Rinvoq interactions: Other medications, alcohol, and more
Rinvoq (upadacitinib) is a prescription drug that’s used to treat certain autoimmune conditions. This drug can interact with other medications and some supplements. For example, Rinvoq can interact with prednisone and certain antibiotics.
Rinvoq is used to treat the autoimmune conditions listed below. Autoimmune conditions occur when your immune system mistakenly attacks healthy tissues in your body.
Rinvoq is used in certain adults to treat:
Rinvoq is also used in certain children to treat moderate to severe atopic dermatitis.
Rinvoq contains the active ingredient upadacitinib. (An active ingredient is what makes a drug work.) The medication comes as an extended-release tablet that you swallow. (Extended-release tablets release the medication into your body slowly over time, rather than all at once.)
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Rinvoq’s possible interactions. And for more information about Rinvoq, including details about its uses, see this article.
Boxed warnings
This drug has boxed warnings about the increased risk of serious infections, cancer, blood clots, heart or blood vessel problems, and death in some people. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
Risk of serious infections: Rinvoq weakens part of your immune system and can raise your risk of serious infections, such as tuberculosis (TB), pneumonia, shingles, and invasive fungal infections. These infections may need treatment in hospital and can even be life threatening. You may have a higher risk if you have diabetes, long-term lung disease, HIV, or a weak immune system.
Before starting Rinvoq, tell your doctor if you have any current infections or infections that keep coming back. Also tell your doctor if you’ve had serious infections in the past, such as TB, hepatitis B, or hepatitis C. Your doctor may test you for these infections before you start Rinvoq.
If you have an infection, your doctor will likely prescribe medication to treat it before you start Rinvoq. They may also recommend getting certain immunizations before you start treatment.
During treatment with Rinvoq, tell your doctor right away if you develop any symptoms of infection, such as fever or cough.
Risk of cancer: Rinvoq can raise your risk of developing cancer, such as lymphoma, lung cancer, or skin cancer. You may have a higher risk if you smoke or have done in the past.
Before starting Rinvoq, tell your doctor if you’ve ever had cancer or been a smoker. During treatment with Rinvoq, your doctor may monitor you for signs of cancer, especially skin cancer.
To help reduce your risk of skin cancer, you should protect your skin from sunlight while taking Rinvoq, especially if you have a light skin tone or a history of sunburns. Use sunscreen with a high protection factor, cover your skin with clothing, and avoid spending lots of time in the sun.
Risk of blood clots: Rinvoq can raise your risk of dangerous blood clots, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). You may have a higher risk if you’re age 50 years or older or you’ve had a past blood clot. You may also have a higher risk if you have cardiovascular (heart and blood vessel) risk factors, such as smoking or obesity.
Before starting Rinvoq, talk with your doctor about your cardiovascular health and your risk of blood clots. Your doctor will consider any risk factors you may have before prescribing Rinvoq.
While taking Rinvoq, see your doctor right away if you have symptoms of a blood clot. These may include swelling or discoloration in your leg, sudden chest or upper back pain, and sudden shortness of breath.
Risk of heart or blood vessel problems and death: Rinvoq can raise the risk of heart and blood vessel problems, such as heart attack and stroke, and death in certain people. You may have a higher risk if you’re age 50 years or older or have cardiovascular risk factors. These include smoking, obesity, high cholesterol, high blood pressure, and diabetes.
Your doctor will consider your cardiovascular risk before prescribing Rinvoq.
While taking Rinvoq, call 911 right away if you have symptoms of a heart attack or stroke. These can include chest pain or pressure, shortness of breath, sudden weakness or numbness in one side of your face or body, and trouble speaking.
Does Rinvoq interact with other drugs?
