If you have rheumatoid arthritis (RA), alopecia areata, or severe COVID-19, your doctor may recommend treatment with Olumiant. It’s a prescription medication that’s used to treat:

  • moderate to severe RA in adults when other medications called tumor necrosis factor (TNF) blockers haven’t worked well enough
  • severe alopecia areata
  • severe COVID-19 that requires hospitalization, along with treatments that help you breathe

Olumiant is not recommended for use with certain other medications.

For more information about this drug’s uses, see the “What is Olumiant used for?” section below.

Olumiant basics

The active drug in Olumiant is baricitinib. It’s not currently available as a generic.

Olumiant belongs to a group of drugs known as Janus kinase (JAK) inhibitors. It comes as tablets that you swallow.

Read on to learn more about Olumiant’s cost, side effects, uses, and more.

Below are answers to some common questions about Olumiant.

How does Olumiant compare with Xeljanz, Rinvoq, and Humira?

Olumiant, Xeljanz, Rinvoq, and Humira are all prescribed to treat rheumatoid arthritis (RA) in certain people. These drugs may also be prescribed to treat other conditions.

Olumiant, Xeljanz, and Rinvoq come as tablets that you swallow. Humira comes as a solution that’s injected under your skin.

To learn more about how these medications are alike and different, talk with your doctor or pharmacist.

Is Olumiant taken in 4-mg doses for any uses? If so, does this dose cause side effects?

Olumiant is sometimes prescribed in a dosage of 4 milligrams (mg) per day. The side effects of a 4-mg dose of Olumiant are expected to be the same as side effects caused by the 2-mg dose.

A dosage of 4 mg once per day is recommended for treatment of severe COVID-19. A 4-mg dose can also be prescribed for severe alopecia areata.

When you start taking Olumiant for alopecia areata, your doctor might prescribe:

  • 4 mg per day, if you have complete or nearly complete scalp hair loss. If your hair regrows with treatment, your doctor might lower your dose to 2 mg per day.
  • 2 mg per day, which might be increased to 4 mg per day if the starting dosage isn’t working well enough.

Talk with your doctor if you have questions about the dosage that’s right for you. You can also see this article for details about Olumiant’s recommended dosages.

If you have questions about effects of Olumiant, see the “What are Olumiant’s side effects?” section below. You can also talk with your doctor or pharmacist.

How does Olumiant work? Is it a biologic?

Olumiant’s mechanism of action (how it works) is to block a protein called Janus kinase. It belongs to a group of drugs known as Janus kinase (JAK) inhibitors.

Janus kinase acts as a messenger between other proteins and cells in your immune system. Blocking Janus kinase stops messages that cause inflammation in your body. This can help reduce symptoms of RA, alopecia areata, and COVID-19.

Olumiant isn’t a biologic. A biologic is a drug that is made using living cells. Instead, Olumiant is a drug that’s made from chemicals.

Does Olumiant treat atopic dermatitis or lupus?

Olumiant is approved by the Food and Drug Administration (FDA) to treat RA, alopecia areata, and COVID-19 in certain situations. But the drug may be prescribed off-label to treat other conditions. (With off-label use, a drug is prescribed for a condition that it isn’t approved to treat.)

In countries other than the United States, Olumiant is approved to treat atopic dermatitis (eczema). Research is being done to determine if the FDA will approve Olumiant to treat eczema in the United States.

There are also studies being done to determine if Olumiant can treat lupus.

If you have questions about off-label uses for Olumiant, talk with your doctor or pharmacist.

Will I have weight gain, depression, or tiredness from Olumiant?

No, Olumiant isn’t known to cause depression, tiredness, or weight gain. These weren’t side effects reported in studies of the drug.

Depression, tiredness, and weight gain are all possible symptoms of rheumatoid arthritis (RA), which Olumiant is used to treat. Alopecia areata and COVID-19 may also cause depression or tiredness. Your doctor can recommend ways to manage these symptoms.

