its brand-name version. Generics usually cost less than brand-name drugs.

Rinvoq side effects

Rinvoq can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Rinvoq. These lists do not include all possible side effects.

For more information on the possible side effects of Rinvoq, talk with your doctor or pharmacist. In addition to side effect details, they can give you tips on how to manage side effects that may be bothersome.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Rinvoq and want to tell the FDA about it, visit MedWatch or call 800-332-1088.

Mild side effects

Mild side effects of Rinvoq can include:

• nausea
• fever
• cough
• upper respiratory infection, such as the common cold

This is a partial list of mild side effects from Rinvoq. To learn about other mild side effects, talk with your doctor or pharmacist or view Rinvoq’s prescribing information.

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or do not go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects include:

• Gastrointestinal perforation (a hole in the stomach, large intestine, or small intestine). Symptoms can include:
  • pain or tenderness in your abdomen
  • nausea and vomiting
  • chills
  • fever

Other serious side effects, explained in more detail in “Side effect details,” include:

• allergic reaction
• serious infections
• blood clots
• cancer
• cardiovascular problems
• increased risk of death
• changes to your levels of liver enzymes, cholesterol, and certain blood cells

Rinvoq has boxed warnings for most of these side effects. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous. See “Side effect details” for more information.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Rinvoq. In clinical trials, allergic reaction was rare, but it did occur. In some cases, allergic reactions were severe.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• difficulty breathing

Call your doctor right away if you have a severe allergic reaction to Rinvoq. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Infections

Taking Rinvoq can cause infections in some people.

Infections are not common with Rinvoq use. However, clinical trials have shown they can happen more often in people taking Rinvoq than in those taking a placebo. (A placebo is a treatment with no active ingredient.)

Serious infections

Rinvoq weakens your immune system, which could raise your risk of serious infections. The drug has a boxed warning for this side effect. (A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.) Such infections could lead to a hospital stay or even be fatal.

In clinical trials, serious infections were more common in people taking Rinvoq with other drugs that can weaken the immune system, such as methotrexate (Otrexup, Rasuvo, Trexall) or corticosteroids (prednisone, dexamethasone).

Examples of serious infections that can occur with Rinvoq include:

• pneumonia
• tuberculosis (TB) and other bacterial infections, such as cellulitis
• fungal infections, such as oral thrush, cryptococcosis, and pneumocystosis
• viral infections, such as shingles and herpes simplex

Although serious infections resulting from Rinvoq use are rare, taking a higher dosage of the drug may increase your risk of this side effect.

If you have a current infection or have had TB, talk with your doctor before starting Rinvoq. Your doctor may want to delay your Rinvoq treatment or prescribe you medication to take with Rinvoq.

Additionally, Rinvoq can cause certain viral infections to become active (cause symptoms) if you already have the virus in your body. This includes hepatitis and herpes viruses. Your doctor may order a test to check for hepatitis before you start taking Rinvoq.

Cancer

People taking Rinvoq may have a higher risk of lymphoma or other types of cancer, including nonmelanoma skin cancer. The drug has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA.

Note that in clinical trials, cancer also occurred in some people taking a placebo or methotrexate.

Talk with your doctor about your cancer risk before starting Rinvoq. If you have a history of cancer or are currently receiving treatment for cancer, your doctor may prescribe an RA drug other than Rinvoq.

Blood clots

It’s possible that Rinvoq may raise your risk of blood clots. The drug has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA.

Blood clots that Rinvoq may cause include deep venous thrombosis (blood clot in a vein), arterial thrombosis (blood clot in an artery), and pulmonary embolism (blood clot in the artery of the lung). These blood clots may be serious and can even be fatal.

Symptoms of a blood clot may include:

• swelling or pain in your arms, legs, hands, or feet
• shortness of breath
• pain in a new area of your body

Talk with your doctor right away if you have any of these symptoms during Rinvoq treatment. If you have a higher risk of blood clots with Rinvoq, your doctor may advise you not to take the drug.

Cardiovascular problems

It’s possible that Rinvoq may raise your risk of cardiovascular problems. Examples of these include heart attack, stroke, and death caused by a cardiovascular issue. The drug has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA.

A drug that belongs to the same class of medications as Rinvoq has caused these problems in clinical trials. Specifically, an increased risk of cardiovascular problems occurred in people with rheumatoid arthritis who:

• were at least 50 years of age
• had at least one risk factor for cardiovascular problems
• were taking a medication known as a Janus kinase (JAK) inhibitor

Smoking can also increase the risk of cardiovascular issues with Rinvoq.

If you have a higher risk of cardiovascular problems with this type of medication, your doctor might advise you not to take Rinvoq. If you have a heart attack or stroke while using the drug, your doctor will recommend that you stop taking Rinvoq.

If you have any symptoms of a heart attack or stroke, call 911 or your local emergency number. These symptoms can include:

• chest pain or tightness
• shortness of breath
• numbness on one side of your body

Increased risk of death

It’s possible that Rinvoq may raise the risk of death in some people. The drug has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA.

Another drug that belongs to the same class of medications has increased this risk in certain people. Specifically, an increased risk of death has been seen in people with rheumatoid arthritis who:

• are at least 50 years of age
• have at least one risk factor for cardiovascular problems

This risk was increased compared with people taking a tumor necrosis factor (TNF) blocker drug.

Your doctor can determine whether your risk is increased with Rinvoq.

