Rinvoq

Also called upadacitinib

Key points about Rinvoq

  • Rinvoq is used to treat rheumatoid arthritis.
  • Rinvoq is also called upadacitinib.
  • Find out how to take it safely and possible side effects. 
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Rinvoq is used for the treatment of adults with moderate-to-severe rheumatoid arthritis. Rinvoq is usually prescribed when commonly used medicines such as methotrexate and other less commonly used medicines like biologics don't work well enough or are unsuitable. 

Rinvoq belongs to a group of medicines called janus kinase (JAK) inhibitors. It works by blocking a substance in your body called janus kinase, thought to cause inflammation. This helps to reduce joint pain, swelling and stiffness and slows or stops further joint damage. Read more about rheumatoid arthritis.

  • In New Zealand Rinvoq is available as 15 mg tablets.
  • The usual dose of Rinvoq is 1 tablet once a day.
  • Always take your Rinvoq exactly as your doctor has told you.
  • The pharmacy label on your medicine will tell you how much Rinvoq to take, how often to take it and any special instructions.

  • Timing: Take your Rinvoq tablets once a day. You can take Rinvoq with or without food. Take your tablet about the same time each day.
  • Swallow your tablet whole with a glass of water. Do not crush, chew or break the tablets.
  • Missed dose: If you forget to take your dose of Rinvoq, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Keep taking Rinvoq regularly. You may notice some relief of joint swelling, pain and stiffness within the first 2–4 weeks of treatment, though it can take up to 3 months to improve. Do not stop taking Rinvoq without talking to your doctor first. If you stop or delay your Rinvoq treatment, your arthritis may get worse. 
While you are taking Rinvoq

Alcohol

Limit your alcohol intake to 1–2 standard drinks once or twice a week. Avoid heavy or binge drinking because it can increase your risk of side effects, such as problems with your liver. 

Vaccines

It is safe for you to have the annual flu vaccine and the COVID-19 vaccine. Keep your flu vaccinations up to date to reduce your risk of getting the flu. Some vaccines should not be taken if you are taking Rinvoq. Always check with your doctor before receiving any vaccines.

Before an operation

If you are going to have an operation (surgery) you need to stop your Rinvoq one week before surgery. It will be restarted again after the operation at a time agreed by your surgeon and rheumatologist (usually when the wound is healed). 

Are you pregnant, trying for a baby or breastfeeding?

Rinvoq should not be used during pregnancy. If you are at risk of becoming pregnant, talk to your doctor about effective contraception during treatment with Rinvoq. If you wish to become pregnant, ask your doctor about stopping Rinvoq. You should continue using contraception for 4 weeks after the final dose of Rinvoq

Do not breastfeed if you are taking Rinvoq as it is uncertain how much of the drug might be excreted in breastmilk.

Here are some things to know when you're taking Rinvoq. Other things may be important as well, so ask your healthcare provider what you should know about.

  • Other medicines: Rinvoq should not be taken with some products. Tell your doctor or pharmacist about all medicines you are taking (including over-the-counter medicines), herbal and complementary medicines and recreational drugs. Your doctor or pharmacist will be able to check for any interactions. 
  • Contraception: Use effective contraception for the whole time you are taking upadacitinib, and for 4 weeks after stopping.

Like all medicines, Rinvoq can cause side effects, although not everyone gets them.

Increased risk of infections

Because Rinvoq weakens your body's immune system, it can make it more likely for you to get infections. These infections may be mild, such as colds and sinusitis, or more severe, such as shingles, tuberculosis (TB) and septicaemia (infection of your blood).

  • Before starting Rinvoq let you doctor know if you have had TB, shingles or hepatitis. You will need to have blood tests and a chest x-ray to check for infections.
  • Also check with your doctor what vaccines you might need. You should not have a live vaccine while taking Rinvoq.
  • Tell your doctor immediately if you come into contact with someone who has an infection such as TB (tuberculosis) while you are taking Rinvoq.
  • Tell your doctor immediately if you develop: 
    • signs of TB such as a cough that won’t go away, night sweats, fever, weight loss
    • signs of shingles such as a painful skin rash with blisters. 
  • You will need to be monitored for infections during treatment and for several months after you have stopped taking Rinvoq

Other side effects

Side effects What should I do?
  • Indigestion
  • Tummy upset
  • Headache
  • Fatigue (feeling unusually tired
    and weak)
  • Tell your doctor if troublesome.
  • Weight gain
  • Acne
  • Tell your doctor if troublesome.
  • Signs of blood clots, such as swelling or pain and tenderness in your leg, sudden chest pain and shortness of breath
  • Tell your doctor immediately or phone Healthline 0800 611 116.
  • Signs of infection in your lung (pneumonia), such as shortness of breath, fever and a cough with mucus
  • Tell your doctor immediately or phone Healthline 0800 611 116.
  • Signs of TB such as a cough that won’t go away, night sweats, fever or weight loss
  • Tell your doctor immediately or phone Healthline 0800 611 116.
  • Signs of an allergic reaction such as muscle or joint pain, fever, rash, intense itching, swelling of the face or hands, sore throat, headache, or difficulty swallowing
  • Tell your doctor immediately or phone Healthline 0800 611 116.

Rinvoq(external link) Medsafe Consumer Information Sheet, NZ
Upadacitinib(external link) Arthritis Australia

Resources

5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)

References

  1. Rinvoq(external link)(external link) Medsafe, NZ

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Maya Patel, Pharmacist, Auckland

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