Skip to main content

Olumiant Disease Interactions

There are 13 disease interactions with Olumiant (baricitinib).

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 rheumatoid arthritis patients receiving baricitinib; the most common serious infections reported included pneumonia, herpes zoster, and urinary tract infection. Use of baricitinib should be avoided in patients with an active, serious infection, including localized infections. The risks and benefits of treatment should be considered before starting baricitinib in patients: with chronic/recurrent infection, who have been exposed to tuberculosis, with history of serious/opportunistic infection, who have resided/traveled in areas of endemic tuberculosis/mycoses, or with underlying conditions that may predispose them to infection. Patients with rheumatoid arthritis should be closely monitored for signs/symptoms of infection during and after baricitinib treatment. Baricitinib should be interrupted in rheumatoid arthritis patients if a serious infection, an opportunistic infection, or sepsis develops. A patient who develops a new infection during treatment with baricitinib should undergo prompt and complete diagnostic testing appropriate for an immunocompromised patient; appropriate antimicrobial therapy should be started, the patient should be monitored closely, and baricitinib should be interrupted if the patient is not responding to therapy. Baricitinib should not be resumed until the infection is controlled.

Patients with coronavirus disease 2019 (COVID-19) should be monitored for signs/symptoms of new infections during and after baricitinib treatment. The risks and benefits of baricitinib in COVID-19 patients with other concomitant infections should be considered.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
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); patients should be evaluated for active infection before administering this agent. Patients (except those with coronavirus disease 2019 [COVID-19]) should be tested for latent TB before starting baricitinib and during therapy; if positive, patients should be treated with standard antimycobacterial therapy before starting baricitinib. Anti-TB therapy should be considered prior to initiating treatment with baricitinib in patients with history of latent/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. During baricitinib use, patients should be monitored for signs/symptoms of TB, including patients who tested negative for latent TB infection prior to initiating therapy.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
Major

JAK inhibitors (applies to Olumiant) cardiovascular risk

Major Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease, Smoking

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers; patients who are current or past smokers are at additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, and pacritinib. Before starting or continuing therapy, the benefits and risks for the individual patient should be considered, especially in patients with other cardiovascular risk factors and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur. Tofacitinib, baricitinib, and upadacitinib are indicated for patients with inadequate response or intolerance to 1 or more TNF blockers, but should be discontinued in patients who have experienced a myocardial infarction or stroke. The dosage recommended for tofacitinib should not be exceeded; for the treatment of ulcerative colitis, tofacitinib should be used at the lowest effective dose and for the shortest duration needed to achieve and/or maintain therapeutic response.

References

  1. "Product Information. Jakafi (ruxolitinib)." Incyte Corporation (2011):
  2. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
  3. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
  4. "Product Information. Inrebic (fedratinib)." Celgene Corporation (2019):
  5. "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp. (2022):
  6. "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group (2021):
View all 6 references
Major

JAK inhibitors (applies to Olumiant) malignancy

Major Potential Hazard, Moderate plausibility. Applicable conditions: Skin Cancer, History - Skin Cancer, Lymphoma, Myeloproliferative Disorder, Smoking

Malignancies (including lymphomas and solid tumors) have been reported in patients treated with tofacitinib and other Janus kinase (JAK) inhibitors used to treat inflammatory conditions; lymphomas and other malignancies have been seen in patients treated with baricitinib or upadacitinib. Patients who are current or past smokers are at additional increased risk of malignancies. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, pacritinib, and fedratinib. Before starting or continuing therapy, the benefits and risks for the individual patient should be considered, especially in patients with a known malignancy (other than successfully treated nonmelanoma skin cancer), patients who develop a malignancy during therapy, and patients who are current or past smokers. Periodic skin examination is recommended for patients who are at increased risk for skin cancer.

References

  1. "Product Information. Jakafi (ruxolitinib)." Incyte Corporation (2011):
  2. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
  3. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
  4. "Product Information. Inrebic (fedratinib)." Celgene Corporation (2019):
  5. "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp. (2022):
  6. "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group (2021):
View all 6 references
Major

JAK inhibitors (applies to Olumiant) thrombosis

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

Thrombosis (including deep venous thrombosis, pulmonary embolism, and arterial thrombosis) has occurred in patients treated for inflammatory conditions with Janus kinase (JAK) inhibitors, including baricitinib, tofacitinib, and upadacitinib; many of these adverse events were serious and some resulted in death. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, fedratinib, and pacritinib. Baricitinib, pacritinib, tofacitinib, and upadacitinib should be avoided in patients who may be at increased risk of thrombosis; for the treatment of ulcerative colitis, tofacitinib should be used at the lowest effective dose and for the shortest duration needed to achieve/maintain therapeutic response. If symptoms of thrombosis occur, baricitinib, pacritinib, tofacitinib, and upadacitinib should be discontinued and patients should be evaluated promptly and treated appropriately.

