Key takeaways:
Rinvoq (upadacitinib) is a prescription medication that treats autoimmune disorders such as rheumatoid arthritis, Crohn's disease, and more. It’s a type of Janus kinase (JAK) inhibitor.
Some Rinvoq side effects are relatively common. Common cold symptoms, acne, and stomach upset are all possible while taking Rinvoq. You can generally manage these side effects at home, but your pharmacist and prescriber are also here to help.
More serious Rinvoq side effects have also been reported. Serious infections and heart-related health complications are possible, albeit rare. They warrant prompt medical attention.
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Excessive inflammation is responsible for many chronic health conditions. And the more pronounced it is, the more problematic these conditions can be.
Inflammation-fighting medications can help change these health outcomes. If you’re living with an autoimmune disorder, a healthcare professional might prescribe an oral medication such as Rinvoq (upadacitinib) to manage the discomfort you’re experiencing. Rinvoq is a Janus kinase (JAK) inhibitor that helps calm down your immune system to reduce inflammation.
Rinvoq is effective and beneficial for many people. But there are still some side effects to keep in mind. Some are mild and easily manageable, while others are more serious.
Rinvoq side effects at a glance
Below are lists of both common and serious Rinvoq side effects to be aware of. Keep in mind that it’s always a good idea to discuss any side effects you experience with a healthcare professional, even if they aren’t listed below.
Some of Rinvoq’s side effects are relatively common or mild:
Fever
Acne
Headache
Nausea and upset stomach
Increased blood creatine phosphokinase (a lab test)
Low red blood cells
Low white blood cells
Rash
Serious, but rare, side effects have also been reported. They include:
Gastrointestinal perforations (a hole in the digestive tract)
Retinal detachment (an issue with the eye)
Shingles
Rinvoq also has a few boxed warnings. This is the FDA’s strictest warning for medications. While rare, these side effects can be life-threatening. Rinvoq has the following boxed warnings:
Increased risk of heart attack and stroke
Increased risk of certain cancers
Increased risk of serious infections
Increased risk of death in people with at least one heart-related risk factor
Here, we’ll detail how to manage or monitor for seven notable Rinvoq side effects.
1. Upper respiratory infections
Rinvoq intentionally suppresses your immune system. This is how it addresses inflammatory symptoms you may be experiencing. However, in turn, there’s a higher risk of picking up some kind of infection.
Upper respiratory tract infections are the most common infection people experience while taking Rinvoq. Think sinus infections, the common cold, and strep throat. A sore throat, cough, and a runny or stuffy nose are all hallmark symptoms.
If you come down with symptoms like these, try to prioritize getting plenty of fluids and rest while you recover. Over-the-counter (OTC) medications such as pain relievers, nasal sprays, and antihistamines can offer some short-term relief, too. Ask your prescriber what medications would be safest to try, though, because not all options may be ideal when paired with Rinvoq.
If your symptoms don't go away within 7 to 10 days, let your prescriber know. This is good to do even if your symptoms still feel relatively mild. They can determine next steps to help you get feeling better.
Good to know: Let your healthcare team know right away if you develop any serious or long-lasting symptoms of an infection while taking Rinvoq. Some infections can become life threatening if left untreated. Your prescriber can decide if you should temporarily stop taking Rinvoq while you recover.
2. Acne
Some people taking JAK inhibitors like Rinvoq develop new or worsening cases of acne. Since it’s relatively common, some healthcare professionals light-heartedly refer to it as “JAKne.” But it isn’t very clear why acne happens with JAK inhibitors.
Standard acne treatments can help manage acne from Rinvoq. Go-to acne treatments often include medications that you apply to your skin. Benzoyl peroxide and topical retinoids are beneficial for many people. Short-term antibiotics can also help. In rare cases, oral treatment with isotretinoin (Absorica, Amnesteem, Claravis) may be necessary.
Your prescriber can help you choose the best treatment for you.
3. Nausea and stomach upset
Nausea is a common side effect associated with many medications. While it’s possible with Rinvoq, thankfully, it's not typically too problematic.
Still, there are things you can do to reduce your chances of experiencing an upset stomach. Taking your medication with food and staying hydrated are helpful preventative measures.
If you’re actively experiencing nausea, you may want to consider:
Temporarily avoiding trigger foods that normally irritate your stomach, even if they sound appetizing
Eating smaller, more frequent meals
Testing out ginger or peppermint oil
Trying an OTC nausea medication, such as bismuth subsalicylate (Pepto-Bismol)
4. Changes to your lab work
Rinvoq can negatively affect your blood work readings, including your cholesterol levels. Some people develop higher cholesterol after starting Rinvoq. It’s very manageable, but to be safe, your prescriber may occasionally monitor your cholesterol while you’re taking Rinvoq.
Immune system changes are also possible. Rinvoq may cause your white blood cells to decrease in number. This can lead to an immune system that’s weaker than normal. Your prescriber may pause your prescription if they fall too low.
What’s more, Rinvoq can affect your red blood cells. You may develop anemia if your red blood cell counts drop too low. It can also affect laboratory measurements related to your muscles (creatinine phosphokinase) and liver (liver enzymes).
Thankfully, you don’t need to worry about these changes on your own. Your prescriber will be in charge of monitoring your blood work. They’ll make any necessary adjustments based on what your lab results say.
5. Serious infections
Many infections are mild in nature, but others are more serious. Some can even be life-threatening. Rinvoq has a boxed warning about this risk. Infections from bacteria, viruses, and fungi have all been reported.
