What is baricitinib?

Why is baricitinib prescribed?

What are the possible side effects?

What are the risks?

Will it affect vaccinations?

What else should I know about baricitinib?

What is baricitinib?

Baricitinib is a type of drug known as a Janus kinase JAK inhibitor.

What are the brand names of baricitinib?

The originator drug is Olumiant.

What does it do?

It works by blocking the action of Janus kinase enzymes, which are involved in the inflammation that causes the symptoms of rheumatoid arthritis.

What is it used for?

It is used to treat rheumatoid arthritis.

How is it taken?

Baricitinib is taken as tablets and is prescribed by a consultant rheumatologist.

Are there any side-effects?

The most common side-effects include throat, nose and chest infections, cold sores, skin infections (cellulitis) and urinary tract infections. There seems to be a particular risk of shingles (a skin infection caused by the chicken pox virus) in people who take JAK inhibitors.

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Why is baricitinib prescribed?

Baricitinib is a type of drug known as a JAK inhibitor, and works by interfering with the inflammatory processes within the immune system that lead to the symptoms of rheumatoid arthritis.

Is there any reason I will not be prescribed baricitinib?

Baricitinib won’t be started if your arthritis isn’t active, you haven’t tried other treatments appropriate for your condition first, or if you’re pregnant or planning to try for a baby.

Your doctor may decide not to prescribe this treatment if you have or have had any of the following:

• an infection
• shingles
• lung disease
• hepatitis or other liver problems, or kidney disease
• heart problems, high blood pressure or high cholesterol, or blood clots (deep vein thrombosis or pulmonary embolism)
• stomach ulcers

When and how do I take baricitinib?

Baricitinib is taken as tablets and can be prescribed by a consultant rheumatologist for adults with rheumatoid arthritis.

How long does baricitinib take to work?

Most people who benefit from this treatment will notice an improvement within four weeks of starting treatment, but further improvements may be seen over the first six months of treatment. It can be used alone or with methotrexate.

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What are the possible side effects?

Baricitinib and the other JAK inhibitors are a relatively new group of medicines. Because of this, we know less about the risk of longer-term side effects.

Because baricitinib affects your immune system, it can make you more likely to pick up infections. These include throat, nose and chest infections, cold sores, skin infections (cellulitis) and urinary tract infections.

You should always read the latest patient information leaflet included with your medicines package to keep you informed about any possible side effects of your prescribed medications.

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What are the risks?

There seems to be a particular risk of shingles (a skin infection caused by the chicken pox virus) in people who take JAK inhibitors. Other side effects include:

• Nausea (sickness)
• increase the risk of blood clots (deep vein thrombosis and pulmonary embolism).

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Will it affect vaccinations?

It's best to discuss vaccinations, including any you may need if you're planning to travel abroad, with your rheumatology team. If possible, it's best to have any vaccinations you may need before starting baricitinib.

It's generally recommended that people on baricitinib avoid live vaccines. These include measles, mumps and rubella (MMR), tuberculosis (BCG), yellow fever and shingles.

Pneumococcal vaccines, which help to protect against pneumonia, and yearly flu vaccines – except the nasal flu vaccine – are fine and are usually recommended.

Can I drink alcohol while on baricitinib?

There's no known interaction between baricitinib and alcohol, so it’s fine to have a drink if you’re taking this medication. However you should follow the recommended weekly low-risk alcohol guidelines, which are less than 11 standard drinks for women, and 17 standard drinks for men

Does baricitinib affect fertility or pregnancy?

At present, we know very little about the effects of baricitinib in pregnancy. To be on the safe side, baricitinib isn’t recommended if you're pregnant or planning a pregnancy. If you could become pregnant, you should use effective contraception while being treated with baricitinib and for at least a week after stopping the treatment.

There's no information currently available about whether baricitinib might affect male or female fertility.

Does it affect breastfeeding?

It's not yet known whether baricitinib passes into breast milk so you should talk to your rheumatology team if you’re thinking of breastfeeding.

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What else should I know about baricitinib?

Some people who take baricitinib may have a reduced white blood cell count, raised cholesterol or raised levels of liver enzymes. These problems are usually mild, but your rheumatology team will arrange regular blood checks while you’re taking baricitinib as a precaution.

If your red or white blood cell count gets too low, your treatment may be stopped until it improves. It’s possible that baricitinib may increase the risk of blood clots, called deep vein thrombosis. These can sometimes move to the lungs, which is called pulmonary embolism. The risk is likely to be greater if you've had blood clots before. You should seek urgent medical care if you develop painful swelling of the legs, chest pains or breathlessness.

Are there any alternatives?

Baricitinib can be prescribed by a consultant rheumatologist for adults with rheumatoid arthritis. It can be used alone or with other disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate. 

You won't be given baricitinib if you haven't tried other treatments appropriate for your condition first.

Will I need any special checks while on baricitinib?

Some people who take baricitinib may have a reduced white blood cell count, raised cholesterol or raised levels of liver enzymes. These problems are usually mild, but your rheumatology team will arrange regular blood checks while you’re taking baricitinib as a precaution.

Can I take other medicines alongside baricitinib?

You'll probably be taking methotrexate as well as baricitinib. However, some drugs may interact with baricitinib. Check with your doctor before starting any new medicines and remember to mention you're on baricitinib if you're treated by anyone other than your usual rheumatology team.

You can carry on taking non-steroidal anti-inflammatory drugs (NSAIDs) or painkillers, if needed, unless your doctor advises otherwise.

Don't take over-the-counter or herbal medicines without discussing it first with your rheumatology team.

Can I continue with baricitinib if I am going to have an operation?

If you're thinking about having surgery, talk this over with your healthcare team. They may advise you to stop baricitinib for a time before and after surgery.

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Updated 14 May 2021