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Drug vs. Drug

Rinvoq vs. Dupixent: Differences, similarities & side effects

Compare the side effects, costs, and indications of Dupixent and Rinvoq to find out which one is best for you
Gerardo Sison medical writer headshot
By | Jun. 6, 2024
A syringe and a pill with a "vs." between them: Rinvoq vs. Dupixent: Differences, similarities & side effects

Key takeaways

  • Rinvoq and Dupixent are prescription drugs for moderate-to-severe atopic dermatitis. However, they also have other FDA-approved uses.  

  • Rinvoq, a JAK inhibitor, is taken orally, while Dupixent, a monoclonal antibody, is administered via injection. 

  • Both drugs are effective for atopic dermatitis, but clinical trials show Rinvoq might provide better skin improvement. 

  • Common side effects of Rinvoq include infections, nausea, and acne; Dupixent’s common side effects are injection site reactions and eye problems.

In this article:

Rinvoq and Dupixent are brand-name prescription drugs that have become popular treatment options for eczema (atopic dermatitis) and other chronic inflammatory diseases. They may be especially useful when other medications have not effectively controlled symptoms such as itching, inflammation, and skin irritation. 

While both drugs share similar treatment goals, they may differ in other uses, mechanisms of action, and potential side effects. As these medications are only available with a prescription, it’s recommended to consult a healthcare provider for the most suitable medication for your condition. 

Read on to learn more about the differences and similarities between Rinvoq and Dupixent. 

Rinvoq vs. Dupixent: Key differences

The main difference between Rinvoq and Dupixent lies in their active ingredients and how they work. Rinvoq is a product of AbbVie Inc. and contains the active ingredient upadacitinib. It belongs to a class of drugs known as Janus kinase (JAK) inhibitors. By targeting JAK1, Rinvoq interferes with the function of certain substances involved in inflammation. It is available as an extended-release pill and is approved for adults and adolescents with moderate to severe atopic dermatitis. Rinvoq is typically taken as a 15- or 30-milligram (mg) tablet once daily. 

Dupixent, developed by Regeneron Pharmaceuticals, Inc., is a monoclonal antibody that blocks the signaling of two key proteins, IL-4 and IL-13, which are believed to play key roles in inflammation associated with atopic dermatitis. It is approved for use in patients ages six months and older and is administered as a subcutaneous injection. Treatment with Dupixent usually starts with two 300 mg injections, followed by one 300 mg injection every other week.

Compare Rinvoq vs. Dupixent key differences
Rinvoq Dupixent
Drug class JAK inhibitor Monoclonal antibody, interleukin-4 receptor alpha antagonist
Brand/generic status Brand Brand
What is the generic name? Upadacitinib Dupilumab
What form(s) does the drug come in? Extended-release tablet Injection under the skin
What is the standard dosage? 15 or 30 mg once daily 600 mg followed by 300 mg every 2 weeks
How long is the typical treatment? Long-term Long-term
Who typically uses the medication? Adults and children 12 years and older, depending on the indication Adults and children 6 months and older, depending on the indication 

 

Rinvoq vs. Dupixent: Conditions treated

Rinvoq and Dupixent are approved by the Food and Drug Administration (FDA) to treat atopic dermatitis. However, apart from this similarity, these drugs differ in their other approved indications. 

In addition to atopic dermatitis, Rinvoq treats different forms of arthritis, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. It is also approved to treat ulcerative colitis and Crohn’s disease, which are types of inflammatory bowel disease (IBD). Still, Rinvoq may only be prescribed after certain medications, such as TNF blockers, have been tried first. 

Dupixent’s indications, other than atopic dermatitis, are as an add-on treatment for asthma and sinus inflammation (chronic rhinosinusitis) that leads to nasal polyps. It can also treat a certain type of inflammation of the esophagus (eosinophilic esophagitis) and a chronic skin disorder called prurigo nodularis, which is characterized by itchy nodules on the skin. 

Compare conditions treated by Rinvoq vs. Dupixent
Condition Rinvoq Dupixent
Atopic dermatitis Yes Yes
Asthma No Yes
Ulcerative colitis Yes No
Crohn’s disease Yes No
Rheumatoid arthritis Yes No
Psoriatic arthritis Yes No
Ankylosing spondylitis Yes No
Non-radiographic axial spondyloarthritis Yes No
Chronic rhinosinusitis with nasal polyposis No Yes
Eosinophilic esophagitis No Yes
Prurigo nodularis No Yes

 

Is Dupixent better than Rinvoq?

Clinical trials have shown that Dupixent and Rinvoq are effective treatment options for atopic dermatitis. The better option may depend on the individual’s age and overall condition.

In a double-blind, randomized clinical trial comparing these drugs, Rinvoq (upadacitinib) was found to be more effective than Dupixent (dupilumab) in improving atopic dermatitis. After 16 weeks of treatment, 71% of patients on Rinvoq showed significant improvement in their skin condition versus 61% of those taking dupilumab. However, those on Dupixent experienced higher rates of certain infections and other adverse events, while those on dupilumab had more issues with eye irritation and injection-site reactions.

Another study followed patients with moderate-to-severe atopic dermatitis who switched from Dupixent (dupilumab) to Rinvoq (upadacitinib). It was found that those who continued with Rinvoq maintained high levels of skin and itch improvement. However, patients who switched from Dupixent to Rinvoq experienced additional improvements in their skin condition within just four weeks. Most patients who didn’t respond well to Dupixent showed better results with Rinvoq, and the safety of Rinvoq over 40 weeks was consistent with previous studies, showing no new safety concerns.

Always consult a healthcare provider to determine the most appropriate treatment option for your condition. 

