Upadacitinib 15 mg tablet (Rematib)

Upadacitinib 15 mg tablet (Rematib) is an oral medication approved for treating autoimmune conditions like rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and atopic dermatitis. It was approved for patients who did not respond well to other treatments. It works by selectively inhibiting Janus kinase (JAK1), an enzyme involved in inflammation signaling, helping reduce pain and swelling. In Bangladesh, Ramatib (Upadacitinib) is available through authorized pharmaceutical distributors and hospital pharmacies.

What is upadacitinib used for?

Upadacitinib tablet received FDA approval in May 2023 for the following indications

• Adults with moderately to severely active rheumatoid arthritis who do not have a sufficient response to one or more TNF blockers. 
• Adults with active psoriatic arthritis who do not have an adequate response to one or more TNF blockers.
• Adults and children patients 12 years of age and older with refractory, moderate to severe atopic dermatitis, whose disease is not adequately controlled with other systemic drug products, including biologics

Not recommended for use in combination with other JAK inhibitors, biologic DMARDs, or potent immunosuppressants such as azathioprine and cyclosporine.

How does Upadacitinib 15 mg work?

Rematib 15 mg works by blocking an enzyme called Janus kinase 1 (JAK1), which sends signals that cause inflammation in the body. Reducing these signals, it helps decrease pain, swelling, and tissue damage in autoimmune conditions like arthritis, eczema, and inflammatory bowel diseases.

Dosage and Administration Guidelines for Upadacitinib

For Rheumatoid Arthritis and Psoriatic Arthritis

15 mg daily once in adult patients with or without food as a whole tablet without splitting or crushing it.

To treat Atopic dermatitis

The recommended dose is 15 mg daily for pediatric patients aged 12 years or older that, at least 40 kg. If the therapeutic response is not reached dose can be increased by 30 mg daily once. Even after that, if a therapeutic response is not received, patients should discontinue taking Rematib.

Dose for Alopecia Areata

The initial dose is 30 mg daily by mouth for 12 weeks or until disease progression. Dose can be modified or continued as 30 mg with your doctor’s permission. To treat eczema, the initial dose is 30 mg daily by mouth for 8 weeks or until disease progression.

Dose for Ulcerative Colitis

To treat ulcerative colitis, the recommended dose is 45 mg daily by mouth for 8 weeks. If anything severe happens, consider 30 mg daily or consult with your doctor.

Dose for Ankylosing Spondylitis

Take 15 mg daily by mouth to treat those patients who have had an inadequate response or intolerance to ≥1 TNF blocker.

What are the common and adverse side effects of Upadacitinib 15 mg?

Rematib 15 mg tablet (Upadacitinib) can cause some mild to serious side effects in patients with or without pre-existing critical health conditions. The chance of getting serious side effects is high for pre-existing critical medical conditions. Let’s have a look at some common and serious side effects that are being seen in the patients:

Common Side Effects

1. Upper respiratory infections (e.g., sinus infections, the common cold)
2. Headache
3. Nausea
4. Increased blood pressure
5. Fatigue or tiredness
6. Acne
7. Elevated liver enzymes (which may indicate liver issues)
8. Diarrhea

Serious Side Effects 

1. Infections: Chemical substances in the medication can increase the risk of tuberculosis, bacterial, fungal, or viral infections (including shingles).
2. Blood Clots: Blood clot problems like deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke can happen, especially in patients who have had blood clot problems before.
3. Heart Problems: This drug can cause heart problems like heart attack, heart failure, and heart-related problems.
4. Cancer: There is a risk of cancers like lymphoma and other malignancies due to immune suppression.
5. Liver problems: If liver problems occur, you may see the signs like yellow eyes or skin, dark urine, and stomach pain. This is a rare case, but there is a possibility that it can happen.
6. Low blood cell counts: Due to immune suppression, this drug can cause low white blood cells, low red blood cells, and lower platelets. Because of these, you may face infection in the injuries, anemia, and an increased risk of bleeding.
7. Gastrointestinal issues: It can also cause Inflammatory Bowel Disease (IBD). And the symptoms of this disease are abdominal pain, diarrhea, or blood in the stool.
8. Raised cholesterol levels: Your cholesterol level may increase. Be aware of this by monitoring your cholesterol level.

Warnings and Precautions

• This medicine is not recommended for those patients who have pre-existing infections, liver problems, kidney problems, or heart problems.
• Pregnancy and breastfeeding: In case of breastfeeding and pregnant women, it should be used with caution and only the doctor’s allows it. Otherwise, if you are planning to get pregnant, better you avoid this medicine. Or complete the treatment first and wait for your doctor’s approval.

• Inform your doctor if you feel any side effects that you can not tolerate anymore.
• The medicine may cause interstitial lung disease or pneumonitis. These are life-threatening conditions and need immediate medical action.
• Stop taking alcohol and smoking, these damage your lungs and strengthen cancer cells to spread to other parts of the body.
• Make a balanced diet and a healthy daily routine to keep yourself mentally and physically strong. You can also meditate. It keeps your mind fresh and strong and increases your fighting capability in any odd situation.
• Tell your doctor right away if you have liver disease, kidney disease, a heart problem, or if you have had a stroke before.
• Tell your doctor if you are taking any antibiotic, vitamin, or other medicine that interacts with this drug.

What Makes Rematib (Upadacitinib) a Reliable Option? 

There are some factors for which you can choose Rematib  over other branded medicines, like

• It is generally well-tolerated based on patient experience reports and physician feedback.
• It is prescribed in several countries as part of standard treatment protocols for autoimmune conditions. 
• The cost-effectiveness is better than other brands, with more positive user experiences.

Storage

Store Rematib 15 mg package below 25 degrees C away from direct sunlight and children.

Frequently Asked Questions About Upadacitinib

Disclaimer: Information above is not for use as a medical advice alternative; always consult your doctor before taking any prescription medicines.