Does Rinvoq (upadacitinib) cause dysgeusia (metallic taste)?

From the Guidelines

Rinvoq (upadacitinib) can potentially cause a metallic taste in the mouth, though this is not listed among its most common side effects. Some patients taking Rinvoq have reported experiencing taste disturbances, including metallic taste (dysgeusia), as an adverse reaction to the medication. Rinvoq is a Janus kinase (JAK) inhibitor used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and atopic dermatitis. The mechanism behind this side effect likely relates to how JAK inhibitors affect signaling pathways that may influence taste perception. If you experience a persistent metallic taste while taking Rinvoq, you should report this symptom to your healthcare provider. They can evaluate whether this side effect is tolerable or if adjustments to your treatment plan are needed. Do not stop taking Rinvoq without consulting your healthcare provider, as the benefits of controlling your underlying condition typically outweigh this side effect. Staying well-hydrated, practicing good oral hygiene, and using sugar-free mints or gum may help temporarily manage the metallic taste sensation.

Key Points to Consider

• The provided evidence does not directly address the incidence of dysgeusia in patients taking Rinvoq 1.
• However, it is known that JAK inhibitors, including upadacitinib, can cause various side effects due to their mechanism of action 1.
• The management of side effects, including those not commonly listed, is crucial for maintaining patient quality of life while on treatment with medications like Rinvoq.
• Regular monitoring and open communication with healthcare providers can help manage any adverse reactions, including taste disturbances 1.

Management and Monitoring

• Patients experiencing metallic taste or any other side effects while on Rinvoq should consult their healthcare provider for evaluation and guidance.
• The provider may consider adjustments to the treatment plan or offer strategies to manage the side effects, balancing the benefits of the medication against its adverse effects 1.
• Given the potential for serious side effects with JAK inhibitors, careful monitoring and patient education are essential components of treatment with these medications 1.

From the Research

Dysgeusia and Metallic Taste

• Dysgeusia, a taste disturbance, is a common side effect of various medications, including antimicrobial and anti-inflammatory drugs 2, 3.
• Some medications can cause a metallic taste, which is often described as bitter, metallic, and/or sour 2, 4.
• The sensation of metallic taste can be influenced by factors such as age, sex, and drug plasma and saliva levels 4.

Medications and Taste Disorders

• Hundreds of drugs have been reported to induce unpleasant tastes and/or odors, including altered chemosensations when administered alone or in combination with other medications 3.
• Drug-induced taste disorders are reported in all drug categories, but predominantly in "antineoplastic and immunomodulating agents," "antiinfectives for systemic use," and "nervous system" 5.
• Some specific medications, such as eszopiclone and topical fluorouracil, have been associated with dysgeusia and metallic taste 4, 6.

Rinvoq (Upadacitinib) and Dysgeusia

• There is no direct evidence in the provided studies that specifically links Rinvoq (upadacitinib) to dysgeusia or metallic taste.
• However, as a medication, it is possible that Rinvoq (upadacitinib) may cause taste disorders as an adverse effect, similar to other medications 2, 3, 5.