Abametapir and Upadacitinib: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jun 30, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abametapir
No brand names on recordUpadacitinib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Abametapir is a lotion used to treat head lice. Even though you rub it on your scalp, some of it gets into your body and can briefly block a liver enzyme (called CYP3A4) that helps break down other medicines.
Upadacitinib (Rinvoq) is cleared partly by that same enzyme. So after using abametapir, your body may clear Rinvoq more slowly, meaning more of it builds up. That could raise your chance of side effects like infections. The good news is this is easy to manage: your care team can space out the two treatments so they do not overlap. Talk with your pharmacist or doctor before using both.
Effect: Increased upadacitinib exposure. Mechanism: Abametapir inhibits CYP3A4; upadacitinib is a partial CYP3A4 substrate, so inhibition reduces its metabolism and increases AUC/Cmax.
- Direction: Increased upadacitinib effect and toxicity risk (e.g., infection, cytopenias).
- Onset: Rapid; inhibition may persist and warrants a 2-week separation.
- Evidence: Theoretical, based on abametapir's known CYP3A4 inhibition.
- Management: Avoid CYP3A4 substrates, including upadacitinib, for 2 weeks after abametapir application. If unavoidable, avoid using abametapir.
Neither is a prodrug requiring CYP3A4 activation, so the effect is additive exposure, not loss of efficacy.
What happens
Increased exposure of CYP3A4 substrate
Interaction Deep Dive
For a period of 2 weeks following abametapir application, refrain from using CYP3A4 substrates. When such avoidance cannot be achieved, do not use abametapir instead1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism by abametapir
How to manage this interaction
This interaction is manageable mainly by keeping the two treatments separated in time.
- The usual approach is to avoid CYP3A4 substrates, including upadacitinib (Rinvoq), for 2 weeks after applying abametapir lice lotion.
- If separating them is not possible, the alternative is to avoid using abametapir and choose a different lice treatment.
- Keep taking your Rinvoq as prescribed, and do not stop it on your own.
- Before using abametapir, tell your pharmacist or prescriber you take Rinvoq so they can help you plan the timing or pick an alternative.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abametapir and Upadacitinib together?
Abametapir can briefly raise upadacitinib (Rinvoq) levels, so avoid Rinvoq for 2 weeks after using abametapir, or skip abametapir; check with your pharmacist to plan timing. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abametapir and Upadacitinib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Abametapir and Upadacitinib interaction managed?
This interaction is manageable mainly by keeping the two treatments separated in time. The usual approach is to avoid CYP3A4 substrates, including upadacitinib (Rinvoq), for 2 weeks after applying abametapir lice lotion. If separating them is not possible, the alternative is to avoid using abametapir and choose a different lice treatment. Keep taking your Rinvoq as prescribed, and do not stop it o… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abametapir or Upadacitinib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: XEGLYZE(TM) topical lotion, abametapir topical lotion. Dr Reddy’s Laboratories Inc (per FDA), Princeton, NJ, 2020. DailyMed
Keep reading about Abametapir
Keep reading about Upadacitinib
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