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JAK Inhibitor (Selective JAK1 Inhibitor)

Upadacitinib

Brand names: Rinvoq

Upadacitinib is an oral Janus kinase (JAK) inhibitor used for inflammatory conditions such as rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, atopic dermatitis and ulcerative colitis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It preferentially inhibits JAK1, interrupting cytokine-driven JAK-STAT signalling that mediates inflammation in immune-mediated diseases.

Prescribing in practice

  • Following an MHRA class review of JAK inhibitors, it should be used with caution in those aged 65 and over, current or past long-term smokers, and those at increased cardiovascular or malignancy risk, with the lowest effective dose used.
  • Serious infections, including tuberculosis reactivation and herpes zoster, can occur, so screening before starting is required.
  • Venous thromboembolism and laboratory changes (lipids, liver enzymes, blood counts) need monitoring per the SPC.

Monitoring

Monitor full blood count, liver function, lipids, and for signs of infection or thromboembolism before and during treatment, with tuberculosis screening at baseline.

Counselling the patient

  • Report signs of infection such as fever, persistent cough or a painful blistering rash promptly.
  • Seek urgent advice for chest pain, breathlessness or a swollen, painful leg.
  • Ensure vaccinations are up to date and avoid live vaccines while on treatment.

Evidence & guidelines

Use is supported by the SELECT trial programme, NICE technology appraisals and the MHRA safety review of JAK inhibitors.

Reference: NICE TA665; SELECT-COMPARE trial; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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