ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
JAK Inhibitor (Selective JAK1 Inhibitor) Pregnancy: D

Upadacitinib

Brand names: Rinvoq

Adult dose

Dose: 15 mg once daily (RA/PsA/AS/JIA); 30 mg once daily (atopic eczema)
Route: oral
Frequency: once daily
Max: 30 mg/day (atopic eczema); 15 mg/day (RA/PsA)
Extended-release tablet — swallow whole; multiple licensed indications; most selective JAK1 inhibitor available

Paediatric dose

Route:
Licensed ≥12 years for JIA (polyarticular/enthesitis-related); 15 mg once daily

Dose adjustments

Renal

Avoid if eGFR <15 ml/min

Hepatic

Avoid in severe hepatic impairment

Clinical pearls

  • SELECT-COMPARE: superior to adalimumab for remission rates at week 26 in RA on MTX
  • High herpes zoster rate — shingles vaccination recommended before initiation
  • Broadest licensed indication among JAKi: RA, PsA, AS, atopic eczema, JIA, Crohn's disease, UC

Contraindications

  • Pregnancy
  • Active TB
  • Active severe infections
  • ANC <1 × 10⁹/L

Side effects

  • Herpes zoster (shingles)
  • URTI
  • Nausea
  • Dyslipidaemia
  • DVT/PE
  • Acne
  • Malignancy risk

Interactions

  • Strong CYP3A4 inhibitors (increase exposure)
  • Live vaccines (CI)
  • Immunosuppressants

Monitoring

  • FBC
  • LFTs
  • Lipids
  • Signs of infection
  • Malignancy screening

Reference: BNFc; BNF 86; NICE TA665; SELECT-COMPARE trial. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways