Rinvoq, Xeljanz, and More: A List of 9 JAK Inhibitors and Ways to Save on Them

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In 2011, the FDA approved Jakafi (ruxolitinib), the first in a new class of medications: Janus kinase (JAK) inhibitors. Since then, several others have been developed, and new uses have been discovered.

These medications work by blocking the actions of JAKs, a set of enzymes (proteins) in your body. JAKs help various immune cells communicate with each other. Often, this communication leads to inflammation in different areas of the body. Many JAK inhibitors can help lower excessive inflammation that's caused by different autoimmune disorders.

From rheumatoid arthritis (RA) to COVID-19, JAK inhibitors can be a treatment option for several health conditions. Let's take a look at a list of nine JAK inhibitor drugs and when healthcare professionals may prescribe them.

1. Rinvoq

Rinvoq (upadacitinib) is a once-daily oral tablet that's FDA approved for several inflammatory health conditions:

• RA in adults

• Psoriatic arthritis (PsA) in people ages 2 years and older

• Ankylosing spondylitis (AS) in adults

• Non-radiographic axial spondyloarthritis in adults

• Atopic dermatitis (AD) - a type of eczema - in adults and adolescents ages 12 years and older

• Ulcerative colitis (UC) in adults

• Crohn's disease in adults

• Polyarticular course juvenile idiopathic arthritis in people ages 2 years and older

Rinvoq isn't a first choice for treating these health conditions. It's usually only considered if other treatments, like Humira (adalimumab), haven't worked well enough. This is partially because Rinvoq and other JAK inhibitors can raise your risk for serious side effects, such as blood clots. We'll talk more about risks and side effects later.

How to save on Rinvoq

Rinvoq is only available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Rinvoq's patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 per month for Rinvoq using a savings card from the manufacturer.

2. Xeljanz

Xeljanz (tofacitinib) is a once- or twice-daily oral JAK inhibitor. It's FDA approved to treat:

• RA in adults

• PsA in adults

• AS in adults

• UC in adults

• Polyarticular course juvenile idiopathic arthritis in people ages 2 years and older

Xeljanz is available as an immediate-release (IR) tablet, an extended-release (ER) tablet, and an oral liquid. Like with Rinvoq, Xeljanz isn't considered a first-choice option for treating these health conditions.

Xeljanz has also been studied for the treatment of alopecia areata. But it's not currently approved for this health condition.

How to save on Xeljanz

Here are some ways to save on Xeljanz, which is only available as a brand-name medication:

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Xeljanz's patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 for Xeljanz IR, Xeljanz XR, and Xeljanz liquid using a savings card from the manufacturer.

3. Olumiant

Olumiant (baricitinib) is a once-daily oral tablet that's FDA approved to treat the following health conditions:

• RA in adults

• Alopecia areata in adults

• Severe COVID in adults requiring hospitalization and oxygen, ventilation, or extracorporeal membrane oxygenation (ECMO)

Olumiant is also FDA authorized to treat severe COVID in children and adolescents ages 2 through 17 years old requiring hospitalization. It's the only JAK inhibitor drug that's FDA approved or authorized for the treatment of COVID.

How to save on Olumiant

Olumiant is a brand-name medication and only provided by certain specialty pharmacies and hospitals. But there are still ways to save on it:

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Olumiant's patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $5 per month for Olumiant using a savings card from the manufacturer.

4. Opzelura

Opzelura (ruxolitinib) is a twice-daily JAK inhibitor cream that's approved to treat AD and certain types of vitiligo in people ages 12 years and older. When prescribed for AD, it's recommended for short-term use only. With vitiligo, Opzelura can be continued long-term as long as it's working well.

How to save on Opzelura

Opzelura is only available as a brand-name medication. But there are still ways to help you save money on your prescription:

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Opzelura's patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 per tube for Opzelura using a savings card from the manufacturer.

5. Cibinqo

Cibinqo (abrocitinib) is an oral tablet that's FDA approved for AD in adults and adolescents ages 12 years and older. It's not a first-choice medication for the condition. But it's an option to consider when other medications haven't worked well to control your symptoms.

This JAK inhibitor drug was approved for AD on the same day as Rinvoq in early 2022. At the time, Cibinqo was only approved for use in adults. But in February 2023, the FDA expanded its use to include adolescents.

How to save on Cibinqo

Here's some options to help you save on Cibinqo, which is only available as a brand-name medication:

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Cibinqo's patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 for Cibinqo using a savings card from the manufacturer.

6. Leqselvi

Leqselvi (deuruxolitinib) is a twice-daily oral tablet. It's FDA approved to treat alopecia areata in adults.

Unlike other JAK inhibitors, it's recommended to do a specific type of genetic test before you start taking Leqselvi. A certain liver enzyme (called CYP2C9) helps break down the medication in your body.