Changes to levels of liver enzymes, cholesterol, and certain blood cells

In some people, taking Rinvoq can lead to changes in the levels of certain cells and substances in the body. These changes may be minor. However, major changes may occur, which could be symptoms of a serious condition caused by Rinvoq.

Rinvoq can cause effects such as:

• low levels of certain white blood cells
• low levels of red blood cells
• high cholesterol
• increased levels of liver enzymes, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

If any of these levels change a lot, your doctor may need to adjust your treatment. This could involve adjusting your Rinvoq dosage or having you stop treatment until the side effect is resolved. In some cases, your doctor could recommend taking other medications to help relieve side effects.

Your doctor will order blood tests throughout your Rinvoq treatment to check for any changes in these levels.

Rinvoq uses

The Food and Drug Administration (FDA) approves prescription drugs such as Rinvoq to treat certain conditions. Doctors may also prescribe Rinvoq off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Rinvoq for rheumatoid arthritis

Rinvoq is FDA approved to treat moderate to severe rheumatoid arthritis (RA). It can be used in adults who:

• have RA that did not respond well to medications called tumor necrosis factor (TNF) blockers, or
• had to stop taking TNF blockers because of negative side effects

With RA, your immune system attacks certain joints in your body. This leads to inflammation and pain in the affected joints. RA usually affects the hands, wrists, and feet. However, it may also affect the shoulders, elbows, knees, or ankles. Over time, untreated RA can cause a person’s joints to become misshapen.

For details about this condition, you can refer to our rheumatoid arthritis hub.

For RA, Rinvoq can be taken alone, with methotrexate, or with nonbiologic disease-modifying antirheumatic drugs (DMARDs), such as hydroxychloroquine (Plaquenil) or leflunomide (Arava).

However, Rinvoq should not be taken with certain other drugs to treat this condition. These include:

• other JAK inhibitors, such as tofacitinib (Xeljanz)
• strong immunosuppressants, such as azathioprine (Azasan) and cyclosporine (Sandimmune, Neoral, Gengraf)
• biologic DMARDs, such as infliximab (Remicade) and adalimumab (Humira)

Effectiveness for rheumatoid arthritis

In clinical trials, Rinvoq was effective in treating RA in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for psoriatic arthritis

Rinvoq is FDA approved to treat psoriatic arthritis (PsA) in adults and children ages 2 years and older who:

• have PsA that did not respond well to medications called TNF blockers, or
• had to stop taking TNF blockers because of negative side effects

With PsA, you have symptoms of arthritis, such as achy or stiff joints. You also have symptoms of psoriasis, including itchy or scaly skin patches. For details about this condition, you can refer to our psoriasis hub and our arthritis hub.

For PsA, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• strong immunosuppressants, such as azathioprine and cyclosporine
• biologic DMARDs, such as infliximab and adalimumab

Note: Doctors will likely prescribe Rinvoq LQ instead of Rinvoq for children under a certain weight. Rinvoq LQ is the oral solution form of Rinvoq. These forms should not be used interchangeably.

Effectiveness for psoriatic arthritis

In clinical trials, Rinvoq was effective in treating PsA in adults. Rinvoq is also expected to be effective for treating PsA in children ages 2 years and older. This is based on the clinical trials of Rinvoq for PsA in adults and for polyarticular juvenile idiopathic arthritis in children.

To learn how Rinvoq performed in these trials, see the drug’s prescribing information.

Rinvoq for atopic dermatitis

Rinvoq is FDA approved to treat moderate to severe atopic dermatitis. (Atopic dermatitis is a type of eczema.) With atopic dermatitis, you have areas of skin that are dry and itchy. For details about this condition, you can refer to our eczema hub.

Rinvoq is used in adults and children ages 12 years and older whose condition either:

• is not well managed with certain systemic medications, including biologics, or
• cannot be treated with certain other medications

Systemic drugs affect the whole body. Biologic drugs are made from living cells.

For atopic dermatitis, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• any immunosuppressants
• biologic DMARDs, such as infliximab and adalimumab

Note: It’s not known whether Rinvoq LQ is safe and effective for children with atopic dermatitis. The manufacturer does not provide Rinvoq LQ dosages for children with this condition.

Effectiveness for atopic dermatitis

In clinical trials, Rinvoq was effective in treating atopic dermatitis in adults and children ages 12 years and older. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for ulcerative colitis

Rinvoq is FDA approved to treat moderate to severe ulcerative colitis (UC). It’s used in adults who:

• have UC that did not respond well to medications called TNF blockers, or
• had to stop taking TNF blockers because of negative side effects

With UC, you have long-term inflammation in your colon. This can cause diarrhea, abdominal pain, and severe urges to have a bowel movement. For details about this condition, you can refer to our ulcerative colitis hub.

For UC, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• strong immunosuppressants, such as azathioprine and cyclosporine
• biologic drugs for UC, such as infliximab and adalimumab

Effectiveness for ulcerative colitis

In clinical trials, Rinvoq was effective in treating UC in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for Crohn’s disease

Rinvoq is FDA approved to treat moderate to severe Crohn’s disease. It’s used in adults who:

• have Crohn’s disease that did not respond well to medications called TNF blockers, or
• had to stop taking TNF blockers because of negative side effects

With Crohn’s disease, you have long-term inflammation in any part of your digestive tract, including your stomach or intestines. This can cause mouth sores, diarrhea, and abdominal pain. For details about this condition, you can refer to our inflammatory bowel disease hub.

