Common Side Effects of Rinvoq
Rinvoq (upadacitinib), a JAK inhibitor for conditions like rheumatoid arthritis, psoriasis, and ulcerative colitis, often causes upper respiratory tract infections, nausea, cough, fever, acne, and headache. These affect more than 10% of users in clinical trials.[1][2]
Serious Side Effects and Risks
Serious risks include infections (like herpes zoster, pneumonia, or tuberculosis), blood clots (deep vein thrombosis or pulmonary embolism), heart-related events (heart attack, stroke), cancers (lymphoma, lung, skin), gastrointestinal tears, liver enzyme elevation, and low blood cell counts (anemia, neutropenia). These are more common in higher-risk patients, such as smokers or those over 50 with heart disease.[1][2][3]
Patients on Rinvoq face a black box warning for serious infections, mortality, malignancy, major cardiovascular events, and thrombosis.[1]
Side Effects by Condition Treated
- Rheumatoid Arthritis or Psoriatic Arthritis: High rates of bronchitis (15%), nausea (6-11%), and herpes zoster (3-4%).[2]
- Atopic Dermatitis: Acne (10%), headache (8%), and elevated creatine kinase (5%).[2]
- Ulcerative Colitis: Acne (9%), flu-like symptoms (7%), and rash (5%).[2]
Long-term use shows persistent infection risks, with 20-30% of patients experiencing at least one serious infection over 3 years.[3]
Who Gets Side Effects and How Often?
Frequency varies by dose (15mg vs. 30mg daily) and patient factors like age, steroid use, or comorbidities. In trials:
- Infections: 40-70% overall, serious in 3-10%.
- Lab abnormalities: Elevated cholesterol (20-40%), anemia (10-20%).[2]
Children under 12 have less data, but similar patterns emerge.[1]
What Happens If You Get Side Effects?
Stop Rinvoq and seek medical help for signs of infection (fever, cough), clots (leg swelling, shortness of breath), heart issues (chest pain), or bleeding. Doctors monitor with blood tests before and during treatment.[1][3]
Rinvoq vs. Other JAK Inhibitors
Compared to Xeljanz (tofacitinib), Rinvoq has similar infection rates but higher herpes zoster risk (4% vs. 2%). Olumiant (baricitinib) shows comparable cardiovascular warnings.[3]
Patient Concerns and Management
Many patients report weight gain, fatigue, or shingles on forums, though not always trial-confirmed. Avoid live vaccines; screen for TB and hepatitis before starting. Use lowest effective dose to minimize risks.[1][2]
[1]: Rinvoq Prescribing Information (FDA)
[2]: Rinvoq Clinical Trial Data (AbbVie)
[3]: Drugs.com - Rinvoq Side Effects