As with other drugs, Rinvoq (upadacitinib) can cause side effects, such as upper respiratory infections, fever, and nausea. If you are not able to tolerate Rinvoq’s side effects, talk with your doctor or pharmacist.

Rinvoq (upadacitinib) is a brand-name drug approved by the Food and Drug Administration (FDA) to treat several inflammatory conditions. Approved uses include Crohn’s disease and rheumatoid arthritis (RA) in adults and polyarticular juvenile idiopathic arthritis in some children.

The Rinvoq side effects you experience may vary depending on several factors, including the form you take and the condition you are using it to treat.

If you have problems with side effects from Rinvoq medication, talk with your doctor or pharmacist. They can discuss ways to manage side effects or other available treatment options. Do not stop taking Rinvoq without consulting your doctor first.

Read on to learn about potential common, mild, and serious side effects of Rinvoq. For additional information about Rinvoq, including details about its forms and uses, see this Rinvoq overview article.

Rinvoq has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see the “Boxed warnings for Rinvoq” section.

Rinvoq can cause certain side effects, some of which are more common than others. These side effects are usually temporary, lasting for a few days or weeks. But if the side effects last for longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Some of the more common side effects of Rinvoq reported in clinical trials are:

The following sections look at the possible side effects of the drug.

Mild side effects can occur while taking Rinvoq. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Rinvoq’s prescribing information.

Mild side effects of Rinvoq can include:

These side effects are usually temporary, lasting for a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Rinvoq and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Rinvoq may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to the drug’s prescribing information.

If you develop serious side effects while taking Rinvoq, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects and their symptoms can include:

* For more information, see “Side effect specifics.”
† Rinvoq has boxed warnings for these side effects. A boxed warning is the most serious warning from the FDA. To learn more, see “Boxed warnings for Rinvoq.”

Though rare, Rinvoq may cause long-term side effects. These are side effects that might develop at any time while you’re taking a drug, even if you’ve taken the drug for a long time.

Examples of long-term side effects reported in Rinvoq’s clinical trials include certain cancers, cardiovascular problems, low blood cell counts, and increased cholesterol.

Long-term side effects may also refer to side effects that might not go away even after you stop taking the drug. Note that stopping Rinvoq treatment may cause symptoms of the condition you’re taking the drug for to return or worsen.

To find out more about possible long-term side effects that may occur with Rinvoq, talk with your doctor.

Rinvoq has boxed warnings about the following risks. A boxed warning is the most serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Keep reading to learn more about these warnings. You can also refer to the Rinvoq prescribing information.

Serious infections

Rinvoq works by reducing the activity of your immune system. This makes your immune system weaker. With a weakened immune system, you may have an increased risk of serious infections. In clinical trials, these infections sometimes required treatment in the hospital. In rare cases, they led to death.

Examples of serious infections that have been reported in people taking Rinvoq include:

Serious infections weren’t common in clinical trials of Rinvoq. People were more likely to have this side effect if they were taking other medications that also weaken the immune system, such as methotrexate (Trexall). Taking a higher dosage of Rinvoq may also increase the risk of serious infections.

What you can do

Be sure to tell your doctor whether you have an active infection before taking Rinvoq. They may want to delay starting treatment until your infection goes away.

If you develop symptoms of a serious infection while taking Rinvoq, talk with your doctor right away. They may have you stop taking Rinvoq in order to treat your infection. They may also decide to have you stop Rinvoq and try a different drug for your condition.

Certain cancers

People taking Rinvoq may have an increased risk of certain types of cancer. These types of cancer include lymphoma and non-melanoma skin cancer. But it’s important to note that cancer also occurred in some people who took a placebo in clinical trials of Rinvoq. (A placebo is a treatment without an active ingredient.)

With cancer, cells in your body divide uncontrollably. This can result in the formation of a tumor.

Cancer symptoms may include weight loss, fatigue, skin changes, and a persistent cough. However, the symptoms may vary depending on the type of cancer you have. If you have any persistent or worrisome symptoms, you should talk with your doctor.