For Crohn’s disease, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• strong immunosuppressants, such as azathioprine and cyclosporine
• biologic drugs for Crohn’s disease, such as infliximab and adalimumab

Effectiveness for Crohn’s disease

In clinical trials, Rinvoq was effective in treating Crohn’s disease in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for ankylosing spondylitis

Rinvoq is FDA approved to treat ankylosing spondylitis in adults who:

• have ankylosing spondylitis that did not respond well to medications called TNF blockers, or
• had to stop taking TNF blockers because of negative side effects

With ankylosing spondylitis, you have inflammation in and around the joints of your spine. This can cause stiffness, pain, and limited range of motion in your back, particularly in the lower back. For details about this condition, you can refer to our arthritis hub.

For ankylosing spondylitis, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• strong immunosuppressants, such as azathioprine and cyclosporine
• biologic DMARDs, such as infliximab and adalimumab

Effectiveness for ankylosing spondylitis

In clinical trials, Rinvoq was effective in treating ankylosing spondylitis in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for non-radiographic axial spondyloarthritis

Rinvoq is FDA approved to treat non-radiographic axial spondyloarthritis (nr-AxSpA) in adults who:

• have nr-AxSpA that did not respond well to medications called TNF blockers, or
• had to stop taking TNF blockers because of negative side effects

With nr-AxSpA, you have inflammation in and around your spinal joints. This can cause stiffness, pain, and limited movement in your back, especially your lower back.

The difference between this condition and ankylosing spondylitis (which Rinvoq also treats) is that with nr-AxSpA, there is no visible joint damage on X-rays. To learn more, you can refer to our arthritis hub.

For nr-AxSpA, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• strong immunosuppressants, such as azathioprine and cyclosporine
• biologic DMARDs, such as infliximab and adalimumab

Effectiveness for non-radiographic axial spondyloarthritis

In clinical trials, Rinvoq was effective in treating nr-AxSpA in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for giant cell arteritis

Rinvoq is FDA approved to treat giant cell arteritis in adults.

Arteritis refers to inflammation of the arteries. Giant cell arteritis affects the arteries in a person’s head and neck. Symptoms include headache, blurred vision, and pain in the mouth, face, or scalp.

For giant cell arteritis, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• strong immunosuppressants, such as azathioprine and cyclosporine
• biologic DMARDs, such as infliximab and adalimumab

Effectiveness for giant cell arteritis

In clinical trials, Rinvoq was effective in treating giant cell arteritis in adults. To learn how the drug performed in these trials, see its prescribing information.

Rinvoq for polyarticular juvenile idiopathic arthritis

Rinvoq is FDA approved to treat polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older who:

• have pJIA that did not respond well to medications called TNF blockers, or
• had to stop taking TNF blockers because of negative side effects

pJIA is a type of arthritis that affects children, and its cause is unknown. This condition affects five or more joints. Symptoms include swollen, painful, and stiff joints, blurry vision, and fever.

For pJIA, Rinvoq should not be taken with certain other drugs. These include:

• other JAK inhibitors, such as tofacitinib
• strong immunosuppressants, such as azathioprine and cyclosporine
• biologic DMARDs, such as infliximab and adalimumab

Note: Doctors will likely prescribe Rinvoq LQ instead of Rinvoq for children under a certain weight. Rinvoq LQ is the oral solution form of Rinvoq. These forms should not be used interchangeably.

Effectiveness for pJIA

In clinical trials, Rinvoq was effective in treating pJIA in children ages 2 years and older. To learn how the drug performed in these trials, see its prescribing information.

Off-label uses for Rinvoq

In addition to the uses listed previously, doctors may prescribe Rinvoq off-label for other purposes. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition. Here are examples of off-label uses for Rinvoq.

Rinvoq for autoimmune conditions

Ongoing research is looking at Rinvoq as a treatment for several autoimmune conditions. (With autoimmune conditions, your immune system mistakenly attacks healthy tissue in your body.) These include:

• non-segmental vitiligo, which causes loss of color in patches of skin
• systemic lupus erythematosus, a condition that causes widespread inflammation in the body

To learn more about possible off-label uses of Rinvoq, talk with your doctor or pharmacist.

Rinvoq and children

Rinvoq is approved for use in certain children with PsA, atopic dermatitis, and pJIA. For more information, see “Rinvoq for psoriatic arthritis,” “Rinvoq for atopic dermatitis,” and “Rinvoq for polyarticular juvenile idiopathic arthritis.”

For treating PsA or pJIA, children may take Rinvoq LQ, an oral solution, instead of the Rinvoq extended-release oral tablet. (Extended release means the drug is released in your body slowly over a period of time.) For more information, see the “Rinvoq dosage” section.

Note that Rinvoq and Rinvoq LQ are not interchangeable.

Rinvoq generic

Rinvoq is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug contains the same active ingredient as in its brand-name version. Generics usually cost less than brand-name drugs.

Rinvoq use with other drugs

Rinvoq is sometimes taken by itself, but it’s often taken in combination with other medications.

For rheumatoid arthritis and psoriatic arthritis, doctors may prescribe Rinvoq in addition to another medication when the initial drug is not treating the condition well enough. Adding Rinvoq to a treatment plan can bring better results. For these conditions, Rinvoq can be taken with nonbiologic disease-modifying antirheumatic drugs (DMARDs), such as methotrexate (Otrexup, Rasuvo, Trexall), hydroxychloroquine (Plaquenil), or leflunomide (Arava).

