Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.
Taking Olumiant (baricitinib) may raise your risk of serious infections. If you suspect that you have an infection or are developing an infection, notify your healthcare provider. Olumiant may also raise the likelihood of heart-related effects (e.g., heart attack), stroke and blood clots. Get medical help right away if you're experiencing the following symptoms: chest pain, breathing difficulties, leg pain/swelling, slurred speech and one-sided body weakness. Using Olumiant is also linked to a higher risk of cancer. Your healthcare provider will closely monitor you for these severe side effects.
Olumiant (baricitinib ) is a treatment option for moderate to severe rheumatoid arthritis (RA). It's considered a disease-modifying antirheumatic drug (DMARD).
This medication, however, isn't a first-choice option. It's typically used after trying at least one tumor necrosis factor (TNF) inhibitor which hasn't produced good results. TNF inhibitors work by blocking TNF which then decreases inflammation (swelling) in the body.
Olumiant, on the other hand, is a Janus kinase (JAK) inhibitor that works by suppressing the body's immune system. Olumiant is available as a prescription tablet.
Therapeutic Classification: Janus kinase (JAK) inhibitor
Olumiant (baricitinib ) is used to treat moderate to severe rheumatoid arthritis (RA).
Millions of U.S. adults receive a diagnosis of arthritis—including RA—every year. In RA, the body's immune system mistakenly attacks the synovium and damages this soft tissue that lines the joints. As a result, people with RA tend to experience joint pain, swelling, and stiffness.
Olumiant (baricitinib ) is taken by mouth with or without food. It can be used by itself or in combination with a non-biologic DMARD, such a methotrexate. A non-biologic DMARD is a chemical based medication. A biologic DMARD is made from naturally occurring sources, like proteins and tissues. Biologic DMARDS, however, should not be used in combination with Olumiant as it can cause additive immunosuppression and risk of infection.
It's not typically recommended to use Olumiant with other Janus kinase (JAK) inhibitors.
Once you receive Olumiant from the pharmacist, store the medication at room temperature between 68 to 77 degrees Fahrenheit (F)—with a safety range between 59 to 86 degrees F.
If you're going to travel with Olumiant, become familiar with the regulations of your final destination. In general, however, consider making a copy of your Olumiant prescription and have the medicine in the original container from your pharmacy, with your name on it.
Olumiant received an emergency use authorization (EUA) from the Food and Drug Administration (FDA) to treat COVID-19 in people who are hospitalized with certain oxygen requirements.
Additionally, the Infectious Diseases Society of America (IDSA) and National Institutes of Health (NIH) guidelines currently support Olumiant for COVID-19 in people who are hospitalized with certain oxygen requirements plus other factors. The IDSA and NIH, however, recommend using Olumiant with one of the following:
You might start noticing some improvement in your symptoms as early as one week.
Side effects are possible with Olumiant.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common side effects with Olumiant include:
Severe side effects are possible with Olumiant. Get medical help right away if you experience the following serious side effects:
The above serious side effects are also possible long-term side effects with Olumiant. Some people may also experience other abnormal lab results relating to cholesterol levels and liver injury. If you're experiencing liver problems, symptoms may include dark-colored urine, upper right-sided stomach pain and jaundice (yellowing of the eyes and skin). Contact your healthcare provider if you have any of these side effects.
Olumiant may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or call the FDA by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Your healthcare provider might change your Olumiant treatment with the following situations:
People with trouble swallowing tablets: If you're having trouble swallowing Olumiant tablets, you can place up to 4 milligrams (mg) of Olumiant in a container with 5 milliliters to 10 milliliters (mL) of water. To mix, gently swirl the tablets in the room temperature water. After you take this mixture, add another 5 milliliters to 10 milliliters of water into the container to rinse and take any remaining mixture.
People with a gastrostomy feeding tube (G-tube): If you have a G-tube, you can place up to four milligrams of Olumiant in a container with 10 milliliters to 15 milliliters of room temperature water. To mix, gently swirl the tablets in the water. Then, use a syringe to transfer the mixture through the G-tube. Afterward, add another 10 milliliters to 15 milliliters of water into the container to rinse before using a syringe to transfer the remaining mixture through the G-tube again.
People with a nasogastric feeding tube (NG-tube): If you have an NG-tube, you can place up to four milligrams of Olumiant in a container with 30 milliliters of room temperature water. To mix, gently swirl the tablets in the water. Then, use a syringe to transfer the mixture through the NG-tube. Afterward, add another 15 milliliters of water into the container to rinse before using a syringe to transfer the remaining mixture through the NG-tube again.
People with severe kidney problems: If you have severe kidney impairment, avoid taking Olumiant.
People with severe liver problems: If you have severe liver impairment, Olumiant isn't recommended.
Pregnant or nursing parents: There is limited safety and effectiveness data about Olumiant's use in pregnant people. As for nursing, there is no available safety and effectiveness information about Olumiant in nursing babies.
If you accidentally forgot your Olumiant dose, take it as soon as you remember. If it's already close to your next scheduled dose, however, then skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.
Try to find ways to help yourself remember to regularly take your medication, like setting up a reminder on your phone or calendar. Missing too many Olumiant doses may lead to further joint damage.
In clinical trials, a one-time high dose of 40 milligrams and daily high doses of 20 milligrams of Olumiant for 10 days didn't result in dose-related side effects. If you think that you're experiencing life-threatening side effects, however, seek immediate medical attention.