Is Olumiant used for psoriasis or psoriatic arthritis?

Olumiant is only approved to treat RA, alopecia areata, and COVID-19 in certain situations. It may be prescribed off-label to treat other conditions, though. (With off-label use, a drug is prescribed for a condition that it isn’t approved to treat.)

Olumiant is currently being studied to see if it’s effective for treating psoriasis. But it’s not currently being looked at as a treatment option for psoriatic arthritis.

If you have questions about off-label uses of Olumiant, talk with your doctor or pharmacist.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and your treatment plan. Since Olumiant is given in the hospital for COVID-19, you can talk with your doctor or insurance provider about the cost of Olumiant treatment for this condition.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Olumiant manufacturer’s website to see if they have support options.

Like most drugs, Olumiant may cause mild or serious side effects. The lists below describe some of the more common side effects that Olumiant may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Olumiant. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Olumiant can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Olumiant’s prescribing information.

Mild side effects of Olumiant that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Olumiant can occur, but they aren’t common. If you have serious side effects from Olumiant, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Serious side effects of Olumiant that have been reported include:

* For more information about this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Olumiant may cause.

Boxed warnings

Olumiant has boxed warnings about serious infections, blood clots, and cancer. A boxed warning is a serious warning from the Food and Drug Administration (FDA). The drug’s boxed warnings are described below.

Serious infections. Taking Olumiant increases your risk of serious infections. This is because Olumiant works by reducing the activity of your immune system. Rarely, these infections can be life threatening and require treatment in a hospital. This includes tuberculosis (TB), for example.

What might help

Call your doctor right away if you have symptoms of an infection while taking Olumiant. These include:

Your doctor will test you for TB and other infections before you start taking Olumiant for rheumatoid arthritis (RA) or alopecia areata. You should not start this drug if you have an active infection. If you have an infection, it will need to be treated before it’s safe for you to take Olumiant.

Blood clots. Rarely, taking Olumiant can cause blood clots, such as:

What might help

Call your doctor right away or seek medical help if you have symptoms of a blood clot while you’re taking Olumiant. These symptoms include:

Cancer. Olumiant reduces the activity of your immune system. This can increase your risk of developing certain types of cancer, including non-melanoma skin cancer and lymphoma.

Cancer doesn’t always cause symptoms. But if you notice any of the following, call your doctor right away:

What might help

Be sure to tell your doctor if you’ve ever had cancer before starting Olumiant. They may decide that a different treatment is safer for your condition.

Serious heart-related events. Recent studies looked at Xeljanz, which is another drug used to treat RA. These studies showed that the drug increased people’s risk of serious heart-related events, including heart attack and stroke.

This risk hasn’t been reported with Olumiant. But because it works in the same way as Xeljanz, Olumiant could also increase this risk, in theory. Because of this, the FDA has applied a boxed warning to Olumiant for serious heart-related events as well.

If you already have risk factors for heart-related events, you may have an increased risk of these if you take Olumiant.

What might help

Talk with your doctor to see if you have risk factors for heart-related events. If you’d like to learn more about this risk with Olumiant treatment, ask your doctor or pharmacist.

Increased risk of death. Recent studies with Xeljanz, another drug used to treat RA, showed that the drug increased people’s risk of death. This risk hasn’t been reported with Olumiant. But because the drugs work in the same way, Olumiant could also increase this risk, in theory.

Because of this, the FDA has applied a boxed warning to Olumiant for this risk as well.

What might help

Talk with your doctor if you’d like to learn more about this risk with Olumiant treatment.

Gastrointestinal perforation

Although very rare, taking Olumiant could cause gastrointestinal perforations. These are holes in your stomach or intestines.

People with diverticulitis or stomach or intestinal ulcers may be at higher risk of this side effect with Olumiant.

You’re also at higher risk if you take certain medications. These include:

Symptoms of gastrointestinal perforation can include:

What might help

Be sure to tell your doctor about your medical history before you begin taking Olumiant.

