Drug reference

Baricitinib

Immunosuppressant

Also known as Olumiant

Immunosuppressant

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

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Mechanism

Baricitinib is an anti-inflammatory, targeted, synthetic small molecule (tsDMARD) that selectively and reversibly inhibits JAK1 and JAK3 more than JAK2. This inhibition targets the JAK-STAT signaling pathway, reducing inflammatory responses.

Indications

Rheumatoid Arthritis (in TNF-alpha inadequate responders)Active, drug-resistant Systemic Lupus Erythematosus (SLE)Alopecia AreataAtopic Dermatitis (off-label)Psoriasis (off-label)rheumatoid arthritisgraft-versus-host diseasemyelofibrosispolycythemia vera

Dosing

Adult: For RA: 2 mg daily (FDA-approved in USA); 2 mg or 4 mg daily (used in Europe). Can be used as monotherapy or in combination with methotrexate or other csDMARDs (e.g., leflunomide, hydroxychloroquine). For active, drug-resistant SLE: 4 mg daily.
Renal adjustment: Use cautiously if at all in patients whose glomerular filtration rate is <60 mL/min/1.73 m2.

Pharmacokinetics

Half-life

Approximately 12 hours

Bioavailability

79%

Metabolism

About 10% via CYP3A4

Excretion

Mainly by the kidneys

Contraindications

Severe renal impairment (glomerular filtration rate <60 mL/min/1.73 m2)
nonuse during breastfeeding
concurrent use of live vaccines

Side effects

Common

Increased risk of infectionHerpes virus reactivationthrombocytopeniaanemianeutropeniaincreased risk of infections (upper respiratory, sinus, common cold, hepatitis c virus)

Serious

Venous thromboembolism (VTE)
Deep vein thrombosis (DVT)
Pulmonary embolism (PE)
increased risk of serious bacterial, fungal, viral, and opportunistic infections leading to hospitalization or death
higher rate of all-cause mortality, including sudden cardiovascular death
higher rate of certain cancers
higher rate of thrombosis, cardiovascular death, myocardial infarction, and stroke
increased risk of venous thromboembolism
deep venous thromboembolism
pulmonary embolism