Upadacitinib

Pediatric Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Rinvoq; Rinvoq LQ

Brand Names: Canada

Rinvoq

Warning
  • Severe infections like tuberculosis, shingles, fungal infections and other bacterial or viral infections have happened in patients who take this drug. Sometimes, these have been deadly. The risk is greater if your child also takes drugs that suppress the immune system like methotrexate or corticosteroids. If your child gets a bad infection, the doctor may stop this drug until the infection is under control. Call the doctor right away if your child has a fever, chills, or sweating; cough; muscle aches; shortness of breath; more sputum or change in color of sputum; red, warm, swollen, painful, or blistered skin; weight loss; stomach pain; diarrhea; pain with passing urine or passing urine more often; or feeling tired or weak.
  • TB (tuberculosis) has been seen in patients started on this drug. These patients were exposed to TB in the past, but never got the infection. The doctor may test to see if your child has been exposed to TB before starting this drug.
  • Lymphoma, skin cancer, and other types of cancer have happened in people treated with this drug.
  • A drug (tofacitinib) like this one has been shown to raise the risk of heart attack, stroke, blood clots, and death. These effects were seen in a study of people taking tofacitinib to treat rheumatoid arthritis. These people were at least 50 years of age and also had at least 1 heart disease risk factor. It is not known if the raised risk happens with this drug. Call the doctor right away if your child has signs of a heart attack, stroke, or blood clot like chest, throat, neck, or jaw tightness, pain, pressure, or heaviness; abnormal arm, back, neck, jaw, or stomach pain; coughing up blood; shortness of breath; cold sweats; severe upset stomach or throwing up; swelling, warmth, numbness, coldness, color change, or pain in a leg or arm; trouble speaking, swallowing, or thinking; weakness on 1 side of the body; change in balance; drooping on one side of the face; feeling lightheaded; or change in eyesight.
  • Tell the doctor if your child smokes, has smoked in the past, or has ever had a heart attack, other heart problems, stroke, or blood clot.

What is this drug used for?

  • It is used to treat eczema.
  • It is used to treat some types of arthritis.
  • If your child has been given this drug for some other reason, talk with the doctor about the benefits and risks. Talk with the doctor if you have questions or concerns about giving this drug to your child.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child has any of these health problems: Kidney disease or liver disease.
  • If your child has had hepatitis B or C.
  • If your child has low red or white blood cell counts.
  • If your child has an infection.
  • If your child is taking any of these drugs: Abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, secukinumab, tocilizumab, ustekinumab, or vedolizumab.
  • If your child is taking any drugs used to suppress the immune system like azathioprine or cyclosporine. There are many drugs that can do this. Ask the doctor or pharmacist if you are not sure.
  • If your child takes any other drugs (prescription or OTC, natural products, vitamins). There are many drugs that interact with this drug, like certain drugs that are used for HIV, infections, or seizures.

If your child is breast-feeding a baby:

  • Be sure your child does not breast-feed a baby while taking this drug and for 6 days after the last dose.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Different forms of this drug cannot be switched with each other. Do not switch between forms without checking with the doctor.
  • Your child may have more chance of getting infections. Have your child wash hands often. Avoid crowds and people with infections, colds, or flu.
  • If your child has had hepatitis B before or carries the virus, talk with your child’s doctor. Drugs like this one can cause the virus to become active. This can lead to very bad and sometimes deadly liver problems.
  • Hepatitis testing needs to be done before taking this drug.
  • Some viral infections like herpes zoster have become active again with this drug. Tell your child’s doctor if your child has ever had a viral infection like herpes zoster.
  • Make sure your child is up to date with all vaccines before treatment with this drug.
  • Talk with the doctor before your child gets any vaccines. Use of some vaccines with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
  • Be sure your child does not get a weakened bacteria like BCG for bladder cancer while using this drug. Talk with the doctor.
  • High cholesterol has happened with this drug. If you have questions, talk with the doctor.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Avoid giving your child grapefruit and grapefruit juice.
  • The chance of skin cancer may be raised. Have your child avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and dress your child in clothing and eyewear that protects your child from the sun.
  • Have your child’s skin checked. Tell your child’s doctor if your child has any skin changes like a new wart, skin sore or reddish bump that bleeds or does not heal, or a change in the color or size of a mole.
  • Holes in the GI (gastrointestinal) tract may rarely happen.
  • If your child is of childbearing age, a pregnancy test will need to be done before starting this drug to make sure your child is not pregnant.

If your child is or may be sexually active:

  • This drug may cause harm to the unborn baby if your child takes it during pregnancy.
  • Have your child use birth control while taking this drug and for some time after the last dose. Ask the doctor how long your child must use birth control. If your child becomes pregnant, call the doctor right away.

Extended-release tablets:

  • Some people have seen the tablet or parts of the tablet in the stool or ostomy output. If this happens, call the doctor.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
  • Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Warm, red, or painful skin or sores on the body.
  • Shingles.
  • A skin lump or growth.
  • Dizziness or passing out.
  • Feeling very tired or weak.
  • Stomach pain that is new or worse.
  • Change in bowel habits.
  • Sudden change in eyesight.
  • Cough.
  • Fever or chills.
  • Severe upset stomach or throwing up.
  • Call your child’s doctor right away if your child has a swollen gland, night sweats, shortness of breath, or weight loss without trying.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

  • Signs of a common cold.
  • Upset stomach.
  • Headache.
  • Pimples (acne).
  • Cold sores.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

All products:

  • Give this drug with or without food.

Extended-release tablets:

  • Have your child swallow whole. Do not let your child chew, break, or crush.

Oral solution:

  • Measure liquid doses carefully. Use the measuring device that comes with this drug.
  • An adapter will need to be put in the bottle. Use a new adapter with each new bottle. Do not take the adapter out of the bottle after it has been put in.

What do I do if my child misses a dose?

  • Give a missed dose as soon as you think about it.
  • If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

All products:

  • Store in the original container at room temperature or in a refrigerator.
  • Store in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Oral solution:

  • Keep lid tightly closed.
  • After opening, throw away any part not used after 60 days.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-05-21

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022