RINVOQ ER (Upadacitinib)

What is this medication?

Upadacitinib, Rinvoq
Antirheumatic, Disease Modifying; Antirheumatic, Miscellaneous; Janus Kinase Inhibitor

Upadacitinib, Rinvoq is indicated for treatment of rheumatoid arthritis.

“ALERT: US Boxed Warning

Serious infections
Patients treated with upadacitinib are at increased risk for developing serious infections that may lead to hospitalization or death. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. If a serious infection develops, interrupt upadacitinib until the infection is controlled. Reported infections include:

Active tuberculosis, which may present with pulmonary or extrapulmonary disease. Patients should be tested for latent tuberculosis before upadacitinib use and during therapy. Treatment for latent infection should be considered prior to upadacitinib use.

Invasive fungal infections, including cryptococcosis and pneumocystosis.

Bacterial, viral, including herpes zoster, and other infections due to opportunistic pathogens.

The risks and benefits of treatment with upadacitinib should be carefully considered prior to initiating therapy in patients with chronic or recurrent infection. Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment with upadacitinib, including the possible development of tuberculosis in patients who tested negative for latent tuberculosis infection prior to initiating therapy

​Malignancies
Lymphoma and other malignancies have been observed in patients treated with upadacitinib.

Thrombosis
Thrombosis, including deep venous thrombosis, pulmonary embolism, and arterial thrombosis have occurred in patients treated with Janus kinase inhibitors used to treat inflammatory conditions. Many of these adverse events were serious and some resulted in death. Consider the risks and benefits prior to treating patients who may be at increased risk. Patients with symptoms of thrombosis should be promptly evaluated and treated appropriately.”

How does this medication work?

Upadacitinib, Rinvoq is an inhibitor of Janus kinase (JAK) enzymes.  JAK enzymes are intracellular enzymes involved in stimulating hematopoiesis and immune cell function through a signaling pathway.

How should I take this medication?

Oral: 15 mg once daily.

How to Take: Administer with or without food. Swallow tablet whole. Immunization status should be current before initiating therapy. Live vaccines should not be given concomitantly, or immediately prior to, upadacitinib.

You Need to Avoid:  Significant drug interactions exist, requiring dose/frequency adjustment or avoidance so avoid starting any new medications without consulting prescriber.  Do not crush, split, or chew dosage form. 

What should I watch for while using this medication?

Before starting Upadacitinib, Rinvoq make sure your physician is aware of any allergies or medications you currently take, if you are pregnant, or breastfeeding. Upadacitinib, Rinvoq use has been associated with rare but serious adverse events such as GI perforation, hematologic toxicity, hepatic effects, increased risk of infection, lipid abnormalities, malignancy, thrombosis, and tuberculosis.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at 2°C to 25°C (36°F to 77°F). Store in the original bottle to protect from moisture. Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Upper respiratory tract infection, nausea

Note this is not a complete list of side effects, only the most common.