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Drug Safety-related Labeling Changes (SrLC)

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RINVOQ LQ (NDA-218347)

(UPADACITINIB)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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06/30/2026 (SUPPL-8)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.8 Hypoglycemia in Patients with Diabetes

Newly added subsection:

Hypoglycemia, including severe hypoglycemia, has been reported following initiation of RINVOQ/RINVOQ LQ and other JAK inhibitors in patients with diabetes. During treatment with RINVOQ/RINVOQ LQ, consider increased monitoring of blood glucose as clinically indicated in patients with diabetes. Advise patients with diabetes to notify their healthcare provider if they develop signs or symptoms of hypoglycemia.

6 Adverse Reactions

Addition of the following to the bulleted line listing:

  • Hypoglycemia in Patients with Diabetes [see Warnings and Precautions (5.8)]

6.2 Postmarketing Experience

Newly added subsection:

The following adverse reactions have been identified during post-approval use of RINVOQ/RINVOQ LQ. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure:

Metabolism and nutrition disorders: Hypoglycemia

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

Additions and/or revisions underlined:

8. Low blood sugar (hypoglycemia) in people with diabetes.

If you have diabetes, your healthcare provider may tell you to check your blood sugar (glucose) more often during treatment with RINVOQ/RINVOQ LQ. Call your healthcare provider if you have any problems with low blood sugar.

Before taking RINVOQ/RINVOQ LQ, tell your healthcare provider about all your medical conditions, including if you:

  • have diabetes

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Hypoglycemia in Patients with Diabetes

Consider advising patients with diabetes to increase monitoring of blood glucose since hypoglycemia, including severe hypoglycemia, has been reported after starting RINVOQ/RINVOQ LQ. Advise patients with diabetes to notify their healthcare provider if they develop signs or symptoms of hypoglycemia [see Warnings and Precautions (5.8)].

10/10/2025 (SUPPL-5)

Approved Drug Label (PDF)

6 Adverse Reactions

6.1 Clinical Trials Experience

Extensive changes; please refer to label for complete information

7 Drug Interactions

7.1 Strong CYP3A4 Inhibitors

Additions and/or revisions underlined:

Upadacitinib exposure is increased when it is co-administered with a strong CYP3A4 inhibitor (such as ketoconazole, clarithromycin, and grapefruit), which may increase the risk of adverse reactions [see Clinical Pharmacology (12.3)]. Monitor patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondylarthritis, pJIA, or giant cell arteritis closely for adverse reactions when co-administering RINVOQ/RINVOQ LQ with strong CYP3A4 inhibitors. Food or drink containing grapefruit should be avoided during treatment with RINVOQ/RINVOQ LQ.

8 Use in Specific Populations

8.6 Renal Impairment

For patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, non- radiographic axial spondyloarthritis, pJIA, or giant cell arteritis no dosage adjustment is needed in patients with mild (eGFR 60 to < 90 mL/min/1.73 m2), moderate (eGFR 30 to < 60 mL/min/1.73 m2), or severe renal impairment (eGFR 15 to < 30 mL/min/1.73 m2).

8.7 Hepatic Impairment

Additions and/or revisions underlined:

For patients with rheumatoid arthritis, psoriatic arthritis, atopic dermatitis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, pJIA, or giant cell arteritis, no dosage adjustment is needed in patients with mild (Child Pugh A) or moderate (Child Pugh B) hepatic impairment.

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

Additions and/o revisions underlined:

What is RINVOQ/RINVOQ LQ?

  • RINVOQ is used to treat adults with moderate to severe ulcerative colitis when 1 or more medicines called tumor necrosis factor (TNF) blockers have been used and did not work well or could not be tolerated, or after taking a different injection or pill (systemic therapy) when your healthcare provider does not recommend TNF blockers.

  • RINVOQ is used to treat adults with moderate to severe Crohn’s disease when 1 or more medicines called tumor necrosis factor (TNF) blockers have been used and did not work well or could not be tolerated, or after taking a different injection or pill (systemic therapy) when your healthcare provider does not recommend TNF blockers.

  • RINVOQ is used to treat adults with giant cell arteritis.

What are the possible side effects of RINVOQ/RINVOQ LQ?

The most common side effects of RINVOQ in people treated for giant cell arteritis include:

  • upper respiratory tract infections (common cold, sinus infections)

  • cough

  • low red blood cell count (anemia)

  • headache

  • rash

  • tiredness

  • shingles (herpes zoster)

  • swelling of the feet and hands (peripheral edema)         

  • nausea

03/26/2025 (SUPPL-2)

Approved Drug Label (PDF)

6 Adverse Reactions

6.1 Clinical Trials Experience

Additions and/or revisions of the following underlined text to Table 7:

Adverse Reaction: Upper respiratory tract infection*

RINVOQ 15mg Once Daily: 17


Adverse Reaction: Pyrexia

Placebo: 3

RINVOQ 15mg Once Daily: 3

RINVOOQ 30mg Once Daily: 6


Adverse Reaction: Herpes zoster

RINVOQ 15mg Once Daily: 5

RINVOQ 30MG Once Daily: 6


Additions and/or revisions underlined:

. . .

Specific Adverse Reactions Serious Infections

. . .

Placebo-controlled Maintenance Study: In UC-3, serious infections were reported in 8 patients (5.9 events per 100 patient-years) treated with placebo, 9 patients (5.0 events per 100 patient- years) treated with RINVOQ 15 mg, and 8 patients (3.7 events per 100 patient-years) treated with RINVOQ 30 mg through 52 weeks.

. . .

Laboratory Abnormalities

Hepatic Transaminase Elevations

. . .
In UC-3, elevations of ALT to greater than or equal to 3 x ULN in at least one measurement were observed in 4.4% of patients treated with RINVOQ 30 mg, 2% of patients treated with RINVOQ 15 mg, and 1.2% of patients treated with placebo for 52 weeks. Elevations of AST to greater than or equal to 3 x ULN in at least one measurement were observed in 2% of patients treated with RINVOQ 30 mg, 1.6% of patients treated with RINVOQ 15 mg and 0.4% of patients treated with placebo. Elevations of ALT to greater than or equal to 5 x ULN were observed in 1.2% of patients treated with 30 mg, 0.4% of patients treated with 15 mg, and 0.4% of patients treated with placebo.

. . .

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

Addition of the following to the bulleted line listing:

. . .

The most common side effects of RINVOQ in people treated for ulcerative colitis include:

. . .

  • fever

. . .