Baricitinib

Drug Name
Baricitinib

Brand Name(s)
Olumiant®

Drug Class
Janus Kinase (JAK) Inhibitor

Baricitinib is a Disease-Modifying Anti-Rheumatic Drug (DMARD) used to treat rheumatoid arthritis (RA).

  • What types of arthritis is baricitinib used for?

    Baricitinib is a Disease-Modifying Anti-Rheumatic Drug (DMARD) used to treat rheumatoid arthritis (RA).

    Baricitinib is recommended for use in combination with methotrexate (MTX) in adult patients with moderate to severely active RA who have had an inadequate response to one or more DMARDs. For patients who cannot tolerate MTX, baricitinib may be given as monotherapy.

    Baricitinib is never used in combination with biologic medications.  Combining baricitinib with biologic therapy is not recommended because of the increased risk for infection.

  • How is baricitinib administered?

    Baricitinib is taken orally in pill form.

  • What is the typical dose and when do I take it?

    Baricitinib is available in 2 mg tablets. The usual dose is one tablet daily.

    Baricitinib should not be used if you have moderate to severe renal impairment.  Your health care provider will assess your renal function prior to starting baricitinib.

  • How long will it take to work?

    Like many of the DMARDs, you will not feel the effects of baricitinib right away. Most people may start noticing the effects about two to eight weeks after they start taking the medication, but full benefits may not occur for three to six months. It is important to be patient and keep taking your medication.

  • When should I not take baricitinib and call my doctor?

    Baricitinib can make it harder for your body to fight infections. Therefore, if you have a fever, think you may have an infection or have been prescribed an antibiotic, contact your healthcare provider immediately. Also contact your prescriber if you are having surgery as you may need to stop baricitinib until you are healed and there is no sign of infection.

    Before taking baricitinib, tell your healthcare provider if you are pregnant or planning to become pregnant or are breastfeeding or planning to breastfeed. Baricitinib should not be used during pregnancy or while breastfeeding.  Currently there are no studies to assess the use of baricitinib during pregnancy and breastfeeding.

    Ideally your vaccinations should be up to date prior to starting baricitinib. If you have already started therapy with baricitinib, most inactive vaccines are recommended, if indicated (i.e. influenza, pneumococcal). Live vaccines are not recommended due to risk of causing infection. Baricitinib may increase your risk of shingles. Please speak with your healthcare providers about the shingles vaccine and other vaccinations before starting baricitinib.

    Anyone who has had a previous allergic reaction to baricitinib should avoid the medication.

    Baricitinib may interact with other medications. Please speak with your healthcare provider about whether any of the other medications you currently take interact with baricitinib.

    Your body may harbour the bacteria that can cause tuberculosis (TB) if you have been exposed to TB in the past. You may not know you are carrying TB as the bacteria remain in an inactive state and cause no symptoms. This is known as latent TB infection (LTBI).  People with LTBI are not infectious and cannot spread TB to others.  Baricitinib can increase the risk of reactivation of LTBI.  Prior to starting baricitinib therapy, your prescriber will screen for LTBI. If you test positive you will be required to take an anti-TB medication prior to starting baricitinib. Please speak with your healthcare provider about LTBI screening before starting a baricitinib.

    Baricitinib has been rarely associated with a small increased risk of developing certain types of cancer. Proof of a link between baricitinib and the development of cancer is difficult as people with inflammatory arthritis are generally at a higher risk of developing certain cancers, as compared to the general population. The role of baricitinib in the development of cancer is currently unknown.  Please speak with your healthcare provider if you have any questions.

  • What are the side effects of baricitinib?

    Like all medications, taking baricitinib carries some risk of side effects, which must be balanced with the potential benefits.  In general, the risk of joint damage and permanent disability (resulting from arthritis) is much greater than the risks of side effects from baricitinib. When monitored properly the vast majority of side effects are rare, most improve over time and are reversible.

    The most common side effect of baricitinib is upper respiratory tract infections (common cold, sinus infections).   Baricitinib may also cause nausea, indigestion and diarrhea. Please tell your healthcare provider if these symptoms become bothersome.

    Baricitinib may affect your blood counts, liver function and cholesterol levels. Your healthcare provider will use regular blood tests to monitor for these changes.

    Baricitinib has very rarely been associated with blood clots in the legs and lungs. Any new swelling, pain or tenderness in the leg or chest pain or shortness of breath should be taken seriously and immediately reported to your healthcare provider.

    Baricitinib may increase your risk of shingles.  Signs of shingles include skin rash or blisters usually on one side of the body with itching, burning or tingling pain. Please talk to your healthcare provider about the shingles vaccine.

    Stomach perforations (holes in the lining of the stomach) have been reported in people taking baricitinib for RA, however the role of baricitinib in these perforations is not known. Baricitinib should be used with caution in patients who may be at increased risk for stomach perforation (i.e. using NSAIDs and/or corticosteroids, people with a history of diverticulitis).  Stomach perforations require immediate medical attention. If you develop fever and severe stomach pain that does not go away, seek medical attention.

  • What helps to reduce side effects?

    Take your baricitinib as prescribed and contact your healthcare provider if you have any concerns while taking the medication.

    Taking baricitinib with food may help reduce nausea and stomach upset.

  • Do I need any monitoring while taking baricitinib?

    You will need blood tests every one to three months. This is important to ensure the baricitinib is having no harmful effects on your blood counts, liver, kidneys or cholesterol levels.


This information was last updated June 2019, with expert advice from:

Jason Kielly, B.Sc. (Pharm.), Pharm.D.
Associate Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health

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