Baricitinib
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
Janus Kinase Inhibitor
Controlled Drug Substance
NO
Baricitinib
Summary
Baricitinib is used to treat moderate to severe rheumatoid arthritis in adults who haven't responded well to other treatments. It's also used for COVID-19 in hospitalized adults requiring oxygen support, and for severe alopecia areata in adults.
Baricitinib works by inhibiting enzymes called Janus kinases (JAKs). These enzymes are involved in immune responses and inflammation. By blocking them, Baricitinib reduces the activity of the immune system, helping to decrease inflammation and alleviate symptoms.
For adults, the usual daily dose of Baricitinib is 2 mg or 4 mg once daily, depending on the condition being treated and the patient's response to the medication. It should be taken with or without food at the same time each day.
Common side effects of Baricitinib include upper respiratory tract infections, nausea, and headache. Serious adverse effects can include serious infections, blood clots, and increased risk of cancer.
Baricitinib is contraindicated in patients with active infections, severe liver impairment, and during pregnancy. It carries the risk of serious infections, increased risk of cancer, cardiovascular events, and blood clots. It should be used with caution in elderly patients and those with a history of cardiovascular disease.
Indications and Purpose
How does Baricitinib work?
Baricitinib works by inhibiting Janus kinase (JAK) enzymes, which are involved in the signaling pathways that regulate immune responses and inflammation. By blocking these enzymes, Baricitinib reduces the activity of the immune system, helping to decrease inflammation and alleviate symptoms in conditions like rheumatoid arthritis, COVID-19, and alopecia areata.
How does one know if Baricitinib is working?
The benefit of Baricitinib is evaluated through regular monitoring of the patient's symptoms and response to treatment. This includes assessing improvements in joint pain and swelling for rheumatoid arthritis, recovery progress for COVID-19, and hair regrowth for alopecia areata. Blood tests and other diagnostic measures may also be used to monitor for side effects and ensure the medication is working effectively.
Is Baricitinib effective?
Baricitinib has been shown to be effective in treating rheumatoid arthritis, COVID-19, and alopecia areata through various clinical trials. In rheumatoid arthritis, it improves symptoms and slows joint damage. For COVID-19, it reduces recovery time in hospitalized patients. In alopecia areata, it promotes hair regrowth. These effects are supported by randomized, double-blind, placebo-controlled studies.
What is Baricitinib?
Baricitinib is used to treat rheumatoid arthritis, COVID-19, and alopecia areata. It works by inhibiting Janus kinase (JAK) enzymes, which play a role in the immune response and inflammation. By reducing the activity of these enzymes, Baricitinib helps decrease inflammation and improve symptoms in these conditions.
What is Baricitinib used for?
Baricitinib is indicated for the treatment of moderate to severe rheumatoid arthritis in adults who have not responded well to other treatments, COVID-19 in hospitalized adults requiring oxygen support, and severe alopecia areata in adults. It helps manage symptoms and improve quality of life in these conditions by modulating the immune response.
Directions for Use
For how long do I take Baricitinib?
The duration of Baricitinib use depends on the condition being treated. For rheumatoid arthritis and alopecia areata, it is typically used long-term as part of ongoing management. For COVID-19, it is used for up to 14 days or until hospital discharge. Always follow your doctor's guidance on the duration of treatment.
How do I take Baricitinib?
Baricitinib should be taken once daily, with or without food, at the same time each day. There are no specific food restrictions associated with its use. If you have difficulty swallowing tablets, they can be dissolved in water. Always follow your doctor's instructions regarding dosage and administration.
How long does it take for Baricitinib to start working?
Baricitinib can start showing effects as early as one week after beginning treatment, particularly in reducing symptoms of rheumatoid arthritis. However, the full therapeutic effect may take longer, depending on the condition being treated and individual patient response. Always consult your doctor for specific expectations regarding your treatment.
How should I store Baricitinib?
Baricitinib should be stored at room temperature, between 68°F to 77°F (20°C to 25°C). It should be kept in its original container, tightly closed, and out of reach of children. Avoid storing it in the bathroom or areas with excess heat and moisture. Proper storage ensures the medication remains effective and safe to use.
What is the usual dose of Baricitinib?
For adults, the usual daily dose of Baricitinib is 2 mg or 4 mg once daily, depending on the condition being treated and the patient's response. For children, the dosage varies based on weight and the specific condition, with a typical dose being 2 mg or 4 mg once daily for those weighing 30 kg or more. Always follow your doctor's specific dosage instructions.
Warnings and Precautions
Can Baricitinib be taken safely while breastfeeding?
Baricitinib is not recommended during breastfeeding due to the potential for serious adverse reactions in nursing infants. It is unknown if Baricitinib is excreted in human milk, but it is present in the milk of lactating animals. Women should not breastfeed during treatment and for four days after the last dose.
Can Baricitinib be taken safely while pregnant?
Baricitinib is contraindicated during pregnancy due to potential harm to the fetus, as evidenced by animal studies showing reproductive toxicity and teratogenic effects. Women of childbearing potential should use effective contraception during treatment and for at least one week after the last dose. If pregnancy occurs, patients should be informed of the potential risks to the fetus.
Can I take Baricitinib with other prescription drugs?
Baricitinib can interact with strong OAT3 inhibitors like probenecid, which may increase its levels in the body. It should not be used with other JAK inhibitors or biologic DMARDs due to the risk of additive immunosuppression. Patients should inform their doctor of all medications they are taking to avoid potential interactions and ensure safe use.
Is Baricitinib safe for the elderly?
For elderly patients, especially those over 65, Baricitinib should be used with caution due to an increased risk of serious infections, cardiovascular events, and malignancies. It is recommended only if no suitable treatment alternatives are available. Regular monitoring and consultation with a healthcare provider are essential to ensure safe use.
Who should avoid taking Baricitinib?
Baricitinib carries important warnings, including the risk of serious infections, increased mortality in older adults with cardiovascular risk factors, and potential for cancer and blood clots. It is contraindicated in patients with active infections, severe liver impairment, and during pregnancy. Patients should be monitored for infections, cardiovascular events, and changes in blood counts during treatment.
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