What you can do

Before you take Rinvoq, tell your doctor whether you have a history of cancer or are currently receiving treatment for cancer. They may recommend that you try a different medication to treat your condition.

Blood clots

A blood clot turns blood from a liquid to a gel, preventing it from flowing. Blood clots are important to help your body stop bleeding, such as when you get a cut. But when blood doesn’t clot properly, serious health problems can occur.

Some types of blood clots are particularly severe. These include:

Though rare, Rinvoq may cause these types of clots and, in severe cases, death. Symptoms of a blood clot may include pain in a new area of your body, shortness of breath, swelling, and pain. Swelling or pain may affect one or both of your arms, legs, hands, or feet.

What you can do

If you develop symptoms of a blood clot while taking Rinvoq, talk with your doctor right away. They may have you stop taking Rinvoq and try a different medication to treat your condition.

Cardiovascular problems

Taking Rinvoq may raise your risk of cardiovascular problems. Examples include:

A similar drug has caused these problems in people with RA who:

  • are ages 50 years and older
  • have at least one risk factor for cardiovascular problems
  • are taking a type of medication known as a Janus kinase (JAK) inhibitor*

Keep in mind that smoking can also increase the risk of cardiovascular problems during Rinvoq treatment.

* Rinvoq is also a JAK inhibitor.

What you can do

While taking Rinvoq, watch for any symptoms of cardiovascular issues. Examples include experiencing shortness of breath or having chest pain. You may also feel numbness or weakness on one side of your body. Call your doctor if you have any of these symptoms. But call 911 or your local emergency number if your symptoms feel severe.

If you have a higher risk of cardiovascular problems with Rinvoq, your doctor may recommend that you do not take the drug. If you have a stroke or heart attack while taking Rinvoq, your doctor will have you stop taking this medication.

Increased risk of death

It’s possible that Rinvoq may raise the risk of death in some people. Another similar drug has increased this risk in certain people with rheumatoid arthritis who:

  • are ages 50 years and older
  • have at least one risk factor for cardiovascular problems

What you can do

Ask your doctor about your risk of complications with Rinvoq. Your doctor can determine whether you have a higher risk of death with this drug.

Learn more about some of the side effects that Rinvoq may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Rinvoq.

Upper respiratory infections

Upper respiratory infections that affect the throat or nasal passages are possible side effects of Rinvoq. The common cold is one example of an upper respiratory infection.

People taking Rinvoq may have a higher risk of upper respiratory infections. These infections occurred more often in people taking Rinvoq than in those taking a placebo (treatment without an active ingredient).

Symptoms of an upper respiratory infection may vary depending on the location and severity of your infection. But common symptoms can include:

  • coughing
  • discomfort in your nose or nasal passages
  • mild fever
  • pain or pressure behind your face, either with or without nasal congestion
  • runny nose or excessive mucus production
  • scratchy or sore throat
  • sneezing

What you can do

Symptoms of upper respiratory infections usually go away within about a week. You can usually treat these symptoms with over-the-counter medications. But if your symptoms worsen or don’t go away, talk with your doctor.

Changes in levels of cholesterol, liver enzymes, and certain blood cells

Rinvoq may cause changes in blood levels of cholesterol, liver enzymes, and certain blood cells.

Specifically, Rinvoq may cause:

These changes are usually minor and don’t typically cause any symptoms. However, they may signify a more serious condition, though this is rare.

What you can do

While taking Rinvoq, you’ll have blood tests to check your levels of cholesterol, liver enzymes, and blood cells. This way, your doctor can ensure that the levels stay within a typical range.

If these levels change, your doctor may adjust your treatment. This could involve changing your Rinvoq dosage or adding another medication to treat the drug’s side effects. Or your doctor may recommend trying a medication other than Rinvoq to treat your condition.