This should include whether you have or have had diverticulitis or stomach or intestinal ulcers. You should also tell them about all the medications you take. They can check if any of them increase your risk of gastrointestinal perforation if taken with Olumiant.

Call your doctor right away if you have symptoms of gastrointestinal perforation. This is especially important if you have fever, pain in your stomach that doesn’t go away, or a change in your bowel habits.

Allergic reaction

Some people may have an allergic reaction to Olumiant. This wasn’t reported during clinical studies of Olumiant, but allergic reactions have been reported since the drug was approved.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Olumiant. But if you think you’re having a medical emergency, call 911 or your local emergency number.

The Food and Drug Administration (FDA) approves prescription drugs such as Olumiant to treat certain conditions. Olumiant may also be prescribed off-label for other conditions. Off-label means an FDA-approved drug is prescribed for a purpose other than what it’s been approved for.

Olumiant for rheumatoid arthritis

Olumiant is approved to treat moderate to severe rheumatoid arthritis (RA) in adults. It’s used when other medications called tumor necrosis factor (TNF) blockers haven’t worked well enough. And it’s used to treat RA that’s active (causing symptoms).

RA is a chronic (long-term) condition that happens when your immune system attacks your joints by mistake. It’s not understood why this occurs in some people.

RA causes symptoms affecting your joints, such as:

Most commonly, RA affects joints in your hands, feet, and wrists. But it can also affect your ankles, elbows, knees, and shoulders. Left untreated over time, RA can cause your joints to become misshapen.

For RA, doctors typically don’t prescribe Olumiant with other RA drugs, including:

For examples of these drugs, see “Interactions” in the “What should be considered before taking Olumiant?” section below.

Olumiant for alopecia areata

Olumiant is approved to treat severe alopecia areata in adults. Alopecia areata is an autoimmune condition, meaning it’s caused by your immune system attacking your body. It’s considered “severe” if it causes loss of 50% or more of your hair.

Alopecia areata causes hair loss that can happen unpredictably. Hair loss can affect your scalp or any place where hair grows on your body.

For alopecia areata, doctors typically don’t prescribe Olumiant in combination with certain drugs, including:

For examples of these drugs, see “Interactions” in the “What should be considered before taking Olumiant?” section below.

Olumiant for COVID-19

Olumiant is approved to treat severe COVID-19 in the hospital. It’s given with other treatments that help you breathe. These may include oxygen therapy, ventilation, and extracorporeal membrane oxygenation (ECMO) treatment.

COVID-19 is a condition that results from a virus called SARS-CoV-2. This condition can range from not noticeable or mild to life threatening. Symptoms can include trouble breathing, cough, fever, body aches, lack of energy, and others. The full effects of COVID-19 aren’t yet known.

Your doctor will recommend the dosage of Olumiant that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths

Olumiant comes as tablets that you swallow. It’s available in three strengths: 1 milligram (mg), 2 mg, and 4 mg.

If you have trouble swallowing tablets, Olumiant can be given in other ways. This is typically done for severe COVID-19 treatment. See the “How is Olumiant taken?” section for details.

Recommended dosage

You’ll likely take Olumiant once per day.

For COVID-19, the recommended Olumiant dosage is typically higher than the starting dosage for rheumatoid arthritis (RA) or alopecia areata. And Olumiant treatment for COVID-19 lasts for 14 days or until you’re discharged from the hospital (whichever is sooner).

Questions about Olumiant’s dosage

Below are a few commonly asked questions about taking Olumiant.

  • What if I miss a dose of Olumiant? If you miss a dose of Olumiant, try to take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and take your next dose at the usual time. Don’t take more than one dose to try and make up for the missed dose.
  • Will I need to use Olumiant long term? It depends on the condition you’re taking the drug for. If you and your doctor agree that Olumiant is working well for your RA or alopecia areata, you’ll likely take the drug long term. But Olumiant treatment for COVID-19 lasts for 14 days or until you’re discharged from the hospital, whichever comes first.
  • How long does Olumiant take to work? Does it start to work quickly? In studies, some people taking Olumiant for RA had a reduction in their symptoms as soon as 1 week after starting the drug. But it may take several weeks before you begin to notice symptom relief. For alopecia areata, it may take up to 36 weeks to see Olumiant’s full effects on hair regrowth. For COVID-19 treatment, Olumiant starts working right away. Olumiant’s effects for COVID-19 may not be noticeable, but the drug works to help prevent serious side effects such as death from COVID-19.