Before you start taking Rinvoq, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Rinvoq interacts with herbs or vitamins and supplements, see the “Are there other interactions with Rinvoq?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Rinvoq. Keep in mind that this table does not include all drugs that may interact with Rinvoq. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| other Janus kinase (JAK) inhibitors (Rinvoq belongs to this drug group) | • baricitinib (Olumiant) • tofacitinib (Xeljanz) | can increase the risk of side effects from Rinvoq and other JAK inhibitors |
| immunosuppressants | • azathioprine (Imuran, Azasan) • cyclosporine (Neoral, others) | can increase the risk of infections |
| biologic immunomodulators | • abatacept (Orencia) • adalimumab (Humira) • infliximab (Remicade) | can increase the risk of infections |
| nonsteroidal anti-inflammatory drugs (NSAIDs) | • aspirin • ibuprofen (Advil, Motrin) • naproxen (Aleve, Naprosyn) | can increase the risk of having a tear in your stomach or intestine |
| corticosteroids | •methylprednisolone (Medrol) • prednisolone • prednisone (Rayos) | can increase the risk of having a tear in your stomach or intestine |
| certain antibiotics | • clarithromycin • erythromycin (Ery-Tab, others) • rifampin (Rifadin, Rimactane) | can increase the risk of side effects from Rinvoq or make Rinvoq less effective |
| certain antifungals | • itraconazole (Sporanox) • ketoconazole • voriconazole (Vfend) | can increase the risk of side effects from Rinvoq |
| certain HIV drugs | • cobicistat (Tybost) • nelfinavir (Viracept) • ritonavir (Norvir) | can increase the risk of side effects from Rinvoq |
| certain seizure medications | • carbamazepine (Tegretol, others) • phenytoin (Dilantin) | can make Rinvoq less effective |
Learn more about certain drug interactions that can occur with Rinvoq.
Interaction with biologic immunomodulators
Rinvoq can interact with biologic immunomodulators, which are used to treat some of the same autoimmune conditions as Rinvoq. These include rheumatoid arthritis, ulcerative colitis, and psoriatic arthritis. (A biologic is a drug made using living cells. And an immunomodulator is a drug that affects your immune system.)
Examples of biologic immunomodulator medications include:
What could happen
Rinvoq and biologic immunomodulators can both raise your risk of infections. So taking these drugs together can raise your risk of this side effect even more.
If you have diabetes, long-term lung disease, HIV, or a weak immune system, you may have a higher risk of infections if you take Rinvoq with a biologic immunomodulator.
What you can do
Your doctor will likely avoid prescribing Rinvoq with a biologic immunomodulator.
If you take Rinvoq and a biologic immunomodulator together, tell your doctor right away if you have symptoms of infection. These may include fever, cough, and sore throat.
If you have questions about taking Rinvoq with a biologic immunomodulator, talk with your doctor or pharmacist.
Interaction with corticosteroids
Rinvoq can interact with corticosteroids (also called steroids), which are used to reduce inflammation (swelling). They’re used for many different conditions, including some of the same conditions as Rinvoq. For example, they may be used to treat rheumatoid arthritis, ulcerative colitis, and psoriatic arthritis.
Examples of corticosteroid medications:
What could happen
Rinvoq and corticosteroids can both sometimes cause tears in the lining or your stomach or intestine. So taking these drugs together can raise your risk of this side effect.
If you have a history of diverticulitis or ulcers in your stomach or intestine, you may have a raised risk of this side effect if you take Rinvoq with a corticosteroid. You may also have a raised risk if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) as well.
What you can do
If you take Rinvoq with a corticosteroid such as prednisone, call your doctor right away if you have symptoms of a tear in your stomach or intestine. These may include new abdominal pain, fever, chills, nausea, or vomiting.
If you have questions about taking Rinvoq with a corticosteroid, talk with your doctor or pharmacist.
Interaction with certain antibiotics
Rinvoq can interact with certain antibiotics, which are used to treat bacterial infections.
Examples of antibiotic medications that can interact with Rinvoq:
Certain antibiotics, such as clarithromycin and erythromycin, can stop your body from breaking down Rinvoq as quickly as usual. Taking Rinvoq with one of these antibiotics can make Rinvoq build up in your body. This can raise your risk of side effects from Rinvoq.
If you have liver or kidney problems, you may have a raised risk of side effects if you take Rinvoq with one of these antibiotics.
