Baricitinib: side effects, uses, dosage and warning

 

Baricitinib side effects

What is baricitinib and its side effects?

Baricitinib is used to reduce pain, stiffness, and swelling in adults with rheumatoid arthritis after other treatments have failed. Baricitinib also helps slow the progression of bone and joint damage.

Baricitinib is also used in adults who are hospitalized with COVID-19 requiring oxygen or assistance with breathing.

Baricitinib may also be used for purposes not listed in this medication guide like being used as part of DMADs

Warnings

Taking baricitinib may increase your risk of life-threatening medical problems including serious infections, a hole or tear in your digestive tract, a heart attack or stroke, blood clots, or cancer.

Tell your doctor if you have a weak immune system, diabetes, chronic lung disease, or an infection such as hepatitis, tuberculosis, shingles, or HIV. Also tell your doctor if you've ever had diverticulitis, an ulcer in your stomach or intestines, cancer, heart problems, or a history of smoking, heart attack, stroke, or blood clots.

Call your doctor right away if you have a fever, night sweats, constant tiredness, weight loss, stomach pain, diarrhea or changes in bowel habits, trouble breathing, wheezing, a severe cough, or lumps in your neck, armpits, or groin.

Seek emergency medical help if you have sudden shortness of breath, chest pain spreading to your neck or arms, nausea, severe dizziness, a cold sweat, weakness on one side of your body, slurred speech, or pain, redness, or swelling in an arm or leg.

Before taking this medicine

Taking baricitinib can increase your risk of life-threatening medical problems including serious infections, a hole or tear in your digestive tract, a heart attack or stroke, blood clots, or cancer. Tell your doctor if you've had:

  • a weak immune system or chronic infection (such as tuberculosis, shingles, HIV, or hepatitis);

  • any type of cancer;

  • kidney disease;

  • diverticulitis, an ulcer in your stomach or intestines;

  • heart problems;

  • a heart attack, stroke, or blood clot;

  • high cholesterol; or

  • if you've ever smoked.

Tell your doctor if you've been sick with signs of infection, such as fever, chills, muscle aches, cough, trouble breathing, skin sores, diarrhea, or painful urination.

Tell your doctor if you've had or been exposed to tuberculosis, or if you recently traveled. Some infections are more common in certain parts of the world, and you may have been exposed during travel.

Also tell your doctor if you have ever had:

  • liver disease (especially hepatitis B or C);

  • chronic lung disease;

  • diabetes; or

  • if you are scheduled to receive any vaccine.

Using baricitinib may increase your risk of developing certain cancers, such as lymphoma or lung cancer. Ask your doctor about this risk.

Tell your doctor if you are pregnant or plan to become pregnant.

Do not breastfeed.

Not approved for use by anyone younger than 18 years old.

How should I take baricitinib?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Talk to your doctor if you cannot swallow whole tablets. You may use baricitinib in a different administration route if you are not able to swallow the tablets.

Your doctor may perform tests to make sure you do not have tuberculosis or other infections.

You may take baricitinib with or without food.

You may get infections more easily, even serious or fatal infections. You will need frequent medical tests.

If you've ever had shingles (herpes zoster), using baricitinib can cause these viruses to become active or get worse.

You must remain under the care of a doctor while you are using baricitinib for COVID-19. Use this medicine for the full prescribed length of time (usually for 14 days or until you leave the hospital, whichever comes first).

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking baricitinib?

Avoid receiving a "live" vaccine. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles).

Baricitinib side effects

Stop taking baricitinib and get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some people taking baricitinib have developed heart attacks, strokes, or serious blood clots. Stop taking baricitinib and seek emergency medical attention if you have:

  • sudden shortness of breath;

  • chest pain or pressure that may spread to your jaw, shoulder, arms, or back;

  • nausea, vomiting, cold sweat;

  • a light-headed feeling, like you might pass out;

  • weakness on one side of your body;

  • slurred speech, drooping on one side of your mouth; or

  • pain, swelling, or redness in an arm or a leg.

Baricitinib may cause serious side effects. Call your doctor at once if you have:

  • fever, chills, night sweats, constant tiredness;

  • wheezing, trouble breathing, severe or worsening cough;

  • increased urination, pain or burning when you urinate;

  • unexplained weight loss;

  • lumps in your neck, armpits, or groin;

  • signs of shingles--flu-like symptoms, tingly or painful blistering rash on one side of your body;

  • a hole (perforation) in your digestive tract--fever, severe stomach pain, diarrhea or changes in bowel habits; or

  • signs of hepatitis--loss of appetite, vomiting, stomach pain (upper right side), dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of baricitinib may include:

  • cold sores, shingles;

  • nausea; or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Baricitinib side effects (more detail)

Baricitinib dosing information

Usual Adult Dose for Rheumatoid Arthritis:

2 mg orally once a day

Comments:
-Limitations of Use: Not recommended for use in combination with other Janus kinase (JAK) inhibitors, biologic DMARDs, or with potent immunosuppressants (e.g., azathioprine, cyclosporine).
-This drug may be used as monotherapy or in combination with methotrexate or other DMARDs.

Use: For the treatment of patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to at least 1 tumor necrosis factor (TNF) blocker

Usual Adult Dose for COVID-19:

4 mg orally once a day
Duration of therapy: 14 days or until hospital discharge, whichever occurs first

Use: For the treatment of coronavirus disease 2019 (COVID-19) in hospitalized patients requiring supplemental oxygen, noninvasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO)

Usual Pediatric Dose for COVID-19:

For investigational use only

2 to less than 9 years: 2 mg orally once a day
9 years and older: 4 mg orally once a day

Duration of therapy: 14 days or until hospital discharge, whichever is first

Comments:
-The US FDA issued an Emergency Use Authorization (EUA) to allow the emergency use of this drug for treatment of COVID-19 in hospitalized pediatric patients (2 to less than 18 years) requiring supplemental oxygen, noninvasive or invasive mechanical ventilation, or ECMO; this drug is not approved by the US FDA for use.
-The optimal duration of therapy is unknown.
-This drug is not authorized for patients younger than 2 years.
-This drug should be used during pregnancy only if the benefit justifies the risk.
-For additional information: https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#coviddrugs.

Use: For the treatment of COVID-19 in hospitalized patients requiring supplemental oxygen, noninvasive or invasive mechanical ventilation, or ECMO. Detailed Baricitinib dosage information

What other drugs will affect baricitinib?

Tell your doctor about all your other medicines, especially:

  • methotrexate (sometimes given with baricitinib);

  • probenecid;

  • steroid medicine such as prednisone or dexamethasone;

  • NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or

  • other drugs to treat rheumatoid arthritis--abatacept, adalimumab, anakinra, azathioprine, certolizumab, cyclosporine, etanercept, golimumabinfliximab, rituximab, sarilumab, tocilizumab, baricitinib.

This list is not complete. Other drugs may affect baricitinib, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Important information about baricitinib

Generic name: baricitinib [ BAR-i-SYE-ti-nib ]
Brand name: Olumiant
Dosage form: oral tablet (1 mg; 2 mg; 4 mg)
Drug classes: AntirheumaticsSelective immunosuppressants

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