Drug Action
Upadacitinib is a selective and reversible inhibitor of the Janus-associated tyrosine kinase JAK1.
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Drug reference
Upadacitinib is a selective and reversible inhibitor of the Janus-associated tyrosine kinase JAK1.
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Rheumatoid arthritis (specialist use only) ▶BY MOUTH ▶Adult: 15 mg once daily
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Absolute lymphocyte count less than 500 cells/mm3. absolute neutrophil count less than 1000 cells/mm3. active serious infection including localised infection. active tuberculosis. haemoglobin less than 8 g/dL
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75 years and over. chronic or recurrent infection. history of serious or opportunistic infection. known malignancy. patients at high risk for deep-vein thrombosis or pulmonary embolism. patients who have travelled or resided in areas of endemic tuberculosis or endemic mycoses. predisposition to infection. risk of viral reactivation (consult product literature). tuberculosis exposure CAUTIONS, FURTHER INFORMATION ▶Immunisation Manufacturer advises patients should receive all recommended vaccinations, including prophylactic varicella zoster vaccination, before starting treatment; live vaccines are not recommended. ▶Tuberculosis Manufacturer advises consider anti- tuberculosis therapy prior to initiation of upadacitinib in patients with previously untreated latent tuberculosis or in patients at risk of tuberculosis infection.
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Manufacturer advises patients should be evaluated for tuberculosis and viral hepatitis before treatment.
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MHRA/CHM ADVICE: UPADACITINIB (RINVOQ ®): ADVICE FOR VENOUS THROMBOEMBOLISM (MARCH 2020) Cases of deep vein thrombosis and pulmonary embolism have been reported in patients taking upadacitinib. Healthcare professionals are advised to use upadacitinib with caution in patients with risk factors for VTE. Patients should be informed of the signs and symptoms of VTE before starting treatment and advised to seek urgent medical attention if these develop. Upadacitinib should be discontinued if clinical features of VTE occur.
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→Appendix 1: upadacitinib
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▶Common or very common Cough. dyslipidaemia. fever. increased risk of infection. nausea. neutropenia. oropharyngeal pain. weight increased ▶Frequency not known Deep vein thrombosis (discontinue and initiate treatment promptly). malignancy. meningitis bacterial. non-melanoma skin cancer. pulmonary embolism (discontinue and initiate treatment promptly). reactivation of infections. venous thromboembolism (discontinue and initiate treatment promptly)
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Manufacturer advises females of childbearing potential should use effective contraception during and for 4 weeks after treatment.
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Manufacturer advises avoid—toxicity in animal studies.
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Manufacturer advises avoid—present in milk in animal studies.
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Manufacturer advises avoid in severe impairment (no information available).
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Manufacturer advises caution in severe impairment (limited information available).
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▶Manufacturer advises monitor for signs and symptoms of infection during and after treatment. ▶Manufacturer advises periodic skin examination in patients at increased risk for skin cancer. ▶Manufacturer advises monitor neutrophils, lymphocytes and haemoglobin before starting treatment, and as clinically indicated thereafter; interrupt treatment if absolute neutrophil count less than 1000 cells/mm3, absolute lymphocyte count less than 500 cells/mm3, or haemoglobin less than 8 g/dL—treatment may be restarted when levels return above these values. ▶Manufacturer advises monitor hepatic transaminases before starting treatment, and as clinically indicated thereafter—interrupt treatment if drug-induced liver injury suspected; monitor lipids 12 weeks after starting Musculoskeletal system treatment, and then as clinically indicated.
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There can be variation in the licensing of different medicines containing the same drug. Modified-release tablet CAUTIONARY AND ADVISORY LABELS 25 A ▶Upadacitinib (non-proprietary) Upadacitinib (as Upadacitinib hemihydrate) 15 mg Rinvoq 15mg modified-release tablets | 28 tablet P £805.56 IMMUNOSUPPRESSANTS › T-CELL ACTIVATION INHIBITORS
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15 mg once daily
First-line fragment. Read the complete Indications and Dose section above.
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