Baricitinib is the first oral drug for the treatment of adult patients with moderate-to-severe rheumatoid arthritis, alone or in combination with methotrexate, that targets and blocks Janus Kinase (JAK) enzymes to reduce inflammation.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic inflammatory disease that gradually destroys the joints. There is no single test for rheumatoid arthritis, but it’s often suspected on the basis of symptoms, such as joint pain or stiffness and swelling that last more than 6 weeks. The most common symptom is pain in multiple joints.

What is Baricitinib?

Barilup is an orally available JAK inhibitor that was developed by a pharmaceutical company called Janssen (“J&J”) and marketed as Barilup (active ingredient, baricitinib or BIA 10-2474). The drug is approved in three countries — the USA, Canada, and the EU.

Baricitinib has been approved for indications, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. It can also be used to slow the progression of other types of arthritis, such as reactive arthritis, Still’s disease, and ulcerative colitis.

Does Baricitinib Work For Everyone?

Studies show that it works for most people. But some people don’t respond to baricitinib. Finding the right drug usually takes time and patience. It may take a few months before you find out if the drug works for you. If this is your first treatment, it is likely to be taken longer than usual (up to 6 months) before you notice an improvement in your symptoms. If the treatment doesn’t work after 6 months, stop taking baricitinib and contact your doctor as there are other treatments that may be more suitable.

What Exactly Does Baricitinib Do?

Barilup blocks Janus Kinase (Jak). Jak is a group of enzymes that activates certain proteins that cause inflammation. By blocking Jak, baricitinib helps to reduce the activity of inflammatory proteins, which eliminates pain and other symptoms associated with rheumatoid arthritis.

How Does Baricitinib Work?

Baricitinib blocks two different types of Jak: Jak 1 and Jak 2. When you have rheumatoid arthritis, your immune system produces lots of cytokines, which are chemical signals that tell cells to become inflamed or to reproduce. These cytokines cause inflammation in your body’s joints, skin, and muscles. Baricitinib is thought to prevent these cytokines from activating enzymes called Janus kinases (Jaks). Jaks normally activate proteins called transcription factors, which cause inflammation. By preventing Jaks from activating the transcription factors, baricitinib may prevent inflammation.

When you start taking Baricitinib, it will take several weeks before you notice any improvement in your symptoms. This is because your immune system cells need time to react to this new drug. The delay between starting treatment and seeing an improvement in the symptoms is called the “wash-out period” and can last from 4 weeks to 6 months, depending on the person. So it may take 4 to 6 months before you can say for sure whether Baricitinib has an effect on your arthritis.

It is important that you try and keep the same schedule of taking baricitinib every day, at the same time. Missing doses can delay your response to treatment. If you miss a dose and remember later in the day, take it as soon as possible. Do not take 2 doses at once to make up for a missed one. Always carry your medicine with you so that you can take it as prescribed.

Who Should Not Take Baricitinib?

Do not take Baricitinib if you are pregnant or planning to become pregnant. Baricitinib could harm your unborn baby. If you are already pregnant and you want to become pregnant while taking Baricitinib, talk to your doctor or dermatologist before using Baricitinib.

Do not take Barilup if you:

  • Are allergic to baricitnib or any of its ingredients;
  • Are pregnant or breastfeeding.

Tell your doctor if:

  • You have any changes in your medical condition, such as pregnancy, fever, infection, head injury, or heart attack;
  • You have had surgery within the last 6 months.

Is Barilup (Baricitinib) Safe?

The drug reduces the symptoms of rheumatoid arthritis and it is believed to do so without significant side effects. Barilup has not been proved safe for use in pregnant women and children, but there are no known harmful effects associated with liver function or organs when taken as prescribed.

The drug is administered orally and has been known to reduce the symptoms of rheumatoid arthritis within weeks of use. Side effects have included nausea and diarrhea, but it is believed these will disappear over time.

Side Effects

Although it has only been tested on small groups of people so far, most side effects have been mild or moderate. Some people who take baricitinib have experienced low blood sugar levels or slowed breathing. Others have felt weak, dizzy, or numb. Some side effects have been more severe.

Barilup may lower blood sugar levels, so people with diabetes or those who take blood sugar control medications, may need to monitor their blood glucose levels. People taking baricitinib may be at a greater risk of developing diabetes.

Patients taking baricitinib may develop a condition called hypophosphatemia, which is characterized by low blood phosphate levels in the body. Low phosphate levels can lead to nerve damage and other health problems. People taking baricitinib should avoid using phosphate binders.

Baricitinib may cause decreased blood pressure, which can lead to dizziness, fainting, and falls. People with heart disease may be at a greater risk of these effects.

People taking baricitinib may also experience a side effect called asthenia (weakness). The most common side effects in clinical studies were diarrhea, nausea, and abdominal pain.

The following side effects are most frequently reported:

  • Headache;
  • Upset stomach;
  • Diarrhea;
  • Dizziness;
  • Impairment of kidney function;
  • Liver toxicity.

If you experience any of these symptoms, contact your doctor immediately.

This is not a comprehensive list of side effects, or possible side effects. Should you notice any other side effects not listed above, please contact your doctor or pharmacist.

Baricitinib is contraindicated in cases where the patient’s renal function is compromised (including acute renal failure), and in whom treatment with JAK inhibitors may increase the risk of severe hepatic events.

Barilup can make you feel drowsy or sleepy, but after taking this drug for several days, your body will become accustomed to its effects. You should take precautions when driving to avoid accidents.

Additional Information of Baricitinib

The main component of this treatment is the drug labetalol. It works by preventing excess release of adrenalin from the neurons in your central nervous system. Labetalol also helps to maintain normal blood flow into your organs and other parts of your body. It’s especially important because stress can cause an increase in blood pressure.

When you first start taking this drug, it may cause drowsiness and dry mouth. This side effect usually goes away with time.

Bottom Line

Barilup is a prescription medication used in adults who cannot be treated with other types of medications. It is approved to treat moderate-to severe rheumatoid arthritis and active psoriatic arthritis. Barilup may also be used for other conditions as determined by your doctor.

The most common side effects of Barilup are diarrhea, nausea, anemia, and feeling tired.

Before taking Barilup, tell your doctor if you have ever had a stomach ulcer or bleeding in the stomach, as well as if you have a history of stroke, heart attack, or heart failure. You should also tell your doctor about all the medications you are taking, including prescription and over-the-counter medicines, such as pain relievers and cough meds.

Barilup is not recommended for use in children because safety and effectiveness in children have not been confirmed. It is not known whether Barilup is excreted into breast milk. Discuss breastfeeding with your doctor before taking this medication.


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