For atopic dermatitis, doctors may prescribe Rinvoq in combination with another medication when the initial drug is not treating the condition well enough. Rinvoq can be taken with topical corticosteroids, such as triamcinolone acetonide 0.1% cream or fluocinolone acetonide 0.025% ointment (Synalar).

For Crohn’s disease, doctors may prescribe Rinvoq in addition to another medication when the initial drug is not treating the condition well enough. Adding Rinvoq to a treatment plan can bring better results. For these conditions, Rinvoq can be taken with:

• methotrexate
• aminosalicylates, such as sulfasalazine (Azulfidine) or mesalamine (Apriso, Lialda)

For giant cell arteritis, your doctor may recommend a tapering course of corticosteroids in combination with Rinvoq at the start of treatment. “Tapering” means your doctor will lower the dosage of the corticosteroid over time until you are taking Rinvoq by itself.

Talk with your doctor if you have questions about adding Rinvoq to your treatment plan to help improve your condition.

Rinvoq dosage

The following information describes the Rinvoq dosage that is commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

In some cases, your doctor may recommend a dosage of Rinvoq that differs from those listed in the following text. They may recommend this if you have liver or kidney problems and are taking the drug for certain conditions.

The dosage information that follows is for adults. For children’s dosage information, see the “Children’s dosage” section immediately after.

Drug forms and strengths

Rinvoq comes as an extended-release oral tablet. (Extended release means the drug is released in your body slowly over a period of time.) Rinvoq tablets are available in three strengths: 15 milligrams (mg), 30 mg, and 45 mg.

Rinvoq also comes as an oral solution marketed under the name Rinvoq LQ. The oral solution is available in a strength of 1 milligram per milliliter (mg/mL). Rinvoq LQ is prescribed for children under a certain weight. Children above that weight may take either Rinvoq or Rinvoq LQ. For details, see the “Children’s dosage” section.

Rinvoq and Rinvoq LQ should not be used interchangeably.

Dosage for rheumatoid arthritis

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

Dosage for psoriatic arthritis

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

Dosage for atopic dermatitis

The typical starting dosage of Rinvoq for adults with atopic dermatitis is 15 mg, taken once per day.

This is also the recommended ongoing dosage for adults ages 65 years and older.

In adults younger than 65 years, the daily dosage may be increased to 30 mg if needed. If their atopic dermatitis does not improve with 30 mg daily, their doctor may recommend stopping treatment with Rinvoq.

Dosage for ulcerative colitis

The typical induction (starting) Rinvoq dosage for ulcerative colitis is 45 mg once daily for 8 weeks.

After this, the recommended maintenance (ongoing) dosage is either 15 mg or 30 mg once daily. If your condition is severe, your doctor may prescribe the higher 30-mg daily dosage. They’ll ultimately prescribe the lowest dosage that’s effective for you.

Dosage for Crohn’s disease

The typical induction Rinvoq dosage for Crohn’s disease is 45 mg once daily for 12 weeks.

After this, the recommended maintenance dosage is either 15 mg or 30 mg once daily. If your condition is severe, your doctor may prescribe the higher 30-mg daily dosage. They’ll ultimately prescribe the lowest dosage that’s effective for you.

Dosage for ankylosing spondylitis

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

Dosage for non-radiographic axial spondyloarthritis

The typical Rinvoq dosage for non-radiographic axial spondyloarthritis is 15 mg, taken once per day.

Dosage for giant cell arteritis

The typical Rinvoq dosage for giant cell arteritis is 15 mg, taken once per day.

Your doctor may recommend a tapering course of corticosteroids in combination with Rinvoq at the start of treatment. “Tapering” means your doctor will lower the dosage of the corticosteroid over time until you are taking Rinvoq by itself. Your doctor will give you instructions on the corticosteroid they prescribe.

Children’s dosage

Here are the recommended dosages of Rinvoq or Rinvoq LQ for the conditions these drugs are approved to treat in children. Dosage will be based on a child’s body weight.

Doctors will prescribe Rinvoq LQ for children who weigh 30 kilograms (kg) or less. For reference, 1 kg is about 2.2 pounds (lb), so 30 kg is about 66 lb. Children weighing above 30 kg may have the option to take either Rinvoq or Rinvoq LQ, depending on the condition being treated.

A child taking Rinvoq LQ may grow during treatment. In such cases, their doctor will recommend increasing the dosage of Rinvoq LQ oral solution. They might also suggest switching to Rinvoq extended-release oral tablets.

If needed, the doctor will provide instructions on how to switch forms safely since Rinvoq LQ and Rinvoq are not interchangeable.

Children’s dosage for psoriatic arthritis

For psoriatic arthritis in children ages 2 years and older, the dosage is as follows. (For reference, 10 kg is about 22 lb, 20 kg is about 44 lb, and 30 kg is about 66 lb.) Rinvoq LQ comes in a strength of 1 mg/mL, so a dose of 1 mg is equal to 1 mL of solution.

Children’s dosage for atopic dermatitis

The typical starting dosage of Rinvoq for children with atopic dermatitis is 15 mg, taken once per day. This is for children ages 12 years and older who weigh at least 40 kg, which is about 88 lb. The manufacturer of Rinvoq does not make recommendations for treating atopic dermatitis in children weighing less than this. It also does not provide dosages of Rinvoq LQ for this condition.

The child’s doctor may increase their daily dosage to 30 mg per day if needed. If the child’s atopic dermatitis does not improve with 30 mg daily, their doctor may recommend stopping treatment with Rinvoq.