References

  1. "Product Information. Jakafi (ruxolitinib)." Incyte Corporation (2011):
  2. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
  3. "Product Information. Rinvoq (upadacitinib)." AbbVie US LLC (2019):
  4. "Product Information. Inrebic (fedratinib)." Celgene Corporation (2019):
  5. "Product Information. Vonjo (pacritinib)." CTI BioPharma Corp. (2022):
  6. "Product Information. Xeljanz (tofacitinib)." Pfizer U.S. Pharmaceuticals Group (2021):
View all 6 references
Moderate

Baricitinib (applies to Olumiant) diabetes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus

The use of baricitinib increases the risk of infections in diabetic patients. Caution is recommended when treating patients with diabetes.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
Moderate

Baricitinib (applies to Olumiant) GI perforation

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

Baricitinib may cause gastrointestinal perforation. Baricitinib-treated patients who may be at increased risk for gastrointestinal perforation (e.g., patients with history of diverticulitis) should be monitored. Patients presenting with new onset abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. Caution is recommended for patients who may be at increased risk.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
Moderate

Baricitinib (applies to Olumiant) hepatic impairment

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

Baricitinib is not recommended in rheumatoid arthritis patients with severe liver dysfunction; baricitinib should only be used in patients with coronavirus disease 2019 (COVID-19) and severe liver dysfunction if the potential benefit outweighs the potential risk. No dose adjustment is necessary in patients with mild or moderate liver dysfunction. Treatment with baricitinib was associated with increased incidence of liver enzyme elevation compared to placebo. Liver enzymes should be evaluated 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, baricitinib should be interrupted until this diagnosis is excluded.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
Moderate

Baricitinib (applies to Olumiant) hyperlipemia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperlipidemia

In controlled clinical trials in patients with rheumatoid arthritis, baricitinib treatment was associated with dose-related increases in lipid parameters including total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. Lipid parameters should be assessed at baseline and about 12 weeks after initiation of therapy in patients with rheumatoid arthritis. Patients should be managed according to clinical guidelines for the management of hyperlipidemia.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
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, lymphopenia, and anemia compared to placebo. Therapy should not be started or should be interrupted in patients with rheumatoid arthritis 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; therapy should not be started or should be interrupted in patients with coronavirus disease 2019 (COVID-19) with an ALC less than 200 cells/mm3 or ANC less than 500 cells/mm3. Evaluation at baseline and thereafter according to routine patient management is recommended; dosing should be modified based on ALC, ANC, and/or hemoglobin levels. Caution is recommended in patients who may be at increased risk.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
Moderate

Baricitinib (applies to Olumiant) renal dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: peritoneal dialysis

Renal function significantly affects baricitinib exposure; renal elimination is the principal clearance mechanism for baricitinib through filtration and active secretion. Baricitinib is not recommended in patients with rheumatoid arthritis and severe renal dysfunction (estimated GFR [eGFR] less than 30 mL/min/1.73 m2); baricitinib is not recommended in patients with coronavirus disease 2019 (COVID-19) who are on dialysis, have ESRD, or have acute kidney injury (eGFR less than 15 mL/min/1.73 m2). Dosage modifications are recommended for rheumatoid arthritis patients with moderate renal dysfunction (eGFR 30 to less than 60 mL/min/1.73 m2) and COVID-19 patients with moderate or severe renal dysfunction (eGFR 15 to less than 60 mL/min/1.73 m2); care should be exercised when using this agent in such patients.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
Moderate

Baricitinib (applies to Olumiant) vaccination

Moderate Potential Hazard, Moderate plausibility.

Use of live vaccines should be avoided with baricitinib. Before starting therapy with baricitinib, immunizations should be updated in patients with rheumatoid arthritis according to current immunization guidelines.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):
Moderate

Baricitinib (applies to Olumiant) viral hepatitis

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

Viral reactivation, including cases of herpes virus reactivation (e.g., herpes zoster), was reported in clinical studies with baricitinib. Patients should be screened for viral hepatitis in accordance with clinical guidelines before starting therapy with baricitinib. If a patient develops herpes zoster during therapy, treatment with baricitinib should be interrupted until the episode resolves.

References

  1. "Product Information. Olumiant (baricitinib)." Lilly, Eli and Company (2018):

Olumiant drug interactions

There are 397 drug interactions with Olumiant (baricitinib).

Olumiant alcohol/food interactions

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


Report options

Share by QR Code
QR code containing a link to this page

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.