What Can I Take Instead of Rinvoq? Exploring Your Medication Options

October 11, 2025 •

4 min read

Janus kinase (JAK) inhibitors are a growing class of medications used to treat various autoimmune disorders [1.4.2]. If you're currently taking Rinvoq and wondering, 'What can I take instead of Rinvoq?', there are several advanced treatment options available to discuss with your doctor.

Quick Summary

This overview details potential alternatives to Rinvoq (upadacitinib), covering other oral JAK inhibitors like Xeljanz and Olumiant, as well as injectable biologics such as TNF inhibitors (Humira) and IL inhibitors (Dupixent, Skyrizi).

Key Points

Diverse Options: Many alternatives to Rinvoq exist, primarily other oral JAK inhibitors (like Xeljanz) and injectable biologics (like Humira, Dupixent, and Skyrizi) [1.2.2].
Different Mechanisms: JAK inhibitors work inside cells to block inflammation signals, while biologics target specific inflammatory proteins outside of cells [1.3.6].
Administration Varies: A key difference is administration; JAK inhibitors are oral pills, while most biologics are self-injected or given as an IV infusion [1.3.2].
Reasons to Switch: Patients may consider switching due to lack of efficacy, managing side effects, cost, or a preference for a different treatment type [1.6.1, 1.6.5].
Boxed Warnings: Rinvoq and other JAK inhibitors carry an FDA-mandated boxed warning for increased risks of serious infections, blood clots, cardiovascular events, and cancer [1.4.3].
Medical Supervision is Essential: Changing medications requires careful planning and supervision from a healthcare professional to ensure safety and continuity of care [1.6.2].
Personalized Treatment: The best alternative depends on the specific autoimmune condition, a patient's health history, and response to previous treatments [1.3.9].

Rinvoq (upadacitinib) is an oral medication known as a Janus kinase (JAK) inhibitor. It works inside cells to disrupt signals that cause inflammation and is approved to treat several autoimmune conditions, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), atopic dermatitis (eczema), and Crohn's disease [1.2.7, 1.3.6]. While effective for many, it may not be the right fit for everyone. This article explores the various alternatives available, but it is crucial to consult with a healthcare professional before making any changes to your treatment plan.

Why Consider an Alternative to Rinvoq?

A decision to switch from Rinvoq can stem from several factors. Patients and their doctors may explore other options due to [1.6.1, 1.6.4, 1.6.5, 1.6.6]:

Lack of Efficacy: The medication may not provide adequate symptom relief or may lose effectiveness over time [1.6.5].
Side Effects: While many people tolerate Rinvoq well, common side effects include upper respiratory tract infections, nausea, cough, and acne [1.6.7]. More serious risks, noted in a boxed warning from the FDA, include serious infections, blood clots, certain cancers, and major cardiovascular events [1.4.3, 1.6.9].
Cost and Insurance Coverage: Accessibility and cost can be significant barriers for some patients, influencing the choice of medication [1.6.3, 1.6.6].
Personal Preference: Some individuals may prefer a different administration method (e.g., a less frequent injection over a daily pill) or have other health conditions that make an alternative a better choice [1.3.1].

Understanding the Main Classes of Alternatives

Alternatives to Rinvoq generally fall into two main categories: other JAK inhibitors and a broad class of drugs called biologics [1.3.2].

JAK Inhibitors: These are small-molecule drugs taken orally, similar to Rinvoq. They work by blocking specific JAK enzymes inside immune cells to interrupt inflammatory signaling [1.3.3].
Biologics: These are larger, complex proteins derived from living sources [1.3.1]. Unlike JAK inhibitors that work inside the cell, biologics typically work outside the cells by targeting specific proteins involved in the inflammatory process, such as Tumor Necrosis Factor (TNF) or interleukins (IL) [1.3.3, 1.3.6]. They are usually administered via injection or intravenous (IV) infusion [1.3.2].

Direct Alternatives: Other Oral JAK Inhibitors

If an oral daily pill is preferred, other JAK inhibitors might be considered. These medications share a similar mechanism of action to Rinvoq but have differences in their specific targets, approved uses, and side effect profiles [1.4.2].

Xeljanz (tofacitinib): Approved for RA, PsA, and ulcerative colitis, Xeljanz is taken once or twice daily. It has similar serious warnings to Rinvoq [1.2.7, 1.4.4].
Olumiant (baricitinib): Used for RA and alopecia areata, Olumiant is a once-daily pill [1.4.2, 1.4.7].
Cibinqo (abrocitinib): Specifically approved for atopic dermatitis, Cibinqo is a once-daily oral tablet [1.4.2].

Broader Alternatives: Biologic DMARDs

Biologics represent an older, more established class of advanced treatment for autoimmune diseases [1.3.2]. They are often recommended before trying a JAK inhibitor [1.4.6]. They are categorized by the specific inflammatory pathway they block.

Tumor Necrosis Factor (TNF) Inhibitors

TNF-alpha is a key protein that drives inflammation. TNF inhibitors were among the first biologics and are widely used [1.2.5].

Humira (adalimumab): Treats a wide range of conditions, including RA, PsA, and Crohn's disease. It is typically injected every other week [1.5.5].
Enbrel (etanercept): Used for RA and PsA, Enbrel is usually injected once a week [1.5.2].
Remicade (infliximab): Administered as an IV infusion, Remicade is used for similar conditions [1.2.5].

