Drug interactions of Upadacitinib

1.Strong CYP3A4 Inhibitors 

Upadacitinib exposure is increased when Upadacitinib is co-administered with a strong CYP3A4 inhibitor (such as ketoconazole, clarithromycin, and grapefruit), which may increase the risk of RINVOQ adverse reactions. Monitor patients closely for adverse reactions when co-administering Upadacitinib 15 mg once daily with strong CYP3A4 inhibitors. Food or drink containing grapefruit should be avoided during treatment with Upadacitinib.

For patients with atopic dermatitis, coadministration of Upadacitinib 30 mg once daily with strong CYP3A4 inhibitors is not recommended. 

For patients with ulcerative colitis taking strong CYP3A4 inhibitors, reduce the Upadacitinib induction dosage to 30 mg once daily. The recommended maintenance dosage is 15 mg once daily. 

2.Strong CYP3A4 Inducers 

Upadacitinib exposure is decreased when Upadacitinib is co-administered with strong CYP3A4 inducers (such as rifampin), which may lead to reduced therapeutic effect of Upadacitinib. Coadministration of Upadacitinib with strong CYP3A4 inducers is not recommended. 

from FDA，2023.04