Overview
Upadacitinib is a selective JAK1 inhibitor taken as a once-daily oral tablet. Compared to tofacitinib, its selectivity for JAK1 aims to provide efficacy while reducing off-target effects. It is approved for moderate-to-severe Crohn's disease and ulcerative colitis.
Key Uses
Moderate-to-severe Crohn's disease
Moderate-to-severe ulcerative colitis
Patients who have failed conventional therapy or biologics
Also approved for rheumatoid arthritis, atopic dermatitis, and ankylosing spondylitis
How It Works
Selectively inhibits JAK1, blocking signalling of key pro-inflammatory cytokines (IL-6, IL-12, IL-23, interferons)
Oral once-daily tablet: 45 mg daily for 12 weeks (induction), then 15 or 30 mg daily (maintenance)
Rapid onset — meaningful response often within 2–4 weeks
Safety & Self-Care
Risk of herpes zoster — discuss varicella vaccine before starting
Regular blood tests: CBC, lipids, liver enzymes, creatinine
Avoid in patients with high cardiovascular risk or history of DVT/PE
Do not take with strong CYP3A4 inducers (e.g. rifampicin) or inhibitors (e.g. ketoconazole)
Avoid live vaccines; maintain inactivated vaccine schedule
Women of childbearing age should use effective contraception during and for 4 weeks after treatment
Contact Your IMCC Team
Contact your IMCC team if you develop a rash or blisters (possible shingles), leg or chest symptoms, unusual infections, or if you are considering pregnancy.
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