It’s important to notify your healthcare team if you have any signs or symptoms of a potentially serious infection, such as a fever or shortness of breath. Your care team can assess your symptoms and give you further instructions. They’ll likely pause your Rinvoq prescription until the situation is addressed.
Because of these risks, your prescriber should screen for infections such as tuberculosis and hepatitis B before you start taking Rinvoq. Rinvoq can activate or exacerbate conditions like these. In some cases, you may be asked to take medications to treat an infection before starting Rinvoq.
6. Higher risk of cancer
Rinvoq also has a boxed warning for an increased risk of cancer. But it’s exceptionally rare.
Lung cancer and lymphoma (a cancer of the lymphatic system) have been observed in some people taking JAK inhibitors. People that currently smoke or have smoked in the past are at greater risk. If you’re a current smoker and you’re interested in quitting, your pharmacist can recommend products and resources to help you on your smoking cessation journey.
Certain types of skin cancer have also been reported with Rinvoq. You can reduce your risk of skin cancer by wearing protective clothing and using sunscreen.
7. Heart problems and blood clots
People that take JAK inhibitors like Rinvoq have a higher risk of experiencing heart-related health problems (cardiovascular events). This includes heart attacks, strokes, and cardiovascular-related death. Blood clots in your lungs, veins, and arteries are also possible. Complications like these are rare, but they’re important boxed warnings to keep in mind.
Not everyone has the same degree of risk, either. These blood-related issues are more likely among adults ages 50 and older with one or more of these health conditions or lifestyle traits:
Diabetes
High blood pressure
High cholesterol
Current or former smokers
Chronic alcohol use
Call 911 or go to the nearest ER if you think you’re having symptoms of a heart attack or a pulmonary embolism. This includes sudden breathing troubles and chest tightness. And if you develop symptoms such as weakness on one side of your body, a severe headache, or speech troubles, a stroke may be unfolding. Go to the nearest ER if you experience symptoms like these.
Frequently asked questions
Rinvoq is sometimes linked to weight gain. But it’s rare overall and isn’t one of the most common side effects. If you notice your body weight changing after starting Rinvoq, track it for a few weeks and mention it to your prescriber. They can tell whether the medication, your condition, or something else may be responsible.
Rinvoq makes it harder to donate blood. You shouldn’t donate blood if you’ve taken Rinvoq within the last month (30 days).
Hair loss isn’t a typical side effect of Rinvoq. But there are some anecdotal reports of people noticing more shedding or hair loss while taking it. If you notice this, talk to your prescriber about your symptoms. Hair loss isn’t always caused by medication; it can also be linked to factors, such as stress, inflammation, or an underlying condition.
Rinvoq isn’t known to commonly cause depression. But mood changes can happen for many reasons when you’re living with a chronic condition. If you feel persistently sad, hopeless, or not like yourself, tell your prescriber. They can help check for medication-related effects and other possible causes.
You should contact your healthcare team any time you have questions or concerns about a side effect. Even if you feel like it’s mild, it’s still worth a call.
That said, some Rinvoq side effects are riskier than others. It’s important to let your prescriber know if you’re experiencing signs or symptoms of an infection — especially if you’re seriously feeling sick.
Call 911 or go to the nearest ER right away if you experience other symptoms, including:
Difficulty breathing
Sudden pain in the center of your chest
One-sided facial or body weakness
Severe headache or dizziness
Slurred speech
New-onset confusion
Rinvoq is sometimes linked to weight gain. But it’s rare overall and isn’t one of the most common side effects. If you notice your body weight changing after starting Rinvoq, track it for a few weeks and mention it to your prescriber. They can tell whether the medication, your condition, or something else may be responsible.
Rinvoq makes it harder to donate blood. You shouldn’t donate blood if you’ve taken Rinvoq within the last month (30 days).
Hair loss isn’t a typical side effect of Rinvoq. But there are some anecdotal reports of people noticing more shedding or hair loss while taking it. If you notice this, talk to your prescriber about your symptoms. Hair loss isn’t always caused by medication; it can also be linked to factors, such as stress, inflammation, or an underlying condition.
Rinvoq isn’t known to commonly cause depression. But mood changes can happen for many reasons when you’re living with a chronic condition. If you feel persistently sad, hopeless, or not like yourself, tell your prescriber. They can help check for medication-related effects and other possible causes.
You should contact your healthcare team any time you have questions or concerns about a side effect. Even if you feel like it’s mild, it’s still worth a call.
That said, some Rinvoq side effects are riskier than others. It’s important to let your prescriber know if you’re experiencing signs or symptoms of an infection — especially if you’re seriously feeling sick.
Call 911 or go to the nearest ER right away if you experience other symptoms, including:
Difficulty breathing
Sudden pain in the center of your chest
One-sided facial or body weakness
Severe headache or dizziness
Slurred speech
New-onset confusion
The bottom line
Common Rinvoq (upadacitinib) side effects include common cold symptoms, acne, and stomach upset. Rare but serious side effects include a higher risk of heart problems, cancer, and serious infections. Notify your healthcare team right away if you have symptoms of an infection or other side effects that feel worrisome.
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References
AbbVie. (2025). Rinvoq- upadacitinib tablet, extended release [package insert]. DailyMed.
American Red Cross Biomedical Services. (n.d.). Medication deferral list.
Chang, A. H., et al. (2024). Drug-induced alopecia areata from upadacitinib. Cureus.
Tobin, E. H., et al. (2025). Upper respiratory tract infections with focus on the common cold. StatPearls.
