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Olumiant (baricitinib) Disease Interactions

There are 11 disease interactions with Olumiant (baricitinib):

Major

Baricitinib (applies to Olumiant) hepatic impairment

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Baricitinib is not recommended in patients with severe hepatic impairment. No dose adjustment is necessary in patients with mild or moderate hepatic impairment. Treatment with baricitinib is associated with increased incidence of liver enzyme elevation. It is recommended to evaluate liver enzymes at baseline and thereafter according to routine patient management. Prompt investigation of the cause of liver enzyme elevation is recommended to identify potential cases of drug-induced liver injury. If increases in ALT or AST are observed and drug-induced liver injury is suspected, interrupt treatment until this diagnosis is excluded.

Major

Baricitinib (applies to Olumiant) infections

Major Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving baricitinib. The most common serious infections reported included pneumonia, herpes zoster, and urinary tract infection. Avoid use of baricitinib in patients with an active, serious infection, including localized infections. Consider the risks and benefits of treatment prior to initiating baricitinib in these patients. It is recommended to interrupt treatment if a patient develops a serious infection, an opportunistic infection, or sepsis. A patient who develops a new infection during treatment with baricitinib should undergo prompt and complete diagnostic testing appropriate for an immunocompromised patient. Initiate appropriate antimicrobial therapy, monitor closely and interrupt treatment if the patient is not responding to therapy. Do not resume baricitinib until the infection is controlled. Closely monitor patients for the development of signs and symptoms of infection during and after treatment.

Major

Baricitinib (applies to Olumiant) renal dysfunction

Major Potential Hazard, Moderate plausibility.

Renal elimination is the principal clearance mechanism for baricitinib through filtration and active secretion. Baricitinib is not recommended in patients with moderate or severe renal impairment (estimated GFR of less than 60 mL/min/1.73 m2). Renal function was found to significantly affect baricitinib exposure. Care should be exercise when using this agent in patients with renal dysfunction.

Major

Baricitinib (applies to Olumiant) thrombosis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Thrombotic/Thromboembolic Disorder

Thrombosis, including deep venous thrombosis (DVT) and pulmonary embolism (PE), has been observed in patients treated with baricitinib. Therapy with baricitinib should be used with caution in patients who may be at increased risk of thrombosis. If clinical features of DVT/PE or arterial thrombosis occur, patients should be evaluated promptly and treated appropriately. Use with caution in patients who may be at increased risk.

Major

Baricitinib (applies to Olumiant) tuberculosis

Major Potential Hazard, Moderate plausibility. Applicable conditions: History - Tuberculosis, Tuberculosis -- Active, Tuberculosis -- Latent

Baricitinib should not be given to patients with active tuberculosis (TB). Evaluate and test patients for latent or active infection before administering this agent. Consider anti-TB therapy prior to initiating treatment with baricitinib in patients with a history of latent or active TB in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent TB but who have risk factors for TB infection. Consultation with a physician with expertise in the treatment of TB is recommended to aid in the decision about whether initiating anti-TB therapy is appropriate for an individual patient. Patients with latent TB should be treated with standard antimycobacterial therapy before initiating treatment. Monitor patients for the development of signs and symptoms of TB, including patients who tested negative for latent TB infection prior to initiating therapy.

Major

Baricitinib (applies to Olumiant) vaccination

Major Potential Hazard, Moderate plausibility.

It is recommended to avoid the use of live vaccines in patients treated with baricitinib. Before starting therapy with baricitinib, consider completion of all age appropriate immunizations according to current immunization guidelines. Care should be exercised as no data are available on the response to live or inactive vaccines.

Major

Baricitinib (applies to Olumiant) viral hepatitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Varicella-Zoster, Infectious Hepatitis

Viral reactivation, including cases of herpes virus reactivation were reported in clinical studies with baricitinib. It is recommended to screen for viral hepatitis in accordance with clinical guidelines before starting therapy with baricitinib. If a patient develops herpes zoster while on therapy with baricitinib, interrupt treatment until the episode resolves.

Moderate

Baricitinib (applies to Olumiant) GI perforation

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Gastrointestinal Perforation, Gastrointestinal Diverticula

Baricitinib may cause gastrointestinal perforation. Therapy with baricitinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis). Patients presenting with new onset abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. Use with caution in patients who may be at increased risk.

Moderate

Baricitinib (applies to Olumiant) hyperlipemia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperlipidemia

In controlled clinical trials, baricitinib treatment was associated with dose-related increases in lipid parameters including total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol. It is recommended to evaluate lipid parameters at baseline and approximately 12 weeks following initiation of treatment. Manage patients according to clinical guidelines for the management of hyperlipidemia.

Moderate

Baricitinib (applies to Olumiant) laboratory abnormalities

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts

Treatment with baricitinib was associated with an increased incidence of neutropenia, decrease lymphocyte counts and in hemoglobin levels. Therapy initiation is not recommended in patients with an absolute lymphocyte count (ALC) less than 500 cells/mm3, absolute neutrophil count (ANC) less than 1000 cells/mm3, or hemoglobin level less than 8 g/dL. Evaluate at baseline and thereafter according to routine patient management and modified dose accordingly. Exercise caution in patients who may be at increased risk.

Moderate

Baricitinib (applies to Olumiant) skin cancer

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: History - Skin Cancer

Non-melanoma skin cancers (NMSCs) have been reported in patients treated with baricitinib. Consider the risks and benefits of baricitinib treatment prior to initiating therapy in patients with a known malignancy other than a successfully treated non-melanoma skin cancer (NMSC) or when considering continuing treatment in patients who develop a malignancy. Periodic skin examination is recommended for patients who are at increased risk for skin cancer. Exercise caution when using this agent in patients at increased risk.

Olumiant (baricitinib) drug interactions

There are 364 drug interactions with Olumiant (baricitinib)

Olumiant (baricitinib) alcohol/food interactions

There is 1 alcohol/food interaction with Olumiant (baricitinib)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.