Children’s dosage for polyarticular juvenile idiopathic arthritis

For polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older, the dosage is as follows.

What if I miss a dose?

If you miss a dose of Rinvoq, take it as soon as you remember. However, if it’s close to the time for your next dose, skip your missed dose and take your next dose as scheduled. Never take a double dose to make up for a missed dose. This could raise your risk of side effects.

To help make sure you do not miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Rinvoq is meant to be used as a long-term treatment. If you and your doctor determine that Rinvoq is safe and effective for you, you’ll likely take it long term.

How Rinvoq works

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

• rheumatoid arthritis (RA)
• psoriatic arthritis (PsA)
• atopic dermatitis
• ulcerative colitis (UC)
• Crohn’s disease
• ankylosing spondylitis
• non-radiographic axial spondyloarthritis (nr-AxSpA)
• giant cell arteritis
• polyarticular juvenile idiopathic arthritis (pJIA)

What happens with these conditions

Each of the conditions Rinvoq is approved to treat is a chronic (long-term) condition in which your immune system attacks certain parts of your body.

RA, PsA, ankylosing spondylitis, nr-AxSpA, and pJIA affect the joints. These conditions cause inflammation, pain, and stiffness.

PsA and atopic dermatitis affect the skin, leading to inflammation and skin changes.

UC affects the colon. This can lead to diarrhea, abdominal pain, and other gastrointestinal symptoms.

Crohn’s disease may affect any part of the digestive tract, including your stomach or intestines. This can cause mouth sores, diarrhea, and other gastrointestinal symptoms.

Arteritis refers to inflammation of the arteries. Giant cell arteritis affects arteries in a person’s head and neck. This can result in headache, blurred vision, and pain in the mouth, face, or scalp.

What Rinvoq does

Rinvoq is a disease-modifying antirheumatic drug (DMARD). It belongs to a class of medications called Janus kinase (JAK) inhibitors.

It works by decreasing the activity of your immune system cells. This can reduce inflammation and relieve symptoms of your condition.

How long does it take to work?

Rinvoq begins working in your body after the first dose. However, it may take several weeks for you to notice an improvement in your symptoms.

Rinvoq and alcohol

There are no known interactions between Rinvoq and alcohol.

However, alcohol may make certain side effects of Rinvoq worse or more likely to occur. Examples of these side effects include nausea and liver problems.

Alcohol may also worsen certain conditions that Rinvoq treats. For example, drinking alcohol can worsen ulcerative colitis symptoms.

If you drink alcohol, talk with your doctor about how much is safe to drink during your Rinvoq treatment.

Rinvoq interactions

Rinvoq can interact with live vaccines. It can also interact with other medications, certain supplements, and certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Learn more about Rinvoq interactions here.

Rinvoq and live vaccines

You should not get live vaccines during your Rinvoq treatment. With live vaccines, you’re injected with a small amount of a virus or bacterium so your body can learn to fight it.

You should not get these vaccines while using Rinvoq because the drug may weaken your immune system. If this happens, your body cannot respond to the vaccine properly. This could make you sick.

Live vaccines you should avoid during your Rinvoq treatment include:

• measles, mumps, rubella (MMR)
• flu nasal spray (FluMist)
• smallpox
• chickenpox
• rotavirus
• yellow fever
• typhoid (tablet form)

Before you start taking Rinvoq, talk with your doctor about whether you need any live vaccines. You and your doctor may decide to delay your Rinvoq treatment until after you’ve received any live vaccines you need.

Rinvoq and other medications

Here you’ll find examples of medications that can interact with Rinvoq. This section does not list all drugs that may interact with Rinvoq.

Before taking Rinvoq, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Rinvoq and strong CYP3A4 inhibitors

Taking Rinvoq with drugs that inhibit (slow down) the activity of an enzyme called CYP3A4 can increase the amount of Rinvoq in your body. (An enzyme is a protein that aids chemical changes in your body.) CYP3A4 helps your body break down drugs. When this process is slowed down, it raises your risk of side effects from Rinvoq.

Examples of CYP3A4 inhibitors include:

• certain antiretrovirals, such as ritonavir (Norvir) or darunavir (Prezista)
• antifungals, such as ketoconazole or itraconazole (Sporanox)
• antibiotics, such as clarithromycin or erythromycin (Ery-Tab)
• calcium channel blockers, such as diltiazem (Cardizem CD, Cartia XT) or verapamil (Verelan)

Talk with your doctor if you’re taking any of these medications. Your doctor may choose to prescribe a drug other than Rinvoq to treat your condition.

Rinvoq and strong CYP3A4 inducers

Taking Rinvoq with medications that induce (speed up) the activity of an enzyme called CYP3A4 can decrease the amount of Rinvoq in your body. CYP3A4 helps your body break down drugs. When this process is sped up, Rinvoq may become less effective.

Examples of CYP3A4 inducers include:

• antibiotics, such as rifampin (Rifadin) or rifabutin (Mycobutin)
• anticonvulsants, such as carbamazepine (Carbatrol, Tegretol), oxcarbazepine (Trileptal), or phenytoin (Dilantin)
• corticosteroids, such as dexamethasone
• certain antiretrovirals, such as efavirenz or nevirapine

Talk with your doctor if you’re taking any of these drugs. Your doctor may prescribe a different drug to treat your condition, or they may adjust the dosage of your other medications.

