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Compare Rinvoq vs. Actemra

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Rinvoq (upadacitinib) and Actemra (tocilizumab) are both medications used to treat inflammatory conditions like rheumatoid arthritis (RA). However, they belong to different medication classes. Rinvoq is a Janus kinase (JAK) inhibitor, while Actemra is an interleukin-6 (IL-6) receptor antagonist. Rinvoq is taken orally, either as an extended-release tablet or an oral solution, and is typically dosed once daily. In contrast, Actemra is administered via injection, either intravenously or subcutaneously, with dosing intervals ranging from weekly to monthly. Rinvoq is available only as a brand-name medication, whereas Actemra has a biosimilar option called Tofidence. Common side effects of Rinvoq include a higher risk of infections, acne, and nausea, while Actemra can cause upper respiratory tract infections, headaches, and high blood pressure. Both medications can increase the risk of infections due to their immunosuppressive effects, but they have different interactions and precautions. For example, Rinvoq should not be taken with grapefruit, and Actemra requires careful monitoring of liver function.

Rinvoq (upadacitinib)
Actemra (tocilizumab)
Rinvoq (upadacitinib)
Actemra (tocilizumab)
Summary of Rinvoq vs. Actemra
Summary for JAK inhibitor
Prescription only
Rinvoq (upadacitinib) is a Janus kinase (JAK) inhibitor. It's used to treat certain inflammatory conditions, such as rheumatoid arthritis (RA), ulcerative colitis (UC), and eczema (atopic dermatitis). But it's not a first-choice option and typically only prescribed when other treatments haven't worked well. Rinvoq (upadacitinib) is taken by mouth, usually once daily. It's available as an extended-release tablet (Rinvoq) and an oral solution (Rinvoq LQ), but the two formulations aren't interchangeable. Side effects include a higher risk of infections, acne, and nausea.
Summary for IL-6 receptor antagonist
Prescription only
Actemra (tocilizumab) is an interleukin-6 (IL-6) receptor antagonist. It treats several inflammatory conditions in children and adults, including rheumatoid arthritis. It works by blocking IL-6, a chemical released by the immune system that causes inflammation and fever. Actemra (tocilizumab) is given as an injection (either through the veins or under the skin), typically weekly or every few weeks, depending on the condition you're taking it treat. Side effects include a higher risk of infections and headache.
Indications of Rinvoq vs. Actemra
Indications for
Moderate-to-severe inflammatory conditions in which other treatments haven't worked:

•Rheumatoid arthritis (RA) in adults

•Psoriatic arthritis (PsA) in adults and children ages 2 years and older

•Eczema (atopic dermatitis) in adults and children ages 12 years and older

•Ulcerative colitis (UC) in adults

•Crohn's disease (CD) in adults

•Ankylosing spondylitis (AS) in adults

•Non-radiographic axial spondyloarthritis (nr-axSpA) in adults

•Polyarticular juvenile idiopathic arthritis (pJIA) in adults and children ages 2 years and older

Indications for

•Moderate-to-severe rheumatoid arthritis (RA) - adults

•Giant cell arteritis (GCA) - adults

•Systemic sclerosis-associated interstitial lung disease (SSc-ILD) - adults

•Polyarticular juvenile idiopathic arthritis (PJIA) - adults and children 2 years and older

•Systemic juvenile idiopathic arthritis (SJIA) - adults and children 2 years and older

•Cytokine release syndrome (CRS) - adults and children 2 years and older

•COVID-19 infection - adults and children 2 years and older
Pros and Cons of Rinvoq vs. Actemra
Pros and Const for JAK inhibitor
Pros

•Can treat many different inflammatory conditions

•Available as a tablet and a liquid

•The tablet only needs to be taken once a day

Cons

•Can raise risk for infections

•Not the best option for people with severe liver or kidney problems

•Not safe for use during pregnancy

Pros and Const for IL-6 receptor antagonist
Pros

•Typically given every 1 to 4 weeks

•Can be used in children age 2 years and older (for some conditions)

•Comes as a prefilled syringe or autoinjector for easy at-home injections under the skin

Cons

•Needs to be given by an injection only

•Can cause liver problems

•Raises your risk for infections because it weakens your immune system
Common Side Effects of Rinvoq vs. Actemra
Common Side Effects for

•Upper respiratory tract infection (25%)

•Acne (16%)

•Herpes simplex virus (HSV) infection (8%)

•Headache (6%)

Note: Side effects listed were reported by people who took Rinvoq for eczema.
Common Side Effects for

•Upper respiratory tract infections (up to 7%)

•Headache (up to 7%)

•High blood pressure (up to 6%)

•Higher liver enzymes (up to 6%)

Note: The side effects you experience might differ depending on why you're taking Actemra (tocilizumab) and whether you're receive it IV or SC.
Warnings of Rinvoq vs. Actemra
Common Side Effects for

•Serious infections

•Possible higher risk of death for people with rheumatoid arthritis

•Risk of cancer

•Possible risk of heart attack, stroke, and other blood clots

•Severe allergic reaction

•Stomach and gut tears

•Abnormal lab results (e.g., blood cell counts, cholesterol levels)

•Possible harm to unborn babies

•Medication in stool

Common Side Effects for

•Risk of serious infections

•Stomach tears and blockage

•Worsening liver problems and risk of liver failure

•Severe allergic reactions

•Lower white blood cell (WBC) and platelet counts

•High cholesterol

•Serious allergic reactions

•Vaccines
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Key takeaways

Summary of Rinvoq vs. Actemra

Indications of Rinvoq vs. Actemra

Pros and Cons of Rinvoq vs. Actemra

Common Side Effects of Rinvoq vs. Actemra

Warnings of Rinvoq vs. Actemra

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