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General Practice 2023

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

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

Baricitinib is a drug that reduces the immune system response, decreasing the action of enzymes that promote inflammation and the appearance of joint damage in cases of moderate to severe rheumatoid arthritis. In this way, this remedy is able to relieve the symptoms of arthritis, such as pain, stiffness and swelling of the joints.

In addition, baricitinib is approved by ANVISA for use in the treatment of COVID-19 in hospitalized adults who need to receive oxygen by mask, nasal catheter or who need high flow oxygen or non-invasive ventilation, as it works by decreasing inflammation and cell damage caused by the coronavirus.

This drug is provided by the SUS in the form of 2 or 4 mg tablets, under the trade name Olumiant, and should only be used under the guidance of a doctor, for the treatment of rheumatoid arthritis when other drugs have not been effective for control symptoms, or for treatment of COVID-19 in hospitals.

What is it for

Baricitinib is indicated for the treatment of pain, stiffness and swelling of the joints caused by moderate to severe rheumatoid arthritis, in addition to decreasing the progression of the disease and damage to bones and joints, when other drugs have not been able to to control or lessen symptoms

This medication can be used alone or in combination with methotrexate, in the treatment of rheumatoid arthritis, as medically indicated.

Is baricitinib recommended for the treatment of COVID-19?

Baricitinib may help block the entry of the new coronavirus into cells and reduce recovery time and mortality in moderate to severe cases, in hospitalized adults or children over two years of age who require oxygen, mechanical ventilation or extracorporeal membrane oxygenation. Therefore, this drug had its use approved in the United States, by the FDA, for the treatment of suspected COVID-19 or SARS-CoV-2 infection confirmed by laboratory tests, and should be used in combination with remdesivir, which is a antiviral.[1, 2]

In Brazil, baricitinib is approved by ANVISA for the treatment of COVID-19, to be used only in adults admitted to hospitals who need to receive oxygen by mask, nasal catheter or high flow, or non-invasive ventilation [3] Check all approved and under study drugs for Covid-19.

How to take it

Baricitinib should be taken orally according to medical advice, and the recommended dose for the treatment of rheumatoid arthritis in adults is 1 tablet of 2 mg or 4 mg, once a day, before or after feeding.

The tablet should always be taken at the same time, but in case you forget to 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 schedules programmed. Do not double the dose to make up for the missed dose.

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

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.

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

It is recommended to discontinue use and seek medical help immediately if symptoms of a severe baricitinib allergy such as difficulty breathing, tight throat, swelling of the mouth, tongue or face, or hives develop, or if you take baricitinib in doses higher than those recommended to monitor side effects. Know how to identify the symptoms of a severe allergic reaction.

Who should not use

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

This medication should be used with caution in people who have blood clotting problems, including the elderly, obese, people with a history of thrombosis or embolism, or people who are going to have some type of surgery and need to be immobilized. In addition, caution should also be exercised in the case of people with liver or kidney failure, anemia or in people with a weakened immune system, who may need dose adjustment by the doctor.

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