Rinvoq and herbs and supplements

Avoid taking Rinvoq with an herbal supplement called St. John’s wort, which some people take to help ease depression symptoms. Taking these together can decrease the level of Rinvoq in your body. This can make Rinvoq less effective.

Talk with your doctor if you take St. John’s wort. They may have you stop taking it during your Rinvoq treatment.

Check with your doctor or pharmacist before using any other herbs or supplements while taking Rinvoq.

Rinvoq and foods

Eating grapefruit or drinking grapefruit juice may increase the amount of Rinvoq in your body. This can make side effects of the drug worse. You should avoid grapefruit and grapefruit juice while taking Rinvoq.

Alternatives to Rinvoq

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Rinvoq, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat the condition they are listed under. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for rheumatoid arthritis

Examples of other drugs that may be used to treat rheumatoid arthritis include:

• disease-modifying antirheumatic drugs (DMARDs), such as:
  • methotrexate (Otrexup, Rasuvo, Trexall)
  • leflunomide (Arava)
  • hydroxychloroquine (Plaquenil)
  • sulfasalazine (Azulfidine)
  • tofacitinib (Xeljanz)
• biologic drugs, such as:
  • abatacept (Orencia)
  • adalimumab (Humira)
  • certolizumab (Cimzia)
  • infliximab (Remicade)
• minocycline (Minocin)

Alternatives for psoriatic arthritis

Examples of other drugs that may be used to treat psoriatic arthritis include:

• DMARDs, such as:
  • methotrexate (Otrexup, Rasuvo, Trexall)
  • leflunomide (Arava)
  • apremilast (Otezla)
  • sulfasalazine (Azulfidine)
  • tofacitinib (Xeljanz)
• biologic drugs, such as:
  • abatacept (Orencia)
  • adalimumab (Humira)
  • certolizumab (Cimzia)
  • infliximab (Remicade)
  • risankizumab-rzaa (Skyrizi)

Alternatives for atopic dermatitis

Examples of other drugs that may be used to treat atopic dermatitis include:

• topical corticosteroids, such as:
  • fluocinolone (Synalar)
  • triamcinolone
  • betamethasone
• topical calcineurin inhibitors, such as:
  • tacrolimus (Protopic)
  • pimecrolimus (Elidel)
• biologic drugs, such as:
  • dupilumab (Dupixent)
  • tralokinumab-ldrm (Adbry)
• other Janus kinase (JAK) inhibitors, such as:
  • abrocitinib (Cibinqo)

Alternatives for ulcerative colitis

Examples of other drugs that may be used to treat ulcerative colitis include:

• aminosalicylates, such as:
  • balsalazide (Colazal)
  • olsalazine (Dipentum)
  • sulfasalazine (Azulfidine)
  • mesalamine (Lialda, Delzicol)
• immunomodulators, such as:
  • azathioprine (Imuran, Azasan)
  • 6-mercaptopurine (6-MP)
  • ozanimod (Zeposia)
• biologics, such as:
  • adalimumab (Humira)
  • infliximab (Inflectra, Remicade, Renflexis)
  • golimumab (Simponi)
  • vedolizumab (Entyvio)
  • risankizumab-rzaa (Skyrizi)

Alternatives for Crohn’s disease

Examples of other drugs that may be used to treat Crohn’s disease include:

• aminosalicylates, such as:
  • sulfasalazine (Azulfidine)
  • mesalamine (Lialda, Delzicol)
• immunomodulators, such as:
  • azathioprine (Imuran, Azasan)
  • 6-mercaptopurine (6-MP)
• biologics, such as:
  • adalimumab (Humira)
  • infliximab (Inflectra, Remicade, Renflexis)
  • vedolizumab (Entyvio)
  • risankizumab-rzaa (Skyrizi)

Alternatives for ankylosing spondylitis

Examples of other drugs that may be used to treat ankylosing spondylitis include:

• DMARDs, such as:
  • methotrexate (Otrexup, Rasuvo,Trexall)
  • sulfasalazine (Azulfidine)
• biologics, such as:
  • secukinumab (Cosentyx)
  • ixekizumab (Taltz)
• tofacitinib (Xeljanz)

Alternatives for non-radiographic axial spondyloarthritis

Examples of other drugs that may be used to treat non-radiographic axial spondyloarthritis include:

• DMARDs, such as:
  • methotrexate (Otrexup, Rasuvo, Trexall)
  • sulfasalazine (Azulfidine)
• biologics, such as:
  • certolizumab (Cimzia)
  • secukinumab (Cosentyx)
  • ixekizumab (Taltz)

Alternatives for giant cell arteritis

Examples of other drugs that may be used to treat giant cell arteritis include:

• DMARDs, such as:
  • methotrexate (Otrexup, Rasuvo, Trexall)
  • tocilizumab (Actemra)
• corticosterioids, such as:
  • prednisone

Alternatives for polyarticular juvenile idiopathic arthritis

Examples of other drugs that may be used to treat polyarticular juvenile idiopathic arthritis (pJIA) include:

• DMARDs, such as:
  • methotrexate (Otrexup, Rasuvo, Trexall)
  • leflunomide (Arava)
  • sulfasalazine (Azulfidine)
• biologics, such as:
  • tocilizumab (Actemra)
  • abatacept (Orencia)
  • adalimumab (Humira)

Rinvoq vs. Dupixent

You may wonder how Rinvoq compares with other medications that are prescribed for similar uses. Here we look briefly at how Rinvoq and Dupixent are alike and different. Your doctor or pharmacist can tell you more about how these two drugs compare.

