tofacitinib vs upadacitinib
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of tofacitinib and upadacitinib. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Xeljanz
Rinvoq
Xeljanz is a medicine that reduces inflammation in your body. It is used to treat conditions like arthritis and ulcerative colitis.
Rinvoq contains upadacitinib and it is a medicine that reduces inflammation in your body. It is used to treat several conditions, including arthritis and Crohn's disease.
Xeljanz treats rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and ulcerative colitis in adults. It is also used to treat psoriatic arthritis and juvenile idiopathic arthritis in children 2 years and older. It is for people who have not responded well to TNF blockers. Do not use Xeljanz with other strong immunosuppressants.
Rinvoq can treat rheumatoid arthritis, psoriatic arthritis, atopic dermatitis (eczema), ulcerative colitis, Crohn’s disease, ankylosing spondylitis, non-radiographic axial spondyloarthritis, polyarticular juvenile idiopathic arthritis, and giant cell arteritis. It is used when other medicines, like TNF blockers, have not worked well enough. For ulcerative colitis and Crohn's disease, you should have tried at least one other approved medicine before using Rinvoq if TNF blockers are not suitable for you.
Xeljanz is a JAK inhibitor. It works by blocking certain enzymes in your body. These enzymes cause inflammation, so blocking them helps to reduce swelling and pain.
Rinvoq is a JAK inhibitor. It works by blocking certain enzymes in your body called Janus kinases (JAKs). By blocking these enzymes, Rinvoq helps to reduce inflammation and relieve symptoms of the conditions it treats.
- • Upper respiratory tract infection (like a cold)
- • Runny nose
- • Diarrhea
- • Headache
- • Increased cholesterol levels
- • Upper respiratory tract infections (like a cold)
- • Acne
- • Herpes simplex (cold sores)
- • Headache
- • Increased blood creatine phosphokinase
- Pain 25,737
- Arthralgia 19,670
- Condition Aggravated 19,467
- Rheumatoid Arthritis 18,797
- Fatigue 16,595
- Pain 4,942
- Arthralgia 4,342
- Covid-19 3,131
- Rheumatoid Arthritis 3,037
- Pain In Extremity 2,575
Xeljanz can increase your risk of serious infections, which could lead to hospitalization or death. It may also increase your risk of blood clots, cancer, and heart problems. Talk to your doctor about these risks before taking Xeljanz.
Rinvoq can cause serious side effects, including serious infections, cancer, blood clots, major heart problems, and death. Your doctor will check you for tuberculosis before you start Rinvoq. Tell your doctor if you have any symptoms of infection, such as fever, cough, or fatigue. If you have a heart attack or stroke, stop taking Rinvoq.
It is not known if Xeljanz will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. You should not breastfeed while taking Xeljanz.
Rinvoq may harm your unborn baby. You should use effective birth control while taking Rinvoq and for some time after your last dose. Talk to your doctor if you are pregnant or plan to become pregnant. Do not breastfeed while taking Rinvoq.
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How to Read This tofacitinib vs upadacitinib Comparison
tofacitinib is classified in the JAK Inhibitor drug class, while upadacitinib sits within the JAK Inhibitor class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, tofacitinib has 100,266 submissions while upadacitinib has 18,027. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for tofacitinib or upadacitinib.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.