Olumiant (baricitinib) is a brand-name oral tablet prescribed for alopecia areata, COVID-19, and rheumatoid arthritis. Olumiant has interactions with some other drugs and certain vaccines. Examples include corticosteroids, such as prednisone (Rayos), and methotrexate.

An interaction occurs when one substance causes another substance to have a different effect than expected.

To learn more about Olumiant’s interactions, keep reading. For additional information about Olumiant, including details about its uses, see this article.

Before you start treatment with Olumiant, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Olumiant interacts with supplements, herbs, or vitamins, see the “Olumiant and other interactions” section.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Olumiant. Keep in mind that this table doesn’t include all drugs that may interact with Olumiant. Some of these interactions are described in detail in the “Drug interactions in depth” section.

Drug class or drug nameDrug examplesInteraction result with Olumiant
other Janus kinase (JAK) inhibitors• infliximab (Remicade)
• tofacitinib (Xeljanz, Xeljanz XR)
• upadacitinib (Rinvoq)
may increase the risk of infection
biologic disease-modifying antirheumatic drugs (DMARDs)• abatacept (Orencia)
• anakinra (Kineret)
• rituximab (Rituxan)
• sarilumab (Kevzara)
• tocilizumab (Actemra)
may increase the risk of infection
corticosteroidsdexamethasone (Hemady)
methylprednisolone (Medrol)
• prednisone (Rayos)
may increase the risk of infection or gastrointestinal (GI) perforation (tears in your digestive tract)
certain immunosuppressants• azathioprine (Azasan, Imuran)
• cyclosporine (Gengraf, Neoral, others)
• tacrolimus (Astagraf XL, Prograf, others)
may increase the risk of infection
nonsteroidal anti-inflammatory drugs (NSAIDs)• ibuprofen (Advil, Motrin)
meloxicam
• naproxen (Aleve, Naprosyn, others)
may increase the risk of GI perforation
tumor necrosis factor (TNF) blockers• adalimumab (Humira)
• certolizumab pegol (Cimzia)
• etanercept (Enbrel)
• golimumab (Simponi, Simponi Aria)
may increase the risk of infection
leflunomide (Arava)can increase the risk of side effects of Olumiant
methotrexate (Otrexup, Trexall, others)may increase the risk of infection or GI perforation
probenecid (Probalan)can increase the risk of side effects of Olumiant
teriflunomide (Aubagio)can increase the risk of side effects of Olumiant

There aren’t any known interactions between Olumiant and alcohol. However, both alcohol and Olumiant may cause headache and nausea as side effects. Drinking alcohol while taking the drug may worsen these side effects.

If you have questions about drinking alcohol while taking Olumiant, talk with your doctor. To learn more about Olumiant’s side effects, see this article.

Here’s a closer look at certain drug interactions of Olumiant.

Corticosteroids

Corticosteroids are prescribed to reduce inflammation. They may be used for the same conditions that Olumiant is prescribed to treat, including alopecia areata, COVID-19, and rheumatoid arthritis (RA).

Interaction result: Taking Olumiant with a corticosteroid can increase the risk of infection or GI perforation (tears in your digestive tract).

Interaction explained: When taken individually, Olumiant and corticosteroids can increase your risk of infection. Taking them together can raise your risk of this side effect. (Keep in mind that Olumiant has a boxed warning about the risk of serious infection. For details, see “Boxed warnings” in this article.)

Both Olumiant and corticosteroids can also cause GI perforation as a side effect. Your risk of GI tears may be greater when these drugs are taken together.

Examples of corticosteroid drugs: Here are some corticosteroids that may interact with Olumiant:

  • dexamethasone (Hemady)
  • methylprednisolone (Medrol)
  • prednisone (Rayos)

Steps you or your doctor may take: In some cases, your doctor may prescribe Olumiant with a corticosteroid to treat your condition. If so, they’ll monitor you closely for symptoms of infection and GI perforation. Symptoms of infection may include fever, cough, and fatigue. Nausea, vomiting, or sudden abdominal pain may be symptoms of a GI tear.

If you have these side effects while taking Olumiant with a corticosteroid, your doctor or pharmacist can recommend what to do.

To learn more about Olumiant and corticosteroids, talk with your doctor or pharmacist.

NSAIDs

NSAIDs are used to ease fever, inflammation, and pain. Certain NSAIDs are available over the counter, meaning you can purchase them without a prescription.

Interaction result: Taking Olumiant with an NSAID can increase the risk of GI tears as a side effect of either drug.

Interaction explained: Both Olumiant and NSAIDs can cause GI tears when taken individually. If you take these drugs together, your risk of this side effect may be greater.