Ingredients

The active ingredient in Rinvoq is upadacitinib, and the active ingredient in Dupixent is dupilumab.

Uses

These drugs are both approved to treat atopic dermatitis in certain adults and children. For this use, Rinvoq can be given to children ages 12 years and older, and Dupixent can be given to children ages 6 months and older.

In addition to atopic dermatitis, Rinvoq is approved to treat:

• rheumatoid arthritis in adults
• psoriatic arthritis (PsA) in adults and children ages 2 years and older
• ulcerative colitis in adults
• Crohn’s disease in adults
• ankylosing spondylitis in adults
• non-radiographic axial spondyloarthritis in adults
• giant cell arteritis in adults
• polyarticular juvenile idiopathic arthritis in children ages 2 years and older

Dupixent is also approved to treat:

• asthma in adults and children ages 6 years and older
• chronic (long-term) rhinosinusitis with nasal polyps (noncancerous growths) in adults and children ages 12 years and older
• eosinophilic esophagitis in adults and children ages 1 year and older
• prurigo nodularis (a skin condition that causes itchy bumps) in adults
• chronic obstructive pulmonary disease (COPD) in adults
• chronic spontaneous urticaria in adults and children ages 12 years and older
• bullous pemphigoid in adults

Forms

Rinvoq comes as an extended-release oral tablet. (Extended release means the drug is released in your body slowly over a period of time.) It also comes as an oral solution marketed under the name Rinvoq LQ.

Dupixent is given as a subcutaneous injection using single-use prefilled syringes or prefilled pens.

Side effects

Rinvoq and Dupixent tend to cause different side effects. For more information, see the “Rinvoq side effects” section earlier and our Dupixent side effects article. You can also refer to the prescribing information for Rinvoq and Dupixent or talk with your doctor for details.

It’s important to note that Rinvoq has several boxed warnings, but Dupixent does not come with any boxed warnings. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). See “Side effect details” in the “Rinvoq side effects” section for details about Rinvoq’s boxed warnings.

Rinvoq vs. Xeljanz

You may wonder how Rinvoq compares with other medications that are prescribed for similar uses. Here we look at how Rinvoq and Xeljanz are alike and different. Your doctor or pharmacist can tell you more about how these two drugs compare.

Ingredients

The active ingredient in Rinvoq is upadacitinib, and the active ingredient in Xeljanz is tofacitinib.

Uses

Rinvoq and Xeljanz are both approved to treat the following in adults:

• rheumatoid arthritis (RA)
• psoriatic arthritis (PsA)
• ulcerative colitis (UC)
• ankylosing spondylitis

In addition, both drugs are approved to treat polyarticular juvenile idiopathic arthritis in children ages 2 years and older.

Rinvoq is also approved to treat:

• PsA in children ages 2 years and older
• Crohn’s disease in adults
• non-radiographic axial spondyloarthritis in adults
• atopic dermatitis in adults and children ages 12 years and older
• giant cell arteritis in adults

Forms

Rinvoq comes as an extended-release oral tablet. (Extended release means the drug is released slowly over a certain period of time.) It also comes as an oral solution marketed under the name Rinvoq LQ.

Xeljanz comes as an oral tablet. It’s available in immediate-release and extended-release forms. (Immediate release means the drug is released into the body right away.) This medication also comes as an oral solution.

Side effects

Rinvoq and Xeljanz have some similar side effects and others that differ. For more information, see the “Rinvoq side effects” section earlier and our Xeljanz side effects article. You can also refer to the prescribing information for Rinvoq and Xeljanz or talk with your doctor for details.

Both Rinvoq and Xeljanz have boxed warnings for cardiovascular problems, increased risk of death, serious infections, cancer, and blood clots. See “Side effect details” in the “Rinvoq side effects” section for details about Rinvoq’s boxed warnings.

Rinvoq vs. Humira

Doctors prescribe Rinvoq and Humira for similar uses. Here we look at how these drugs are alike and different. Your doctor or pharmacist can tell you more about how these two drugs compare.

Ingredients

The active ingredient in Rinvoq is upadacitinib, and the active ingredient in Humira is adalimumab.

Uses

Both Rinvoq and Humira are approved to treat the following conditions in adults:

• rheumatoid arthritis (RA)
• psoriatic arthritis (PsA)
• ulcerative colitis (UC)
• Crohn’s disease
• ankylosing spondylitis

Both drugs are also approved to treat polyarticular juvenile idiopathic arthritis in children ages 2 years and older.

Individually, these drugs may be used to treat some of the listed conditions in children: Rinvoq is approved to treat PsA in children ages 2 years and older. Humira is approved to treat UC in children ages 5 years and older and Crohn’s disease in children ages 6 years and older.

Rinvoq is also approved to treat:

• atopic dermatitis in adults and children ages 12 years and older
• non-radiographic axial spondyloarthritis in adults
• giant cell arteritis in adults

Humira is also approved to treat:

• plaque psoriasis in adults
• hidradenitis suppurativa in adults as well as children ages 12 years and older
• certain types of uveitis (eye inflammation) in adults and children ages 2 years and older

Forms

Rinvoq comes as an extended-release oral tablet. (Extended release means the drug is released in your body slowly over a period of time.) It also comes as an oral solution marketed under the name Rinvoq LQ.

