Does Rinvoq (upadacitinib) cause dry mouth?

Dry Mouth (Xerostomia) Associated with Rinvoq (Upadacitinib)

Rinvoq (upadacitinib) is not specifically known to cause dry mouth as a common side effect based on the available evidence.

Mechanism and Causation

• Dry mouth (xerostomia) is a common side effect of many medications, particularly those with anticholinergic properties that block muscarinic receptors, including tricyclic antidepressants, antihistamines, and certain antipsychotics 1
• Medications commonly associated with dry mouth include anticholinergics, bupropion, stimulants, beta-blockers, and opioids 1
• JAK inhibitors like Rinvoq (upadacitinib) are not specifically listed among medication classes known to commonly cause dry mouth 1, 2

Clinical Significance and Assessment

• Dry mouth can significantly impact quality of life, causing oral discomfort, difficulty swallowing, decreased taste sensation, and increased risk of dental complications 2
• When a patient on Rinvoq reports dry mouth, it's important to consider other potential causes:
  • Concomitant medications with known xerogenic effects 2, 3
  • Dehydration, which can exacerbate dry mouth symptoms 1
  • Underlying conditions such as Sjögren's syndrome or sicca syndrome 4

Management Strategies for Medication-Associated Dry Mouth

• For mild dry mouth symptoms, regardless of cause, the following approaches are recommended:

  • Dietary modifications and improved hydration with limited caffeine intake 4, 1
  • Topical measures including water sips, saliva substitutes, and moisture-preserving mouth rinses or sprays 4, 1
  • Salivary stimulants such as sugarless chewing gum, lozenges, or candy 4

• For moderate to severe dry mouth that significantly impacts quality of life:

  • Consider systemic sialagogues such as cevimeline or pilocarpine if appropriate 4
  • Dental referral to ensure adequate hygiene and protect against the risk of dental caries 4
  • If dry mouth is severe and persistent despite management, consider medication review to identify and potentially modify other contributing medications 2, 3

Important Considerations

• Dry mouth from medication use is often underreported and can have significant impact on oral health and quality of life 3
• Nearly two-thirds of commonly prescribed medications can cause dry mouth, but warnings about this adverse effect are not always readily available to healthcare providers 3
• If a patient on Rinvoq develops significant dry mouth, consider a comprehensive medication review to identify other potential causative agents 2, 3
• Good oral hygiene practices are essential for patients experiencing dry mouth to prevent dental complications 2

Monitoring and Follow-up

• Regular dental check-ups are important for patients experiencing chronic dry mouth to monitor for dental caries and other oral complications 4, 2
• If dry mouth persists despite management strategies and significantly impacts quality of life, further evaluation for underlying causes may be warranted 4, 2