Allergic reaction

As with most drugs, Rinvoq can cause an allergic reaction in some people. In clinical trials, allergic reactions were rare, but some were severe.

Symptoms can be mild or serious and may include:

  • rash
  • itching
  • flushing
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

If you have mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Rinvoq. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Rinvoq may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Is weight gain or weight loss a side effect of Rinvoq?

It’s possible for weight gain to occur with Rinvoq. But weight loss is not a known side effect of the drug.

Weight gain was reported as a rare side effect in clinical trials of Rinvoq for treating atopic dermatitis, which is a type of eczema. However, weight gain wasn’t reported as a side effect of taking Rinvoq to treat other conditions that the drug is approved for.

Also, Rinvoq is sometimes taken with methotrexate (Trexall) to treat RA. Weight gain is a possible side effect of methotrexate.

Weight loss was not a reported side effect of Rinvoq. However, weight loss is a symptom of two of the drug’s possible side effects: serious infections and increased risk of certain cancers.* If you experience unexplained weight loss while taking Rinvoq, contact your doctor. They’ll determine what’s causing the weight loss and recommend treatment options if needed.

If you have more questions about Rinvoq and your weight, talk with your doctor.

* Rinvoq has boxed warnings for these side effects. A boxed warning is the most serious warning from the FDA. To learn more, see the “Boxed warnings for Rinvoq” section.

Does Rinvoq cause hair loss?

No, hair loss wasn’t a side effect reported in clinical trials of Rinvoq.

However, hair loss is a possible side effect of methotrexate, which some people take with Rinvoq to treat RA.

If you have more questions, or if you’re concerned about hair loss while taking Rinvoq, talk with your doctor.

Does Rinvoq suppress my immune system?

Yes, Rinvoq works by suppressing (reducing the activity of) your immune system. For this reason, the drug is known as an immunosuppressant.

Reducing the activity of your immune system can help reduce inflammation and relieve symptoms of your condition. However, having a suppressed immune system also increases your risk of infections, including serious infections. (See “Boxed warnings for Rinvoq” for details about possible infections while taking Rinvoq.)

Because of this risk of infections, you’ll need to avoid getting live vaccines right before starting Rinvoq and while taking the drug. Live vaccines, such as the one for chickenpox, contain a small amount of a live virus or bacterium. This is unlike inactive vaccines, which don’t contain any live virus or bacterium. (For details about live vaccines to avoid and a list of other drug interactions, see this Rinvoq interactions article.)

Before you start taking Rinvoq, tell your doctor about any recent vaccines you’ve had. Also talk with them about whether you need any live vaccines. If you’ve recently received or need a live vaccine, your doctor may delay starting your treatment with Rinvoq.

If you have more questions about how Rinvoq affects your immune system, talk with your doctor.

Does Rinvoq make you tired?

It’s possible that Rinvoq may make you tired. In clinical trials, people taking Rinvoq for atopic dermatitis or Crohn’s disease reported fatigue as a side effect. However, people taking the drug to treat other conditions the drug is approved for did not report experiencing fatigue.

Note that fatigue can be a symptom of other side effects Rinvoq can cause. For example, feeling tired is a symptom of cancer, and Rinvoq may increase the risk of certain cancers.

In addition, fatigue is also a symptom of some of the conditions Rinvoq treats, such as ulcerative colitis and Crohn’s disease. Taking Rinvoq may actually help ease the fatigue that such conditions cause.

After starting Rinvoq treatment, let your doctor know if you have fatigue that bothers you. They can diagnose the cause and discuss ways to lessen this side effect.

Rinvoq may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Rinvoq.

Rinvoq has several boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details about these warnings, see “Boxed warnings for Rinvoq.”

Other precautions

Be sure to talk with your doctor about your health history before you take Rinvoq. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Blood disorders: If you have a history of blood disorders, be sure to tell your doctor before you start taking Rinvoq. Examples of blood disorders include anemia, lymphopenia, and neutropenia. Rinvoq can decrease the levels of certain blood cells. For this reason, your doctor may order more lab tests than usual during your Rinvoq treatment. Or they may prescribe a drug other than Rinvoq for you.