It’s important to discuss your overall health and medical conditions with your doctor when considering treatment with Olumiant. You should also tell your doctor and pharmacist about any medications you take. They can then check for drug interactions between those medications and Olumiant.

These and other things to consider before taking Olumiant are described below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Olumiant, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Olumiant.

Interactions with drugs or supplements

Olumiant can interact with several types of drugs. Doctors typically don’t prescribe Olumiant with such drugs. These drugs include:

This list does not contain all types of drugs that may interact with Olumiant. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Olumiant.

* Olumiant is a type of JAK inhibitor.

Other interactions

You should not get live vaccines while you’re taking Olumiant. Live vaccines contain a weakened, but live version of the virus or bacteria they protect against.

These vaccines don’t usually cause infection in people with a healthy immune system. But Olumiant weakens your immune system, so live vaccines could lead to a serious infection in people taking Olumiant.

Examples of live vaccines include:

Note: The flu vaccine injection and the COVID-19 vaccine are not live vaccines. They’re inactive vaccines, meaning they contain a killed version of the virus or bacteria they protect against. These vaccines are safe to receive during Olumiant treatment.

Talk with your doctor before getting a vaccine while you’re taking Olumiant. It’s recommended to make sure your vaccinations are up to date before you begin Olumiant therapy.

Boxed warnings

Olumiant has boxed warnings about the risk of serious infections, cancer, and blood clots. It also has boxed warnings about the risk of heart-related events, such as heart attack or stroke, and an increased risk of death.

These are serious warnings from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

For more information, see the “What are Olumiant’s side effects?” section above.

Other warnings

Olumiant may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Olumiant. Factors to consider include those in the list below.

  • Increased infection risk. Olumiant reduces your immune system activity. If you have other risk factors for infection, you may have a higher risk of infection with Olumiant. This includes diabetes, lung disease (such as asthma or chronic obstructive pulmonary disease [COPD]), HIV, or a weakened immune system. Talk with your doctor about ways to reduce this risk. They can also help determine if Olumiant is safe for you to take.
  • Active infection. You should not start taking Olumiant if you have an infection that’s active (causing symptoms). Olumiant reduces your immune system activity, which could make it harder to treat your infection. Your doctor should treat any current infection you have before you start Olumiant therapy.
  • Tuberculosis (TB) or hepatitis B or C. Tell your doctor if you’ve previously had hepatitis B, hepatitis C, or TB. Taking Olumiant could cause these infections to become active (start causing symptoms) again in your body. Your doctor can help determine whether Olumiant is safe for you to take.
  • Kidney problems. Your body gets rid of Olumiant through your kidneys. If your kidneys aren’t working properly, Olumiant may build up in your body. This increases your risk of side effects and could cause even more damage to your kidneys. If you have problems with your kidneys, you may be prescribed a lower dose of Olumiant. But only after your doctor determines that your kidneys are healthy enough for this drug. Olumiant should not be used in people with severe kidney problems, though.
  • Liver problems. Olumiant can elevate levels of your liver enzymes. This can be a sign of liver damage. If you already have liver problems, you may be at higher risk for this side effect. And Olumiant could make your liver problems worse. Your doctor can help determine whether Olumiant is safe for you to take.
  • Low level of red blood cells or white blood cells. Tell your doctor if you have a low level of red blood cells or white blood cells. Treatment with Olumiant can decrease these levels. So you should not start taking Olumiant until your levels return to normal. And you’ll need to have blood tests to monitor your blood cell levels if your doctor prescribes Olumiant to you. If your levels become too low, your doctor may pause or stop your Olumiant therapy.
  • Diverticulitis or ulcers in your stomach or intestines. Although it’s not common, Olumiant can cause gastrointestinal perforation (holes in your stomach). People with diverticulitis or stomach or intestinal ulcers who take Olumiant may have a higher risk for this side effect. Your doctor can help determine whether Olumiant is safe for you to take.
  • Allergic reaction. If you’ve had an allergic reaction to Olumiant or any of its ingredients, you should not take Olumiant. Ask your doctor what other medications are better options for you.

