Upadacitinib can make it harder for your body to fight infections. Therefore, if you have a fever, think you may have an infection or have been prescribed an antibiotic, contact your healthcare provider immediately.
Also, contact your prescriber if you are having surgery, as you may need to stop upadacitinib until you are healed and there is no sign of infection.
Before taking upadacitinib, tell your healthcare provider if you are pregnant or planning to become pregnant or are breastfeeding or planning to breastfeed. Currently there are no studies to assess the use of upadacitinib during pregnancy and breastfeeding. Your healthcare provider will discuss the risks and benefits of taking upadacitinib while you are pregnant.
Upadacitinib may increase your risk of developing shingles. Ideally, all your vaccinations, including the singles vaccine should be up to date prior to starting upadacitinib. If you have already started therapy with upadacitinib, most inactive vaccines are recommended (i.e. influenza, pneumococcal). Live vaccines are not recommended due to risk of causing infection. Please speak with your healthcare providers about vaccinations before starting upadacitinib.
Anyone who has had a previous allergic reaction to upadacitinib should avoid the medication.
Upadacitinib interacts with a number of other medications. Please speak with your healthcare provider about whether any of the other medications you currently take interact with upadacitinib. It is also recommended that you avoid grapefruit juice and St. John’s Wort while taking upadacitinib.
Your body may harbour the bacteria that can cause tuberculosis (TB) if you have been exposed to TB in the past. You may not know you are carrying TB as the bacteria remain in an inactive state and cause no symptoms. This is known as latent TB infection (LTBI). People with LTBI are not infectious and cannot spread TB to others. Upadacitinib can increase the risk of reactivation of LTBI. Prior to starting upadacitinib therapy, your prescriber will screen for LTBI. If you test positive, you will be required to take an anti-TB medication prior to starting upadacitinib. Please speak with your healthcare provider about LTBI screening before starting upadacitinib.
Upadacitinib has been rarely associated with a small increased risk of developing certain types of cancer. Proof of a link between upadacitinib and the development of cancer is difficult as people with inflammatory arthritis are generally at a higher risk of developing certain cancers, as compared to the general population. The role of upadacitinib in the development of cancer is currently unknown. Please speak with your healthcare provider if you have any questions.
If you are starting this medication and are a current or past smoker, or have had a heart attack, other heart problems, known malignancy or cancer, stroke, or blood clots in the past, you should ensure your doctor is aware of the risks factors you have and discuss the risks and benefits of this treatment. These factors may put you at higher risk for serious problems with this medication. It is important that your doctor is aware if you have any of these risk factors if you are starting this medication.
If you are unsure whether your doctor is aware of these risk factors you may have, you should contact your doctor and make an appointment to discuss these risk factors as well as the risks and benefits of using this medication.