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Rinvoq Disease Interactions

There are 9 disease interactions with Rinvoq (upadacitinib).

Major

JAK inhibitors (applies to Rinvoq) cardiovascular risk

Major Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease, Smoking

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers; patients who are current or past smokers are at additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, and pacritinib. Before starting or continuing therapy, the benefits and risks for the individual patient should be considered, especially in patients with other cardiovascular risk factors and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur. Tofacitinib, baricitinib, and upadacitinib are indicated for patients with inadequate response or intolerance to 1 or more TNF blockers, but should be discontinued in patients who have experienced a myocardial infarction or stroke. The dosage recommended for tofacitinib should not be exceeded; for the treatment of ulcerative colitis, tofacitinib should be used at the lowest effective dose and for the shortest duration needed to achieve and/or maintain therapeutic response.

References

  1. "Product Information. Jakafi (ruxolitinib)." Incyte Corporation (2011):
  2. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
  3. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
  4. "Product Information. Inrebic (fedratinib)." Celgene Corporation (2019):
  5. "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp. (2022):
  6. "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group (2021):
View all 6 references
Major

JAK inhibitors (applies to Rinvoq) malignancy

Major Potential Hazard, Moderate plausibility. Applicable conditions: Skin Cancer, Lymphoma, Myeloproliferative Disorder, Smoking

Malignancies (including lymphomas and solid tumors) have been reported in patients treated with tofacitinib and other Janus kinase (JAK) inhibitors used to treat inflammatory conditions; lymphomas and other malignancies have been seen in patients treated with baricitinib or upadacitinib. Patients who are current or past smokers are at additional increased risk of malignancies. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, pacritinib, and fedratinib. Before starting or continuing therapy, the benefits and risks for the individual patient should be considered, especially in patients with a known malignancy (other than successfully treated nonmelanoma skin cancer), patients who develop a malignancy during therapy, and patients who are current or past smokers. Periodic skin examination is recommended for patients who are at increased risk for skin cancer.

References

  1. "Product Information. Jakafi (ruxolitinib)." Incyte Corporation (2011):
  2. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
  3. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
  4. "Product Information. Inrebic (fedratinib)." Celgene Corporation (2019):
  5. "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp. (2022):
  6. "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group (2021):
View all 6 references
Major

JAK inhibitors (applies to Rinvoq) thrombosis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Thrombotic/Thromboembolic Disorder

Thrombosis (including deep venous thrombosis, pulmonary embolism, and arterial thrombosis) has occurred in patients treated for inflammatory conditions with Janus kinase (JAK) inhibitors, including baricitinib, tofacitinib, and upadacitinib; many of these adverse events were serious and some resulted in death. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, fedratinib, and pacritinib. Baricitinib, pacritinib, tofacitinib, and upadacitinib should be avoided in patients who may be at increased risk of thrombosis; for the treatment of ulcerative colitis, tofacitinib should be used at the lowest effective dose and for the shortest duration needed to achieve/maintain therapeutic response. If symptoms of thrombosis occur, baricitinib, pacritinib, tofacitinib, and upadacitinib should be discontinued and patients should be evaluated promptly and treated appropriately.

References

  1. "Product Information. Jakafi (ruxolitinib)." Incyte Corporation (2011):
  2. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
  3. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
  4. "Product Information. Inrebic (fedratinib)." Celgene Corporation (2019):
  5. "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp. (2022):
  6. "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group (2021):
View all 6 references
Major

Upadacitinib (applies to Rinvoq) infections

Major Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral, Tuberculosis -- Latent

Serious and sometimes fatal infections, including opportunistic and reactivation of infections have been reported in patients receiving upadacitinib treatment. It is recommended to avoid the use of upadacitinib in patients with an active, serious infection, including localized infections. Closely monitor patients for the development of signs and symptoms of infection during and after treatment with upadacitinib. Interrupt therapy if a patient develops a new infection or an opportunistic infection and appropriate antimicrobial therapy should be initiated. Treatment with upadacitinib may be resumed once the infection is controlled.

References

  1. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
Moderate

Upadacitinib (applies to Rinvoq) cytopenias

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts

The use of upadacitinib is associated with an increase incidence of neutropenia, lymphopenia, and anemia. Avoid initiation or interrupt treatment with upadacitinib in patients with low neutrophil counts (i.e., ANC less than 1000 cells/mm3), lymphocyte counts (i.e., less than 500 cells/mm3) and low hemoglobin levels (i.e., less than 8 g/dL). It is recommended to evaluate patients for abnormal blood cell counts at baseline and thereafter according to routine patient management.

References

  1. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
Moderate

Upadacitinib (applies to Rinvoq) gastrointestinal perforation

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Gastrointestinal Diverticula

Gastrointestinal perforation has been reported with the use of upadacitinib. This agent should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis or taking NSAIDs). It is recommended to monitor for new onset abdominal symptoms for early identification of gastrointestinal perforation.

References

  1. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
Moderate

Upadacitinib (applies to Rinvoq) hepatic impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

The use of upadacitinib is not recommended in patients with severe hepatic impairment. No dose adjustment is required in patients with mild or moderate hepatic impairment. Treatment with upadacitinib is associated with increased incidence of liver enzyme elevation. Evaluate baseline liver function and thereafter according to routine patient management. Treatment should be interrupted if drug-induced liver injury is suspected.

References

  1. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
Moderate

Upadacitinib (applies to Rinvoq) hyperlipidemia

Moderate Potential Hazard, Moderate plausibility.

Treatment with upadacitinib is associated with increases in lipid parameters, including total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. Care should be exercised when using this agent in patients with hyperlipidemia. It is recommended to monitor patients after initiation of treatment, and thereafter according to the clinical guidelines and to manage patients accordingly.

References

  1. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
Moderate

Upadacitinib (applies to Rinvoq) vaccination

Moderate Potential Hazard, Moderate plausibility.

Use of live, attenuated vaccines during, or immediately prior to, upadacitinib therapy is not recommended. Prior to initiating treatment with upadacitinib, it is recommended that patients be brought up to date with all immunizations, including prophylactic zoster vaccinations, in agreement with current immunization guidelines.

References

  1. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):

Rinvoq drug interactions

There are 445 drug interactions with Rinvoq (upadacitinib).

Rinvoq alcohol/food interactions

There is 1 alcohol/food interaction with Rinvoq (upadacitinib).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.