Olumiant and alcohol

There’s no known interaction between alcohol and Olumiant.

But alcohol and Olumiant can both cause nausea. So your risk for this side effect may be increased if you drink alcohol while taking this drug.

If you drink alcohol, talk with your doctor about whether it’s safe for you to consume it during Olumiant therapy.

Pregnancy and breastfeeding

It’s not known if it’s safe to take Olumiant while pregnant.

If you’re pregnant or planning to become pregnant, talk with your doctor before you take Olumiant. And call your doctor right away if you become pregnant while taking this drug.

It’s also not known if Olumiant passes into human breast milk. But because of the risk of possible serious side effects in a breastfed child, you should not breastfeed while taking this drug. Your doctor can recommend safe ways to feed your child.

Your doctor will explain how you should take Olumiant. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Olumiant

Olumiant comes as a tablet that you swallow.

If you have trouble swallowing tablets, your doctor might recommend dissolving your Olumiant tablet(s) in water and drinking this solution. You should swish a little bit of water around in the cup after you finish drinking the solution, and drink that water as well. This is to make sure you swallow your entire dose. Be sure to follow the specific instructions from your doctor or another healthcare professional about how to do this.

Healthcare professionals can also give Olumiant via a tube placed in your nose, mouth, or stomach. This might be done for COVID-19 treatment in the hospital.

Questions about taking Olumiant

Below are a couple of common questions about taking Olumiant.

  • Can Olumiant be chewed, crushed, or split? You should swallow Olumiant tablets whole. Splitting or chewing the tablets is not recommended by Olumiant’s manufacturer. And you should not crush Olumiant tablets unless your doctor recommends this. If you’re having trouble swallowing Olumiant tablets whole, check out this article or talk with your doctor or pharmacist.
  • Should I take Olumiant with food? You may take Olumiant with or without food.
Questions for your doctor

You may have questions about Olumiant and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Olumiant affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are there to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

Do not take more Olumiant than your doctor prescribes. Taking more than this can lead to serious side effects.

What to do in case you take too much Olumiant

Call your doctor if you think you’ve taken too much Olumiant. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

If you have rheumatoid arthritis (RA), alopecia areata, or COVID-19 that’s being treated in a hospital, your doctor may prescribe Olumiant.

Ask your doctor for information about the risks and benefits of taking Olumiant for your condition. Here are a few questions to consider:

  • What should I expect when starting treatment with Olumiant?
  • How will I know if Olumiant is working for me?
  • How long will I need to take Olumiant?
  • What lab tests will I need to have done while I’m taking Olumiant? How often will I need to have blood drawn for tests?

For more information and updates about conditions such as RA and COVID-19, consider signing up for our newsletters. You can also find support and other resources for living with RA from our Bezzy RA community.

Q:

Is it safe for older adults to take Olumiant?

Anonymous

A:

In general, Olumiant is safe for older adults to take.

The initial studies of Olumiant included people over 65 years old. There weren’t any noticeable differences in older people with how the drug worked and how safe it was.

But keep in mind that Olumiant is removed from the body through your kidneys. Older adults typically have lower kidney function than younger people. If your kidneys aren’t working well, Olumiant can build up in your body. And this can increase your risk of side effects.

So, if you’re over 65 years old, your healthcare professional will monitor your kidney function. And they’ll adjust your Olumiant dose if needed.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline 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.