Certain other antibiotics, such as rifampicin, can make your body break down Rinvoq faster than usual. This can make Rinvoq less effective at treating your condition.
Your doctor will likely avoid prescribing these antibiotics with Rinvoq.
If you need to take clarithromycin or erythromycin with Rinvoq, your doctor may lower your dosage of Rinvoq. Or they may have you stop taking Rinvoq temporarily until the infection is treated. You should not take a higher dose of either medication than your doctor prescribes.
If you have questions about taking antibiotics with Rinvoq, talk with your doctor or pharmacist.
When should I avoid Rinvoq?
Certain health conditions or other factors could raise your risk of harm if you take Rinvoq. In such cases, your doctor may not prescribe Rinvoq for you. These are known as contraindications. Allergic reaction is the only contraindication of Rinvoq.
If you’ve had an allergic reaction to Rinvoq or any of its ingredients, your doctor likely won’t prescribe Rinvoq for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Does Rinvoq interact with alcohol?
Rinvoq is not known to interact with alcohol. But Rinvoq and alcohol can cause some similar side effects, such as nausea and liver problems. So you may be more likely to experience these side effects if you drink alcohol during your Rinvoq treatment.
If you have questions about consuming alcohol while taking Rinvoq, talk with your doctor or pharmacist.
Are there other interactions with Rinvoq?
Rinvoq may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Rinvoq.
Does Rinvoq interact with supplements?
Before you start taking Rinvoq, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Rinvoq interactions with herbs
Rinvoq can interact with St. John’s wort, which is used to treat depression and other conditions. Taking St. John’s wort with Rinvoq can make your body break down Rinvoq more quickly. This can make Rinvoq less effective for treating your condition. Your doctor will likely recommend that you avoid taking St. John’s wort with Rinvoq.
Rinvoq and vitamins
There are currently no reports of Rinvoq interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Rinvoq.
Does Rinvoq interact with food?
Rinvoq can interact with grapefruit and grapefruit juice. Consuming grapefruit with Rinvoq can stop your body from breaking down Rinvoq as quickly as usual. This can make Rinvoq build up in your body, which can raise your risk of its side effects.
Your doctor will usually recommend that you avoid consuming grapefruit while taking Rinvoq.
If you have questions about consuming other foods with Rinvoq, talk with your doctor or pharmacist.
Does Rinvoq interact with vaccines?
You should not receive live vaccines shortly before starting Rinvoq or during your Rinvoq treatment. (Live vaccines contain weakened versions of the bacteria or virus that they’re meant to protect against.) This is because getting a live vaccine while you’re taking Rinvoq increases your risk of infection.
Examples of live vaccines include measles, mumps, rubella (MMR), rotavirus, chickenpox, shingles, and the nasal spray flu vaccine. If you need to receive a vaccine, talk with your doctor first to make sure it’s safe.
Does Rinvoq interact with lab tests?
There are currently no reports of Rinvoq interacting with lab tests. If you have questions about having certain lab tests during your treatment with Rinvoq, talk with the healthcare professional ordering the test.
Does Rinvoq interact with cannabis or CBD?
There are currently no reports of Rinvoq interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Rinvoq.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Does my health history affect whether I should take Rinvoq?
Certain medical conditions or other health factors may raise the risk of interactions with Rinvoq. Before taking Rinvoq, talk with your doctor about your health history. They’ll determine whether Rinvoq is right for you.
Health conditions or other factors that might interact with Rinvoq include:
Infections. Rinvoq has a boxed warning about the risk of serious, even life threatening infections. You may have a higher risk if you have diabetes, long-term lung disease, HIV, or a weak immune system. For more information, see the boxed warning at the start of this article.
Before starting Rinvoq, tell your doctor if you have any current infections or infections that keep coming back. Also tell your doctor if you’ve had serious infections in the past, such as TB, hepatitis B, or hepatitis C. Your doctor may test you for these infections before you start Rinvoq.
Before you start taking Rinvoq, your doctor may prescribe medication to treat any infections you have. They may also recommend getting certain vaccinations.