Rinvoq vs. Dupixent: Insurance coverage and cost comparison

Most insurance plans typically cover Rinvoq and Dupixent. However, the extent of coverage can vary based on the specifics of your health plan. Medicare Part D coverage for these drugs may also differ and should be confirmed with your insurance provider. Rinvoq, being a newer treatment, may have lower coverage rates across different plans than Dupixent.

The average retail cost of Rinvoq and Dupixent without insurance can vary widely, but with discounts or assistance programs, the price may be reduced. A one-month supply of Rinvoq without insurance may cost around $8,000, while a one-month supply of Dupixent without insurance is around $5,000. Using a SingleCare discount card may help offset the out-of-pocket costs of these medications. 

Compare coverage & cost of Rinvoq vs. Dupixent
Rinvoq Dupixent
Typically covered by insurance? Yes Yes
Typically covered by Medicare Part D? Yes Yes
Quantity 30, 15 mg tablets 2, 2 ml of 300 mg/2 ml pens
Average retail price $8,291 $5,139
SingleCare cost $5,900 $3,603

 

Dupixent vs. Rinvoq side effects

Dupixent and Rinvoq carry a risk of various side effects. The types of side effects and their severity can depend on the medication and dosage. 

The most common side effects of Rinvoq include upper respiratory infections, such as the common cold, nausea, acne, headache, cough, fatigue, weight gain, muscle pain, and fever. On the other hand, the most common side effects of Dupixent include injection site reactions, which can cause redness, swelling, itching, and joint pain. Dupixent can also cause eye problems, such as inflammation, redness, itching, and dryness in the eyes. 

RELATED: Dupixent face rash and redness: Causes and treatment

Both medications have been linked to an increased risk of herpes simplex virus reactivation, which includes cold sores and herpes keratitis, particularly in individuals who carry the virus. Both medications can also lead to serious, although less frequent, side effects. For example, Rinvoq may increase the risk of serious infections, while Dupixent has been linked to severe allergic reactions.

Compare side effects of Rinvoq vs. Dupixent
Rinvoq Dupixent
Side effect Applicable? Frequency Applicable? Frequency
Upper respiratory tract infections Yes 23% Yes 18%
Injection site reactions No – Yes 10%
Joint pain No – Yes 2%
Headache Yes 6% No –
Acne Yes 10% No –
Herpes Yes 4% Yes 2%-4%
Pink eye No – Yes 10%
Dry eye No – Yes <1%
Eye itching No – Yes 1%
Cough Yes 3% No –
Nausea Yes 3% No –
Stomach pain Yes 3% No –
Fever Yes 2% No –
Weight gain Yes 2% No –
Muscle pain Yes 1% Yes 3%
Fatigue Yes 1% No –
Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.
Source: DailyMed (Rinvoq), DailyMed (Dupixent)

Rinvoq and Dupixent drug interactions

Rinvoq is mainly metabolized or processed in the liver by CYP3A4 enzymes. Taking Rinvoq with other medications that can block or increase the activity of these enzymes may increase Rinvoq blood levels, leading to increased side effects or decreasing its effectiveness. Medications that can affect the metabolism of Rinvoq include certain antibiotics, antifungals, antivirals, and anticonvulsants, among others.

Dupixent may have the potential to interact with certain substances that are metabolized by the CYP3A4 enzymes, such as warfarin and cyclosporine. However, some studies indicate that taking Dupixent with other medications metabolized by these liver enzymes has no significant effects. Caution may be recommended while taking certain drugs.

As Rinvoq and Dupixent can dampen certain signals of inflammation in the immune system, it’s recommended to avoid live vaccines right before and during treatment. Always consult a healthcare provider before starting treatment if you take other medications, including over-the-counter medicines, prescription drugs, and herbal supplements. 

RELATED: Important information about Dupixent and vaccines

Compare Rinvoq vs. Dupixent drug interactions
Drug Drug Class Rinvoq Dupixent
Biaxin (clarithromycin) 

Ketek (telithromycin) 

Erythrocin (erythromycin)

Rifadin (rifampin)

 Antibiotic Yes No
Nizoral (ketoconazole) 

Sporanox (itraconazole) 

Vfend (voriconazole) 

Noxafil (posaconazole)

 Antifungal Yes No
Cardizem (diltiazem) 

Calan (verapamil)

 Calcium channel blocker Yes No
Norvir (ritonavir) 

Prezista (darunavir) 

Reyataz (atazanavir)

 Antiviral Yes No
Tegretol (carbamazepine) 

Dilantin (phenytoin) 

Luminal (phenobarbital)

 Anticonvulsant Yes No
St. John’s wort  Herbal supplement Yes No
MMR (Measles, Mumps, Rubella) 

Varivax (Varicella) 

Rotarix (Rotavirus) 

Zostavax (Herpes Zoster)

 Live vaccines Yes Yes
Consult a healthcare professional for other possible drug interactions.

Rinvoq and Dupixent drug warnings

Various warnings are associated with Rinvoq and Dupixent, as they each come with their own set of risk factors for serious side effects.

People taking Rinvoq may be at an increased risk of serious infections, such as bacterial, viral, and fungal infections. They also face an increased risk of thrombosis or blood clots, including deep vein thrombosis, pulmonary embolism, and arterial thrombosis. The medication carries warnings related to malignancies, including reports of lymphoma and lung cancer, and the potential for major adverse cardiovascular events, such as heart attacks and strokes. 

Dupixent carries warnings mainly related to hypersensitivity reactions, which could develop as a severe allergic reaction requiring medical attention. Eye problems, including conjunctivitis and keratitis, have been reported, especially in people with predisposed conditions.

It is unknown whether Rinvoq or Dupixent can harm an unborn baby. Therefore, they should only be used during pregnancy if the potential benefits outweigh the potential risks. Consult a healthcare provider if you are pregnant or breastfeeding before starting treatment.