If you think you or someone else may have overdosed on Olumiant, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Olumiant, call 911 immediately.
It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if this medicine is working properly and to decide whether you should continue to use it. Blood and urine tests are needed to check for unwanted effects.
You will need to have a skin test for tuberculosis before you start using this medicine. Tell your doctor if you or anyone in your home has ever had a positive reaction to a tuberculosis skin test.
Your body's ability to fight infections may be reduced while you are using baricitinib. It is very important that you call your doctor at the first sign of an infection. Check with your doctor right away if you have a fever, chills, cough, flu-like symptoms, or unusual tiredness or weakness.
This medicine may increase your risk of serious heart or blood vessel problems (eg, heart attack, stroke), especially in patients with rheumatoid arthritis who are 50 years of age and older and with a heart or blood vessel disease. Call your doctor right away if you have chest pain or discomfort, confusion, difficulty in speaking, double vision, headache, inability to move arms, legs, or facial muscles, nausea, pain or discomfort in the arms, jaw, back, or neck, sweating, trouble breathing, or vomiting.
This medicine may increase your risk of cancer (eg, lymphoma, lung cancer, non-melanoma skin cancer). Tell your doctor right away if you have black, tarry stools, general feeling of illness, swollen glands, weight loss, yellow skin and eyes, persistent non-healing sore, reddish patch or irritated area, shiny bump, pink growth, or white, yellow or waxy scar-like area on the skin.
This medicine may increase your risk of developing blood clots (eg, arterial thrombosis, deep vein thrombosis, pulmonary embolism), especially in patients with rheumatoid arthritis who are 50 years of age and older and with a heart or blood vessel disease. Check with your doctor right away if you have anxiety, chest pain, cough, dizziness, lightheadedness, or fainting, fast heartbeat, pain, redness, or swelling in the arm or leg, pains in the chest, groin, or legs, especially calves of the legs, severe headaches, sudden loss of coordination, sudden onset of slurred speech, sudden vision changes, or trouble breathing.
Baricitinib can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection:
While you are being treated with baricitinib, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Baricitinib may lower your body's resistance and there is a chance you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.
This medicine can cause serious allergic reactions, including angioedema or urticaria. Tell your doctor right away if you start to have swelling of your face, lips, tongue, throat, arms, or legs, or if you are having trouble swallowing or breathing.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Before taking Olumiant, talk with your healthcare provider if any of the following apply to you:
Use caution when taking organic anion transporter 3 (OAT3)-inhibiting medications, such as probenecid—a gout medication that's typically used with Zyloprim (allopurinol). OAT3 is a protein that helps move medications—like Olumiant—around in your body. Taking an OAT3-inhibiting medication raises the amount of Olumiant in the body. High Olumiant levels also raise the likelihood of side effects.
Olumiant hasn't been studied with biologic DMARDs (made from naturally occurring sources—like proteins and tissues)—like Humira (adalimumab)—or other JAK inhibitors—like Xeljanz (tofacitinib). As a result, combining these types of medications with Olumiant isn't recommended.
There are several different non-biologic (chemical-based) disease-modifying antirheumatic drugs (DMARDS) that are used to treat rheumatoid arthritis (RA). Some DMARDs are biologics (made from naturally occurring sources—like proteins and tissues), and others are non-biologics (chemical-based). Since Olumiant is a chemical-based DMARD and also a JAK inhibitor, the following medications are most similar to Olumiant.
Clinical trials suggest that the following combinations are more effective than Humira with methotrexate:
Olumiant with methotrexate, however, has a higher potential for side effects. Although studies suggest that Olumiant has a greater risk of side effects, this medication might be the least costly JAK inhibitor.
Olumiant is available as a prescription. Olumiant isn't typically available at your local retail pharmacies. Your healthcare provider may need to send a prescription to a specialty pharmacy.
Olumiant is a brand-name specialty medication. It isn't available as a generic product yet. Without insurance coverage, this medication can be expensive.
If cost is a concern, the manufacturer—Eli Lilly—offers savings cards for people with commercial or no insurance. To find out if you're eligible, visit Eli Lilly's website or call 1-844-658-6426.
While Olumiant can be used by itself to treat rheumatoid arthritis (RA), some people will take Olumiant in combination with other medications—like methotrexate.
If you're taking Olumiant, you've probably tried a few different treatment options for rheumatoid arthritis (RA). While living with RA can understandably feel difficult and isolating, there are ways to help improve your quality of life. Refer to the following general tips:
Verywell Health's drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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Food and Drug Administration. Olumiant label.
Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care & Research. 2021;73(7):924-939. doi:10.1002/acr.24596
Centers for Disease Control and Prevention. Arthritis related statistics.
National Center for Complementary and Integrative Health. Rheumatoid arthritis: in depth.
Food and Drug Administration. Baricitinib emergency use authorization.
National Institutes of Health. COVID-19 treatment guidelines.
Infectious Diseases Society of America. IDSA guidelines on the treatment and management of patients with COVID-19.
National Institutes of Health. LiverTox: clinical and research information on drug-induced liver injury.
Harrington R, Ahmad Al Nokhatha S, Conway R. JAK inhibitors in rheumatoid arthritis: an evidence-based review on the emerging clinical data. Journal of Inflammation Research. 2020;13:519-531. doi:10.2147/JIR.S219586.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rheumatoid Arthritis.
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