Examples of NSAIDs: Here are some NSAIDs that may interact with Olumiant:

  • ibuprofen (Advil, Motrin)
  • meloxicam
  • naproxen (Aleve, Naprosyn, others)

Steps you or your doctor may take: Before taking any NSAIDs with Olumiant, talk with your doctor or pharmacist. They can recommend whether it’s safe to take these drugs together.

If you take an NSAID with Olumiant, watch for nausea, vomiting, or sudden abdominal pain. These may be symptoms of GI perforation. Your doctor or pharmacist can recommend what to do if you have these symptoms.

To learn more about Olumiant and NSAIDs, talk with your doctor or pharmacist.

Methotrexate

Methotrexate (Otrexup, Trexall, others) is prescribed for several cancers and other conditions, including RA. (Olumiant is also prescribed to treat RA.)

Interaction result: Taking Olumiant with methotrexate can increase the risk of infection and GI perforation.

Interaction explained: Both Olumiant and methotrexate can increase your risk of infection when taken alone. Your risk of infection may be greater when these drugs are taken together. (Keep in mind that Olumiant has a boxed warning about the risk of serious infection. For details, see “Boxed warnings” in this article.)

When taken individually, Olumiant and methotrexate can also cause GI perforation. Taking them together can raise your risk of this side effect.

Steps you or your doctor may take: Your doctor may prescribe Olumiant with methotrexate to treat RA. If so, they’ll monitor you closely for symptoms of infection and GI perforation. Fever, cough, and fatigue may be symptoms of infection. Symptoms of GI perforation may include nausea, vomiting, and sudden abdominal pain.

If you have an infection or GI tear while taking Olumiant with methotrexate, your doctor or pharmacist can recommend what to do.

To learn more about Olumiant and methotrexate, talk with your doctor or pharmacist.

Olumiant may have other interactions, such as with supplements, foods, vaccines, or lab tests. Keep in mind that the following information does not include all other possible interactions with Olumiant.

Olumiant and supplements

It’s possible for drugs to interact with supplements, vitamins, and herbs.

Olumiant and herbs

There are no reports of herbs interacting with Olumiant. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Olumiant treatment.

Olumiant and vitamins

There are no reports of vitamins interacting with Olumiant. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Olumiant.

Olumiant and food

There were no reports of food interactions with Olumiant. If you’d like to learn more about eating certain foods during treatment with Olumiant, talk with your doctor.

Olumiant interactions with vaccines

Olumiant may interact with live vaccines. A live vaccine contains weakened pieces of the bacterium or virus it’s meant to defend against. Live vaccines usually won’t cause infection for people with healthy immune systems.

However, Olumiant treatment may lower the activity of your immune system. This could result in your immune system being unable to fight the virus or bacterium in a live vaccine. This may increase your risk of becoming ill or developing symptoms of the illness the vaccine is meant to prevent.

Examples of live vaccines that may interact with Olumiant include:

Before starting Olumiant treatment, talk with your doctor or pharmacist about any vaccines you may need. They can talk with you about the timing of the vaccines and when it’s safe to begin Olumiant treatment.

Olumiant and lab tests

Olumiant is not known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

OLUMIANT AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been reported to interact with Olumiant. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Olumiant. The impact of cannabis may affect how well you stick to your Olumiant treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Olumiant. Before you take this drug, be sure to talk with your doctor about your health history. Olumiant may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Olumiant include:

  • Digestive system problems: Olumiant treatment may cause GI perforation (tears in your digestive tract). This risk may be greater for people with certain digestive system problems, including diverticulitis. Before taking Olumiant, tell your doctor about any digestive system problems you have. They can recommend whether Olumiant is a safe treatment option.
  • Kidney or liver problems: If you have a kidney or liver problem, such as kidney failure or liver failure, talk with your doctor before taking Olumiant. These conditions may increase your risk of side effects from the drug. To reduce this risk, your doctor may prescribe a lower Olumiant dosage than is typical.
  • Allergic reaction: If you’ve had an allergic reaction to Olumiant or any of its ingredients, your doctor will likely not prescribe Olumiant. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
  • Breastfeeding: It’s not known whether it’s safe to take Olumiant while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Olumiant may have on a child who is breastfed. To be safe, your doctor may advise you not to breastfeed during Olumiant treatment or for at least 4 days after your last dose. If you’re breastfeeding or planning to, talk with your doctor before taking Olumiant. They can talk with you about treatment options and ways to feed your child.
  • Pregnancy: Olumiant may not be safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or can become pregnant, tell your doctor before starting Olumiant. They can advise you on the right treatment plan for you.

You can take certain steps to help prevent interactions with Olumiant. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Olumiant label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Olumiant doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Olumiant by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.