Baricitinib: what it is for, how to take it and side effects

Baricitinib is a medicine indicated for the treatment of rheumatoid arthritis, atopic dermatitis, alopecia areata or COVID-19, as it works by reducing the immune system’s response, reducing inflammation in the body.

This medicine can be offered free of charge by the SUS, as long as it has a medical indication, and is found in the form of 2 or 4 mg tablets, under the trade name Olumiant.

Baricitinib should only be used with medical indication, for the duration of treatment advised by the doctor and with regular monitoring to assess the effectiveness of the treatment and the emergence of side effects.

What is it for

Baricitinib is indicated for the treatment of:

• Moderate to severe active rheumatoid arthritis, can be used alone or in combination with methotrexate;
• Moderate to severe atopic dermatitis;
• COVID-19 in hospitalized adults who need to receive oxygen via mask, nasal catheter or who require high flow oxygen or non-invasive ventilation;
• Alopecia areata grave.

Baricitinib works by inhibiting janus kinase enzymes, known as JAKs, which results in less activation of the immune system and a decrease in inflammatory substances in the body.

The use of baricitinib should only be carried out with the recommendation of a rheumatologist, dermatologist or infectious disease specialist, with regular medical monitoring in order to assess the effectiveness of the treatment and the emergence of side effects.

Make an appointment with a rheumatologist in the nearest region:

How to drink

The baricitinib tablet should be taken orally, with a glass of water, before or after food.

The normally recommended doses for adults are:

• Rheumatoid arthritis: 1 tablet of 4 mg baricitinib, once a day. In some cases, the doctor may indicate the dose to be 1 tablet of 2 mg, once a day;
• Atopic dermatitis: 1 tablet of 4 mg baricitinib, once a day. For elderly people over 75 years of age or people with chronic or recurrent infections, the doctor may recommend a dose of 1 tablet of 2 mg, once a day;
• COVID-19: 1 tablet of 4 mg of baricitinib, once a day, for 14 days or until hospital discharge;
• Alopecia areata: 1 tablet of 4 mg baricitinib, once a day. In some cases, the doctor may indicate the dose to be 1 tablet of 2 mg, once a day.

The tablet should always be taken at the same time, but if you forget, you should take the dose as soon as you remember and then readjust the times according to this last dose, continuing the treatment according to the new scheduled times. Do not double the dose to make up for a forgotten dose.

Before starting treatment with baricitinib, your doctor should recommend tests to make sure you do not have tuberculosis or other infections.

In the case of treating COVID-19, in people who cannot swallow the tablet whole, the doctor may recommend letting the tablet dissolve in the mouth, or having the nurse apply it through a gastrostomy tube, nasoenteric tube or orogastric tube.

Possible side effects

Some of the most common side effects that may occur during treatment with baricitinib are an allergic reaction to the components of the tablet, nausea or an increased risk of infections including tuberculosis, fungal, bacterial or viral infections such as herpes simplex or shingles.

Additionally, baricitinib may increase the risk of developing lymphoma, deep vein thrombosis, or pulmonary embolism.

It is recommended to stop use and seek emergency room immediately if severe allergy symptoms appear, such as difficulty breathing, a feeling of a closed throat, swelling in the mouth, tongue or face, or hives. Know how to identify the symptoms of a serious allergic reaction.

You should also go to the emergency room if you take baricitinib in doses higher than those recommended so that side effects can be monitored.

Who shouldn’t use

Baricitinib should not be used by pregnant or breastfeeding women, in cases of tuberculosis or fungal infections such as candidiasis or pneumocystosis.

This medicine should be used with caution in people who have blood clotting problems, including the elderly, obese people, people with a history of thrombosis or embolism or people who are going to have some type of surgery and need to be immobilized.

Furthermore, caution should also be exercised in the case of people with liver or kidney failure, anemia or people with a weakened immune system, who may require dose adjustment by the doctor.