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Updated June 2023
Upadacitinib (brand name: Rinvoq®) is a tablet that belongs to a class of medicines called Janus Kinase (JAK) inhibitor. JAK inhibitors work by blocking signals involved in inflammation. Blocking these signals in Rheumatoid Arthritis reduces pain, stiffness, swelling and damage in the joints.
This information sheet has been produced by the Australian Rheumatology Association to help you understand the medication that has been prescribed for you. It includes important information about:
Please read it carefully and discuss it with your doctor. This information sheet is not intended to replace the product information or discussion with your rheumatologist.
Upadacitinib should only be used if no suitable treatment alternatives are available in patients:
If you stop or delay your upadacitinib treatment, your disease may get worse. Keep taking your treatment, unless advised by your rheumatologist to stop or unless serious side effects occur (see Side effects).
If you stop upadacitinib for any reason, you must contact your rheumatologist. Failure to do so may mean that your treatment may no longer be funded.
Upadacitinib is taken by mouth in tablet form. It is a modified release tablet and must be swallowed whole. Do not crush, break or chew the tablet.
Take this medication with a full glass of water at the same time each day. It can be taken with or without food.
If you miss a dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medication to make up for a missed dose.
The usual dose for adults with rheumatoid arthritis and other inflammatory conditions is 15mg taken once a day.
This medication may be used alone or with other arthritis medications including:
There may be some instances where these medications may not be right for you, always check with your doctor prior to taking any of these medications.
Upadacitinib cannot be used with other biologic DMARDs or targeted synthetic DMARDs (such as baricitinib, tofacitinib, etanercept and adalimumab).
You might experience side effects with your treatment. Tell your doctor if you notice side effects that you think are caused by this medication. Many side effects disappear when upadacitinib treatment is stopped.
The most common side effects reported are mild upper respiratory tract infections (common cold, sinus infections), nausea, cough, and fever. Infections may need treatment and upadacitinib may need to be stopped for a while if you develop infection, so it is important to contact your doctor for advice.
If you have an active infection of any kind, treatment with upadacitinib will not be started until the infection is treated successfully.
People with rheumatoid arthritis and other inflammatory conditions have an increased risk of cardiovascular disorders. Recent reports have associated some JAK inhibitors with an increased risk of heart related events. Ensure your doctor is aware of any pre-existing risk factors (e.g. high blood pressure, high cholesterol, smoking status) so they can be appropriately managed.
Use with other medications
Some medications may not be used with upadacitinib as it may change their effectiveness and how well upadacitinib may work for you. Medications that may change how upadacitinib works include:
This list is not exhaustive. You should inform your doctor and pharmacist of all of the medications you are taking or plan to take. This includes over the counter or herbal/naturopathic medications to see if these affect upadacitinib.
Use with alcohol
You may drink alcohol while taking upadacitinib. However, if you are also taking methotrexate you should be cautious about how much alcohol you drink.
If you are taking upadacitinib you should not be immunised with ‘live’ vaccines such as:
Talk with your rheumatologist before receiving any vaccines.
Pneumococcal vaccines and the yearly seasonal flu vaccinations are encouraged.
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If you require surgery for any reason, treatment with upadacitinib should be stopped one week before surgery. It will be restarted again after the operation at a time agreed by your surgeon and rheumatologist.
Use in pregnancy and when breastfeeding
More detailed information is available here.