Humira is given as a subcutaneous injection. Humira comes in three forms: a single-use pen, a single-use prefilled syringe, and a single-use vial of liquid solution.

Side effects

Rinvoq and Humira have some similar side effects and others that differ. For more information, see the “Rinvoq side effects” section earlier and our Humira side effects article. You can also refer to the prescribing information for Rinvoq and Humira or talk with your doctor for details.

Rinvoq has a boxed warning for blood clots, cardiovascular problems, and increased risk of death. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). See “Side effect details” in the “Rinvoq side effects” section for details about Rinvoq’s boxed warnings.

Both Rinvoq and Humira have boxed warnings for cancer and serious infections.

How to take Rinvoq

You should take Rinvoq according to your doctor’s or another healthcare professional’s instructions. It comes as an oral tablet that you swallow whole. It also comes as an oral solution called Rinvoq LQ that doctors may prescribe for children.

If your child’s doctor prescribes Rinvoq LQ, you’ll give your child their dose using an oral syringe included with the prescription.

When to take

You can take Rinvoq at any time of day, but it’s best to take it at the same time each day.

If your child takes Rinvoq LQ, you’ll need to give them a dose twice per day. Try to give their doses at the same times each day. Your child’s doctor can advise you on how much time to allow between doses.

To help make sure you do not miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Note that with some extended-release oral tablets such as Rinvoq, you may occasionally see pieces of the tablet in your stool. This is not unusual for extended-release oral tablets. (Extended release means the drug is released in your body slowly over a period of time.)

But let your doctor know if you’re seeing the drug in your stool regularly. This could be a sign that the drug is not breaking down properly in your body. In this case, your doctor may recommend switching treatments for your condition.

Taking Rinvoq with food

You can take Rinvoq with or without food.

Can Rinvoq be crushed, split, or chewed?

No, you should not crush, split, or chew Rinvoq tablets. You should swallow each tablet whole with some water.

Rinvoq and pregnancy, breastfeeding, and birth control

If you can become pregnant, are breastfeeding, or are using birth control, it’s important to consider whether Rinvoq is a safe choice for you.

It is not recommended to take Rinvoq during pregnancy or while breastfeeding. If you or your partner can become pregnant, your doctor will suggest you use certain birth control options while taking Rinvoq.

Refer to our Rinvoq pregnancy, breastfeeding, and birth control article for more information on these topics. If you have additional questions, talk with your doctor.

Common questions about Rinvoq

Here are answers to some frequently asked questions about Rinvoq.

Is Rinvoq an immunosuppressant?

Yes, Rinvoq is an immunosuppressant drug. It works by decreasing the activity of your immune system. This can reduce inflammation and relieve symptoms of RA, such as pain and swelling in your joints.

Rinvoq is a disease-modifying antirheumatic drug (DMARD). It belongs to a class of medications known as Janus kinase (JAK) inhibitors.

By weakening your immune system, Rinvoq can raise your risk of serious infections. (See the “Rinvoq side effects” section to learn more.)

Because of how Rinvoq affects your immune system, you should avoid getting live vaccines during your treatment. (See the next question for more information.)

Can I get vaccines while I’m taking Rinvoq?

You can get inactive vaccines while you’re taking Rinvoq. These vaccines do not have any live viruses or bacteria in them. However, you should avoid getting live vaccines during treatment.

With live vaccines, you’re injected with a small amount of a live virus or bacterium so that your body can learn to fight it. You should not get these vaccines while using Rinvoq because the drug weakens your immune system. Your body will not be able to respond to the live vaccine properly, and it may make you sick.

For examples of live vaccines to avoid while taking Rinvoq, see the “Rinvoq and live vaccines” section.

Examples of inactive vaccines that you can get during Rinvoq treatment include:

• hepatitis A
• hepatitis B
• flu shot
• Tdap (tetanus, diphtheria, whooping cough)
• COVID-19
• typhoid shot

Before you begin taking Rinvoq, talk with your doctor about whether you need any live vaccines. You and your doctor may decide to delay your treatment until you’ve received any live vaccines you need.

Is Rinvoq a biologic?

No, Rinvoq is not a biologic drug. Biologics are medications made from living organisms rather than chemicals.

Instead, Rinvoq is a nonbiologic disease-modifying antirheumatic drug (DMARD). It belongs to a class of drugs called JAK inhibitors.

Rinvoq works by decreasing the activity of your immune system cells. This can help reduce symptoms of the conditions Rinvoq is used to treat.

Some biologics are also used for the conditions Rinvoq treats. For examples of such biologic drugs, see the “Alternatives to Rinvoq” section.

Talk with your doctor if you’re interested in taking a biologic drug for your condition.

Rinvoq precautions

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Listed here are the boxed warnings for Rinvoq. See “Side effect details” in the “Rinvoq side effects” section for details about these boxed warnings.

• serious infections
• cancer
• blood clots
• cardiovascular problems
• increased risk of death

Other precautions

Before taking Rinvoq, talk with your doctor about your health history. Rinvoq may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• diverticulitis
• currently taking nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate (Otrexup, Rasuvo, Trexall)
• high cholesterol or a history of high cholesterol
• liver problems
• blood disorders such as neutropenia, lymphopenia, or anemia
• any condition that shortens digestion time, such as an ileostomy or colostomy
• an allergic reaction to Rinvoq or any of its ingredients
• pregnancy
• breastfeeding

Note: For more information about the potential negative effects of Rinvoq, see the “Rinvoq side effects” section.