Upadacitinib

RINVOQ

Open Upadacitinib in the interactive console ↗

Pronunciation: yoo-pad-a-SYE-ti-nib (RIN-voek)

Upadacitinib ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Upadacitinib ballicule

Upadacitinib RINVOQ mascot mnemonic cartoon — Visual mnemonic: Upadacitinib mascot
**“Ren, the Uppity City nibbler”**
jack → Janus kinase (JAK) inhibitor

What it isJAK1-selective oral inhibitor; rheumatoid and psoriatic arthritis, atopic dermatitis, ulcerative colitis, and Crohn disease.

Why this oneBeat adalimumab in RA and carries the broadest JAK labeling: joints, skin and both IBDs.

What limits itSerious infection, malignancy, cardiovascular events, and thrombosis are boxed; screen for tuberculosis and hepatitis B.

Pearls

Reserved for inadequate response to a TNF inhibitor.
Contraception for 4 weeks after last dose; no breastfeeding for 6 days.

Upadacitinib molecular structure (skeletal formula) — Molecular structure: Upadacitinib

Upadacitinib prescription history

Animated chart of estimated U.S. prescriptions per year, Tyrosine kinase inhibitors (2001–2026). Upadacitinib enters in 2019 (estimated).

FDA-approved for

rheumatoid arthritis (2019)
atopic dermatitis, psoriatic arthritis, ulcerative colitis, Crohn disease

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryNot assigned — PLLR-era drug

Defining liabilitySerious infection, cytopenias, hepatic injury and malignancy risk require laboratory and clinical monitoring.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Serious infections (incl. TB, invasive fungal, opportunistic); mortality; malignancy (lymphoma, lung cancer); major adverse cardiovascular events; thrombosis (DVT/PE/arterial).

FDA dosing	Population	Start	Target	Max
Rheumatoid arthritis / ankylosing spondylitis / non-radiographic axial spondyloarthritis	Adults	15 mg QD	15 mg QD	15 mg QD
Psoriatic arthritis	Adults	15 mg QD	15 mg QD	15 mg QD
Psoriatic arthritis / polyarticular JIA (weight-based)	2–<18 yr	10–<20 kg: 3 mg BID (LQ); 20–<30 kg: 4 mg BID (LQ); ≥30 kg: 6 mg BID (LQ) or 15 mg QD tablet	per weight band	15 mg QD (≥30 kg tablet)
Atopic dermatitis	≥12 yr ≥40 kg & adults <65 yr	15 mg QD	15 mg QD	30 mg QD
Atopic dermatitis	Adults ≥65 yr	15 mg QD	15 mg QD	15 mg QD
Ulcerative colitis	Adults	45 mg QD ×8 wk (induction)	15 mg QD (maintenance)	30 mg QD (maintenance)
Crohn's disease	Adults	45 mg QD ×12 wk (induction)	15 mg QD (maintenance)	30 mg QD (maintenance)
Giant cell arteritis	Adults	15 mg QD with tapering corticosteroids	15 mg QD	15 mg QD

Renal RA/PsA/AS/nr-axSpA/pJIA/GCA: no adjustment. AD: severe (eGFR 15–<30) 15 mg QD. UC/CD: severe induction 30 mg QD, maintenance 15 mg QD. ESRD (<15): not recommended

Hepatic Mild–moderate (Child-Pugh A/B): no adjustment except UC/CD induction 30 mg QD. Severe (Child-Pugh C): not recommended

RINVOQ LQ oral solution and RINVOQ extended-release tablets are not substitutable

Instructions

RINVOQ tablets: swallow whole, do not split/crush/chew; with or without food
RINVOQ LQ oral solution: dosed twice daily; not substitutable with tablets
Before starting: test/treat latent TB, screen viral hepatitis, check CBC and hepatic function, verify pregnancy status, update immunizations
Avoid live vaccines during treatment
Do not initiate/interrupt if ALC <500, ANC <1000, or Hgb <8 g/dL

Available strengths

ER tab 15, 30, 45 mg
sol 1 mg/mL

Cautions

Serious/opportunistic infections and TB — screen and monitor
Viral reactivation (HBV, herpes zoster)
Malignancy including lymphoma and NMSC
Major adverse cardiovascular events
Thrombosis (DVT/PE/arterial)
Hypersensitivity (anaphylaxis, angioedema)
GI perforation
Hypoglycemia in patients with diabetes
Lab abnormalities: neutropenia, lymphopenia, anemia, lipid and liver-enzyme elevations
Embryo-fetal toxicity — use contraception

Adverse reactions

Upper respiratory tract infection
Herpes zoster, herpes simplex
Bronchitis
Nausea
Cough
Pyrexia
Acne
Headache
Increased CPK, neutropenia

Pregnancy May cause fetal harm (animal teratogenicity); advise contraception; pregnancy surveillance program

Lactation Breastfeeding not recommended during and for 6 days after last dose

Cost

Upadacitinib (RINVOQ)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $	brand $	CostPlus
15 mg	ER tab	30 qd	—	$6,879.27/mo	not offered
30 mg	ER tab	30 qd	—	$6,878.82/mo	not offered
45 mg	ER tab	30 qd	—	$13,788.67/mo	not offered
1 mg/mL	sol	per unit		—	not offered

Generic entry2038 est.

Open Upadacitinib in the interactive console ↗

Self-check

Which JAK subtype does upadacitinib selectively inhibit?
JAK1.
Which two infections require screening before upadacitinib?
Tuberculosis and hepatitis B.