But the CYP2C9 enzyme works more slowly in some people than others. If this is the case for you, Leqselvi can build up in the body, making side effects more likely to happen. If tests show that CYP2C9 works more slowly in your body, you shouldn't take Leqselvi. This is also the case if you take other medications that slow down CYP2C9, such as amiodarone (Pacerone).

Leqselvi was approved in July 2024 but hasn't launched commercially yet. Check back with GoodRx on ways to save on it.

7. Jakafi

Jakafi contains the same active ingredient as Opzelura: ruxolitinib. But Jakafi is a twice-daily oral tablet. It's not FDA approved to treat any autoimmune disorders.

This JAK inhibitor can help treat:

• Myelofibrosis, a type of blood cancer, in adults

• Polycythemia vera, a different type of blood cancer, in adults

• Acute and chronic graft-versus-host disease (a complication that can happen after a stem cell transplant) in people ages 12 years and older

Jakafi has been studied as a potential treatment for alopecia areata. But it isn't currently FDA approved for the health condition.

How to save on Jakafi

Jakafi is a brand-name medication that can only be filled at specialty pharmacies. Here's a few options to help you save:

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Jakafi's patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 per month for Jakafi using a savings card from the manufacturer.

8. Vonjo

Vonjo (pacritinib) is a twice-daily oral tablet that's FDA approved to treat myelofibrosis in adults. Vonjo works a bit differently than other JAK inhibitors on this list. It also blocks the action of another enzyme called interleukin-1 receptor-associated kinase 1 (IRAK1). Blocking JAKs and IRAK1 may be helpful if people haven't responded to other treatments, such as Jakafi. It can also be prescribed for people who haven't tried other JAK inhibitors yet.

How to save on Vonjo

Vonjo has a financial assistance program available called CTI Access. They offer a variety of ways to help you save money. In some cases, you may pay as little as $0 per month. This includes copay cards for people with commercial or private insurance and patient assistance programs for people who are uninsured or underinsured.

9. Inrebic

Inrebic (fedratinib) is a once-daily oral tablet that's FDA approved to treat myelofibrosis in adults. Inrebic blocks the actions of several enzymes, including JAKs. Because it works through multiple pathways, it can be an option if a person has already tried Jakafi without success. It's also an option for people who haven't tried any JAK inhibitors yet.

How to save on Inrebic

There are ways to save on Inrebic. The medication's manufacturer offers copay assistance to help lower costs for people with commercial insurance. They also have a patient assistance program for people who are uninsured or underinsured. If you're eligible, you may receive Inrebic at no cost.

What are the side effects of JAK inhibitor drugs?

The side effects of JAK inhibitors vary, depending on which one you're taking. You should discuss the side effects of the medication you've been prescribed with your healthcare team. Below, we'll discuss some of the most notable risks. But keep in mind, this isn't a comprehensive list of all possible side effects.

Side effects of oral JAK inhibitors approved for autoimmune disorders

Oral JAK inhibitors like Xeljanz, Rinvoq, and more lower the immune system's response. This helps lower inflammation from autoimmune disorders. But it can also raise your risk for infection. Notably, you may be more likely to experience a flare-up of viral infections like shingles or herpes. Adults over 65 years old have a higher risk of this side effect.

These oral JAK inhibitors also include boxed warnings (the FDA's strictest medication warning) about a higher risk of potentially life-threatening side effects. These include a higher risk of:

• Blood clots, especially with high doses

• Heart attacks

• Strokes

• Different types of cancer, such as lung cancer and lymphoma

• Death from any cause, especially with higher doses

These warnings were based on a study that compared Xeljanz to Humira for treating RA. The study found a higher risk of these complications for people taking Xeljanz. Olumiant, Rinvoq, Cibinqo, and Leqselvi have similar warnings.

Side effects of Opzelura

Opzelura includes the same boxed warnings described above for oral JAK inhibitors. It can also make infections more likely to happen. But many of Opzelura's common side effects occur where it's applied. This includes acne or itching around the application site. Body-wide side effects, like diarrhea or headaches, are less common.

Side effects of JAK inhibitors approved for blood cancers

Similar to other JAK inhibitors, those approved for blood cancers can raise the risk of infections. Jakafi, Vonjo, and Inrebic can also lower the number of platelets and other blood cells. This can lead to serious bleeding. This side effect is most frequently reported with Jakafi.

Vonjo can cause severe diarrhea. This typically gets better over time but can lead to dehydration. Your healthcare team may suggest anti-diarrheal medications or dose changes if this happens.

Inrebic includes a boxed warning for encephalopathy (a change in brain function). People with vitamin B1 (thiamine) deficiencies have a higher risk of this. Symptoms include confusion, coordination problems, and uncontrollable eye movements.

Jakafi, Vonjo, and Inrebic don't include the boxed warnings that other JAK inhibitors do. This is because the study that led to these warnings focused on people being treated for RA. Because these JAK inhibitors aren't approved for inflammatory conditions, the FDA didn't require a boxed warning to be added to their official labeling. But keep in mind that there's still a higher risk of these serious complications when taking them.

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