Interleukin (IL) Inhibitors

This class of biologics targets various interleukins, which are proteins (cytokines) that signal between immune cells [1.2.5].

Dupixent (dupilumab): A primary treatment for atopic dermatitis and asthma, Dupixent works by blocking IL-4 and IL-13. It is given as an injection every two weeks [1.5.1, 1.5.4].
Skyrizi (risankizumab): Used for PsA, plaque psoriasis, and Crohn's disease, Skyrizi targets IL-23 and is administered as an injection every 2 to 3 months after initial doses [1.2.3, 1.5.5].
Cosentyx (secukinumab): An IL-17 inhibitor used for PsA and plaque psoriasis [1.2.5].

Comparison Table: Rinvoq vs. Key Alternatives


Medication (Generic)	Drug Class	Administration	Commonly Treated Conditions	Key Consideration
Rinvoq (upadacitinib)	JAK Inhibitor	Oral tablet, once daily [1.2.7]	RA, PsA, Atopic Dermatitis, Crohn's [1.4.9]	Boxed warning for serious infections, clots, cardiovascular events, and cancer [1.4.3].
Xeljanz (tofacitinib)	JAK Inhibitor	Oral tablet, 1-2 times daily [1.2.7]	RA, PsA, Ulcerative Colitis [1.2.7]	Shares the same boxed warnings as Rinvoq [1.4.3].
Humira (adalimumab)	Biologic (TNF Inhibitor)	Subcutaneous injection, every 2 weeks [1.5.5]	RA, PsA, Crohn's, Plaque Psoriasis [1.5.5]	Risk of serious infections; biosimilars are available [1.5.5].
Dupixent (dupilumab)	Biologic (IL-4/IL-13 Inhibitor)	Subcutaneous injection, every 2 weeks [1.5.1]	Atopic Dermatitis, Asthma [1.5.1]	Common side effects include injection site reactions and eye issues [1.5.4].
Skyrizi (risankizumab)	Biologic (IL-23 Inhibitor)	Subcutaneous injection, every 2-3 months [1.2.3]	PsA, Crohn's, Plaque Psoriasis [1.2.3]	Less frequent dosing schedule after initiation [1.2.3].

Making the Switch: A Doctor-Guided Process

Switching from Rinvoq to another advanced therapy must be managed by a healthcare provider. The process is highly individualized and depends on the reason for the change (e.g., side effects vs. lack of efficacy) [1.6.1]. Your doctor will consider your specific health profile, the medications' mechanisms, and potential risks. In some cases, a 'washout period'—a break between stopping one drug and starting another—may be necessary to prevent adverse interactions.

Conclusion

For individuals seeking an alternative to Rinvoq, a diverse landscape of effective treatments exists. Options range from other oral JAK inhibitors like Xeljanz and Olumiant to a variety of injectable biologics that target different inflammatory pathways, such as TNF inhibitors (Humira, Enbrel) and IL inhibitors (Dupixent, Skyrizi). The choice between a daily pill and an injection, the specific condition being treated, side effect profiles, and insurance coverage are all critical factors in the decision-making process [1.3.1]. The most important step is an open conversation with your rheumatologist or dermatologist to determine the safest and most effective path forward for your health.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment. For more information on drug safety, you can visit the FDA's Drug Safety and Availability page.

Frequently Asked Questions

The main differences are their drug class and how they are administered. Rinvoq is an oral, once-daily JAK inhibitor that works inside cells [1.3.6]. Humira is a biologic TNF inhibitor given as a subcutaneous injection, typically every other week, that works outside of cells [1.5.5].

No, there are no over-the-counter (OTC) alternatives to Rinvoq. Rinvoq and its alternatives, like biologics and other JAK inhibitors, are potent prescription medications for treating autoimmune diseases. While OTC NSAIDs like ibuprofen may help with mild symptoms, they do not modify the disease course [1.2.5].

Xeljanz (tofacitinib) can be a good alternative as it is also an oral JAK inhibitor used for similar conditions like rheumatoid arthritis and psoriatic arthritis [1.2.7]. The choice between them depends on factors like your specific condition, health history, and insurance coverage, and should be discussed with your doctor. Both carry similar boxed warnings for serious side effects [1.4.3].

JAK inhibitors (like Rinvoq) are small-molecule drugs made from chemicals that are taken orally and work inside cells to block inflammatory signals [1.3.1]. Biologics (like Humira or Dupixent) are large, complex proteins made from living sources that are injected or infused and work by targeting specific inflammatory molecules outside of cells [1.3.1, 1.3.3].

You should not stop taking Rinvoq or any prescription medication without consulting your healthcare provider. Abruptly stopping can lead to a flare-up of your condition's symptoms. Your doctor can provide guidance on how to safely discontinue or switch your medication [1.6.4].

Often, biologics like TNF inhibitors are recommended as the first-choice advanced treatment after conventional DMARDs fail, largely because there is more long-term safety and efficacy data available [1.3.8, 1.4.6]. JAK inhibitors are often considered if biologics are not effective or tolerated [1.4.6].

While lifestyle changes like an anti-inflammatory diet (such as the Mediterranean diet), exercise like yoga or tai chi, and supplements like curcumin may help manage symptoms of inflammatory conditions, they are not direct alternatives to powerful medications like Rinvoq [1.2.5]. These approaches should be considered complementary and discussed with your doctor.