Last update April 1, 2021

Baricitinib

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

A selective and reversible inhibitor of Janus kinases 1 and 2.
It is used alone or associated with methotrexate in moderate to severe rheumatoid arthritis.
Oral administration once a day.
Used experimentally in the treatment of the COVID-19 coronavirus (Favalli 2020).

Since the last update we have not found published data on its excretion in breastmilk.

Its pharmacokinetic data makes it difficult to accurately predict its possible excretion in breastmilk, because although its high volume of distribution would hinder it, its molecular weight and low fixation to plasma proteins would facilitate it.

Its frequent side effects are mild to moderate infections and thrombocytopenia.

Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in cases of prematurity.

It is known from pharmacokinetics that after 5 elimination half-lives (T½) 96.9 % of the drug is eliminated from the body and from 7 T½ the plasma concentrations of the drug in the body are negligible. In general, a period of five to seven half-lives can be considered a safe waiting period before resuming breastfeeding.
Taking the longest published T½ (12.5 h) as a reference, these 5 - 7 T½ would correspond to 2,5 -3,5 days. Meanwhile, express and discard milk from the breast regularly to maintain production.


See below the information of this related product:

Alternatives

  • Adalimumab ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Auranofin (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Aurothiomalate Sodium (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Certolizumab ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Etanercept ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Hydroxychloroquine Sulfate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Infliximab ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Methotrexate (obstetric and immunosuppressive use) (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Penicillamine (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Sulfasalazine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Tocilizumab ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Baricitinib in other languages or writings:

Group

Baricitinib belongs to this group or family:

Tradenames

Main tradenames from several countries containing Baricitinib in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 79 %
Molecular weight 371 daltons
Protein Binding 50 %
VD 1.1 l/Kg
pKa 13.89 -
Tmax 1 (0.5 - 3) hours
12.5 hours

References

  1. Favalli EG, Biggioggero M, Maioli G, Caporali R. Baricitinib for COVID-19: a suitable treatment? Lancet Infect Dis. 2020 Sep;20(9):1012-1013. Consulted on Sept. 10, 2020 Abstract
  2. EMA - Eli Lilly. Baricitinib (Olumiant). Ficha técnica. 2017 Full text (in our servers)
  3. EMA - Eli Lilly. Baricitinib (Olumiant). Drug Summary. 2017 Full text (in our servers)

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