Diverticulitis: Rinvoq treatment may increase your risk of gastrointestinal perforation. You may have a higher risk of this side effect if you have a history of diverticulitis. Be sure to discuss your medical history with your doctor before starting Rinvoq treatment.

Risk factors for severe infections: If you have an active infection, your doctor will recommend treating it before starting Rinvoq. If you have a history of certain viral or bacterial infections, they may reactivate (cause symptoms again). These infections include tuberculosis, hepatitis B, hepatitis C, and shingles. Because Rinvoq suppresses the immune system, taking it can worsen your infection. Your doctor will likely treat any active infection you have before you start taking Rinvoq.

Other conditions may increase the risk of serious infections. These include diabetes, chronic lung disease, and HIV. If you have any of these conditions, let your doctor know. This will help them determine whether Rinvoq is right for you.

Recent vaccination with a live vaccine: Before you start taking Rinvoq, tell your doctor about any vaccines you’ve recently received or are planning to receive. Rinvoq can weaken your immune system. As a result, certain vaccines called live vaccines could make you sick if you get them right before or during Rinvoq treatment. For more information, see “Does Rinvoq suppress my immune system?”

Use of nonsteroidal anti-inflammatory drugs (NSAIDs) or certain other medications: Rinvoq treatment may increase your risk of gastrointestinal perforation. Your risk of this side effect may increase further if you take certain medications. Examples include NSAIDs, such as ibuprofen (Motrin, Advil) and naproxen (Aleve). Methotrexate (Trexall) and corticosteroids, such as prednisone, can also increase this risk.

If you take any of these medications, be sure to tell your doctor. Your doctor may adjust your Rinvoq treatment to make sure the drug is safe for you to take.

High cholesterol: Rinvoq can increase cholesterol levels. If you currently have high cholesterol or have a history of high cholesterol, inform your doctor before you start taking Rinvoq. They may monitor you more closely than usual during treatment.

Conditions that decrease digestion time: Pieces of Rinvoq oral tablet may appear in stool. This can happen more often when substances move quicker than usual through the digestive system. Decreased digestion time can occur in people who have had certain digestive system procedures, such as a colostomy or a bowel resection.

If you have a condition that decreases digestion time, tell your doctor. Also let them know if you regularly see the medication in your stool. This could indicate that your body is not breaking down the drug effectively. If this applies to you, your doctor may recommend a treatment other than Rinvoq for your condition.

Liver problems: Rinvoq may cause increased levels of certain enzymes made in the liver. These enzymes are called alanine aminotransferase and aspartate aminotransferase. A large increase in these enzyme levels sometimes indicates liver damage.

If you have liver problems or a history of liver problems, make sure to tell your doctor. They may monitor you more closely than usual during your Rinvoq treatment. Or they may prescribe a drug other than Rinvoq to treat your condition.

Allergic reaction: If you’ve had an allergic reaction to Rinvoq or any of its ingredients, you should not take this drug. Ask your doctor whether other medications are better options for you.

Kidney problems: If you have kidney problems, tell your doctor. Rinvoq is not recommended for treatment of certain conditions if you have severe kidney problems. Your doctor may recommend a lower dosage of Rinvoq or a drug other than Rinvoq to treat your condition.

Pregnancy and breastfeeding: Taking Rinvoq during pregnancy or while you’re breastfeeding is not recommended. For more information, see this article about reproductive health and Rinvoq.

Alcohol with Rinvoq

There are no known interactions between alcohol and Rinvoq. However, drinking alcohol could increase your risk of certain side effects from Rinvoq. These side effects include nausea and liver problems.

If you drink alcohol, talk with your doctor about whether it’s safe for you to drink it while taking Rinvoq.

For details about possible interactions of Rinvoq with other medications and more, see this overview article.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.