Barixen

Indications

Baricitinib is used to treat moderate to severe rheumatoid arthritis in adults when other disease-modifying medicines have not worked well enough or cannot be used. It is also used for moderate to severe atopic dermatitis (eczema) and severe alopecia areata (patchy hair loss), and in hospital for some adults with severe COVID-19. Treatment is started and monitored by a specialist.

How It Works

Baricitinib blocks enzymes called Janus kinases (JAK1 and JAK2). These pass signals inside immune cells that drive inflammation. Blocking them calms the overactive immune response, reducing joint pain and swelling, skin inflammation, or immune attack on hair follicles.

Dosage and Administration

As prescribed. The usual adult dose is 2 mg or 4 mg once a day, chosen by the specialist according to the condition, age, kidney function and other medicines. Take by mouth at about the same time each day, with or without food. Do not stop or change the dose without medical advice.

Interactions

• Probenecid raises baricitinib levels; the dose is usually reduced.
• Live vaccines (such as yellow fever, oral polio, BCG, MMR) should not be given during treatment; get recommended vaccines before starting.
• Other strong immunosuppressants and biologic medicines for arthritis increase the risk of serious infection and are not usually combined with it.
• Tell the doctor about all medicines, including those that affect blood clotting.

Contraindications

• Pregnancy.
• Active serious infection, including active tuberculosis.
• Allergy to baricitinib or any ingredient of the product.
• It may not be suitable with severe kidney or liver impairment or very low blood cell counts; the doctor will decide.

Side Effects

Common: colds and other upper airway infections, nausea, raised cholesterol, cold sores, shingles, urine infections, headache, acne, and changes in blood tests such as raised liver enzymes or platelets.

Get urgent medical help if you have: fever, chills, cough, burning when passing urine or other signs of a serious infection; a painful, swollen leg, sudden chest pain or breathlessness (possible blood clot); chest pain, weakness on one side of the body or slurred speech (possible heart attack or stroke); a painful blistering rash; or swelling of the face or trouble breathing.

Pregnancy and Lactation

Do not use during pregnancy. Women who can become pregnant should use effective contraception during treatment and for at least one week after the last dose. Do not breastfeed while taking it.

Precautions and Warnings

• It lowers the immune defence; the doctor will test for tuberculosis and hepatitis before starting and check blood counts, liver tests and cholesterol during treatment.
• People aged 65 or over, current or past long-term smokers, and those with heart disease or a history of blood clots have a higher risk of heart problems, clots and some cancers; the doctor will weigh this carefully.
• Tell the doctor if you have frequent infections, diabetes, cancer, or bowel problems such as diverticulitis.
• Have regular skin checks; protect your skin from strong sun.

Overdose

Contact a doctor or go to hospital if too much has been taken. Symptoms are watched and blood tests may be done.

Therapeutic Class

Janus kinase (JAK) inhibitor; immunosuppressant.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.