Cancer. Rinvoq has a boxed warning about the risk of developing cancer, such as lymphoma, lung cancer, or skin cancer. If you’ve ever had cancer, or you’re a current or past smoker, you may have a higher risk. Talk with your doctor about whether Rinvoq is right for you. For more information, see the boxed warning at the start of this article.
Cardiovascular risk factors. Rinvoq has boxed warnings about the risk of blood clots and cardiovascular (heart and blood vessel) problems, such as heart attack and stroke. You may have a higher risk if you’re age 50 years or older or have cardiovascular risk factors. These include smoking, obesity, high cholesterol, high blood pressure, and diabetes. Your doctor will consider your cardiovascular risk before prescribing Rinvoq. For more information, see the boxed warning at the start of this article.
Diverticulitis or stomach ulcers. Rinvoq can sometimes cause a tear in the lining of your stomach or intestine. If you have a history of diverticulitis or ulcers in your stomach or intestine, you may have a higher risk of this side effect. Talk with your doctor about whether Rinvoq is right for you.
Conditions that shorten digestion time. Rinvoq tablet releases the medication slowly as it passes through your digestive system. If you have a condition that shortens digestion time, such as a colostomy, the tablet may pass through your digestive system before all the medication is released. This could make Rinvoq less effective. Your doctor will likely monitor your condition to make sure Rinvoq is working for you. If you frequently notice whole tablets or pieces of tablet in your stool, tell your doctor.
Low levels of red or white blood cells. If you have low levels of red or white blood cells, Rinvoq can make this worse. Your doctor will likely monitor your blood cells while you’re taking Rinvoq.
Liver problems. If you have a liver problem, Rinvoq could make it worse. Your doctor will likely monitor your liver function while you’re taking Rinvoq. But if you have a severe liver problem, such as increased liver enzyme levels, your doctor likely won’t prescribe Rinvoq. This is because Rinvoq could build up in your body and raise your risk of side effects.
Kidney problems. If you have severe kidney problems, such as renal failure, Rinvoq can build up in your body and raise your risk of side effects. Your doctor may prescribe a dosage of Rinvoq that’s lower than usual.
Pregnancy. Rinvoq is not safe to take during pregnancy. The drug can harm a developing fetus. If you’re pregnant or planning a pregnancy, talk with your doctor about other treatment options for your condition. If you’re able to become pregnant, you should use birth control while taking Rinvoq and for 4 weeks after your last dose.
Breastfeeding. It’s not known whether it’s safe to take Rinvoq while breastfeeding. The drug may pass into breast milk and cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options. Your doctor will likely recommend that you don’t breastfeed while taking Rinvoq and for 6 days after your last dose.
Allergic reaction. If you’ve had an allergic reaction to Rinvoq or any of its ingredients, your doctor will likely not prescribe Rinvoq. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
How can I prevent interactions?
Taking certain steps can help you avoid interactions with Rinvoq. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
It’s also important to understand Rinvoq’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Rinvoq, ask your pharmacist to print a copy for you.)
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Rinvoq exactly as prescribed can also help prevent interactions.
What should I ask my doctor?
If you still have questions about Rinvoq and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
To learn more about Rinvoq, see these articles:
This article is incredibly informative and essential for anyone taking Rinvoq! It’s crucial to understand the potential interactions it may have with other medications and substances like alcohol. Thanks for shedding light on these important considerations—it’s better to be safe and well-informed.
This is super helpful! I was prescribed Rinvoq recently, and I had no idea that it could interact with other medications and even alcohol. Thanks for providing such detailed information. I’ll definitely discuss this with my doctor to make sure I’m managing everything safely.
Thanks for this comprehensive overview on Rinvoq interactions! It’s so important to be aware of how different medications and substances can affect each other. The alcohol interaction section was particularly eye-opening for me. Keep up the great work!
Great article! It’s so important to be aware of potential interactions when taking medications like Rinvoq. I appreciate the detailed breakdown on how other medications and even alcohol can affect its efficacy and safety. Always best to stay informed and consult with a healthcare professional. Thanks for sharing this valuable information!