6 known interactions • 4 major • 2 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Strong CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir)
Increase upadacitinib AUC ~75%, raising immunosuppression and adverse effect risk.
Management: Reduce upadacitinib dose to 15 mg once daily; avoid with strong CYP3A4 inhibitors in higher-dose indications.
Strong CYP3A4 inducers (rifampin, carbamazepine)
Reduce upadacitinib exposure by ~60–75%, risking therapeutic failure.
Management: Avoid combination. If rifampin is essential, consider alternative JAK inhibitor or disease therapy.
Live vaccines
JAK inhibitor immunosuppression may render live vaccines ineffective and poses risk of disseminated infection.
Management: Complete all vaccinations before treatment. Do not give live vaccines during Rinvoq therapy.
Other biologic DMARDs (TNF inhibitors, IL-6 inhibitors, abatacept)
Dual biologic/JAK inhibitor combinations increase infection risk without demonstrated efficacy advantage.
Management: Contraindicated. Use only one immunomodulatory biologic or JAK inhibitor.
Anticoagulants (warfarin) / antiplatelet agents
JAK inhibitors may modestly affect platelet function; warfarin levels may be unpredictably altered.
Management: Monitor INR and bleeding signs when initiating or adjusting Rinvoq.
Methotrexate / azathioprine
Combined immunosuppression increases infection risk and hepatotoxicity potential.
Management: Monitor CBC, LFTs, and signs of infection regularly. Low-dose MTX may be co-prescribed intentionally.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Rinvoq. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.