Rinvoq (Upadacitinib): A Comprehensive Guide to Uses, Dosage, Side Effects
Rinvoq, known generically as upadacitinib, is an oral Janus kinase (JAK) inhibitor developed by AbbVie. It has been approved by the FDA for the treatment of several inflammatory conditions, including rheumatoid arthritis, psoriatic arthritis, atopic dermatitis (eczema), ulcerative colitis, Crohn’s disease, ankylosing spondylitis, and non-radiographic axial spondyloarthritis. GoodRx+1Wikipedia+1
Medical Uses of Rinvoq
Rinvoq is prescribed for patients who have not responded adequately to other treatments. Its approved indications include:
- Rheumatoid Arthritis (RA): For adults with moderate to severe RA who have had an inadequate response or intolerance to one or more disease-modifying antirheumatic drugs (DMARDs).Wikipedia+1GoodRx+1
- Psoriatic Arthritis (PsA): For adults with active PsA who have had an inadequate response or intolerance to one or more DMARDs.
- Atopic Dermatitis (Eczema): For adults and children aged 12 years and older with moderate to severe atopic dermatitis not adequately controlled with other therapies.Wikipedia
- Ulcerative Colitis (UC): For adults with moderately to severely active UC who have had an inadequate response or intolerance to one or more tumor necrosis factor (TNF) blockers.GoodRx+6Wikipedia+6GoodRx+6
- Crohn’s Disease (CD): For adults with moderately to severely active CD who have had an inadequate response or intolerance to one or more TNF blockers.
- Ankylosing Spondylitis (AS) and Non-Radiographic Axial Spondyloarthritis (nr-axSpA): For adults with active AS or nr-axSpA who have had an inadequate response or intolerance to one or more TNF blockers.GoodRx
Dosage and Administration
Rinvoq is available in extended-release tablets and an oral solution (Rinvoq LQ). The dosage varies based on the condition being treated:GoodRx+6GoodRx+6GoodRx+6
- Rheumatoid Arthritis and Psoriatic Arthritis: 15 mg once daily.
- Atopic Dermatitis:
- Adults and adolescents (12 years and older, weighing at least 40 kg): 15 mg once daily; may increase to 30 mg once daily based on response.
- Children (2 years and older): Dosage based on body weight using Rinvoq LQ oral solution.GoodRx
- Ulcerative Colitis:
- Induction: 45 mg once daily for 8 weeks.
- Maintenance: 15 mg once daily; may increase to 30 mg once daily based on response.
- Crohn’s Disease:
- Induction: 45 mg once daily for 12 weeks.
- Maintenance: 15 mg once daily; may increase to 30 mg once daily based on response.
- Ankylosing Spondylitis and nr-axSpA: 15 mg once daily.
Dosage adjustments may be necessary for patients with liver or kidney impairment or those taking certain medications. GoodRx
Side Effects
Common Side Effects:
- Upper respiratory tract infections (e.g., common cold, sinus infections)
- Acne
- Nausea
- Headache
- FeverWikipediaGoodRx+2GoodRx+2Wikipedia+2GoodRx+2GoodRx+2GoodRx+2
Serious Side Effects:
- Serious infections (e.g., tuberculosis, bacterial, fungal, or viral infections)
- Increased risk of heart problems, including heart attack and stroke
- Increased risk of certain cancers
- Blood clots
- Liver enzyme elevations
- Gastrointestinal perforationsGoodRxGoodRx+1GoodRx+1
Patients should be monitored regularly for signs of infection, changes in blood counts, liver function, and lipid levels.
Drug Interactions
Rinvoq can interact with other medications, potentially altering its effectiveness or increasing side effects. Notable interactions include:
- Strong CYP3A4 Inhibitors: (e.g., ketoconazole) may increase Rinvoq levels.
- Strong CYP3A4 Inducers: (e.g., rifampin) may decrease Rinvoq levels.
- Other Immunosuppressants: Concurrent use with other potent immunosuppressants is not recommended due to increased risk of infection.
Patients should inform their healthcare provider of all medications they are taking to assess potential interactions.
Cost and Savings Options
Rinvoq is a specialty medication and can be expensive. The price for a 30-day supply of Rinvoq 15 mg tablets starts at approximately $6,244.67. GoodRx+1GoodRx+1
Savings Options:
- GoodRx Coupons: GoodRx offers coupons that can significantly reduce the out-of-pocket cost of Rinvoq.
- Manufacturer Assistance Programs: AbbVie provides a co-pay card for eligible patients with commercial insurance, potentially lowering the cost.GoodRx
- Patient Assistance Programs: Various programs are available from federal and state governments, non-profits, and other organizations to help patients access medications at reduced costs. GoodRx
Comparisons with Other Treatments
Rinvoq vs. Xeljanz (Tofacitinib):
- Both are JAK inhibitors used to treat similar inflammatory conditions.GoodRx+9GoodRx+9GoodRx+9
- Rinvoq is more selective for JAK1, potentially offering a different side effect profile.
- Dosing regimens and specific indications may vary between the two medications.GoodRx
Rinvoq vs. Enbrel (Etanercept):
- Enbrel is a biologic TNF inhibitor administered via subcutaneous injection, while Rinvoq is an oral medication.GoodRx
- Both are used to treat rheumatoid arthritis and other inflammatory conditions but have different mechanisms of action and administration routes.
Patients should consult their healthcare provider to determine the most appropriate treatment option based on their specific condition and medical history.
Conclusion
Rinvoq (upadacitinib) offers a valuable treatment option for patients with various inflammatory conditions who have not responded adequately to other therapies. Its oral administration provides convenience, and its targeted mechanism of action addresses specific pathways involved in inflammation. However, patients should be aware of potential side effects and the importance of regular monitoring. Cost considerations are significant, but resources like GoodRx and manufacturer assistance programs can help mitigate expenses.
Note: This information is intended for educational purposes and should not replace professional medical advice. Always consult with a healthcare provider for medical guidance tailored to your health situation.
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