Names and pronunciation
(bar i sye′ti nib) Olumiant
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Drug reference
(bar i sye′ti nib) Olumiant
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Func. class.: Antirheumatic, antiin- flammatory
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Chem. class.: JAK inhibitor
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ACTION: An oral Janus kinase (JAK) inhibitor. Janus kinases are enzymes that transmit signals arising from cytokine or growth factor receptor interactions
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USES: Treatment of moderately to severely active rheumatoid arthritis in patients who have had an inadequate response to 1 or more tumor necrosis factor (TNF) antagonists
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CONTRAINDICATIONS: Hyper sensitivity Precautions: Vaccinations, lipid eleva- tions, anemia, lymphopenia, neutrope- nia, GI perforation, viral reactivation, TB
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Black Box Warning: Hepatitis exacerba- tion, hepatotoxicity, lactic acidosis, HIV
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SIDE EFFECTS EENT: Rhinitis, sinusitis GI: Nausea, GI perforation, hepatotoxicity INTEG: Skin cancer RESP: Pulmonary embolism SYST: Infection, new primary malignancy
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INTERACTIONS Increase: effect of product—strong OAT3 inhibitors (probenecid)
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DOSAGE AND ROUTES • Adult: PO 2 mg daily; may give with or without methotrexate or other nonbio- logic disease-modifying antirheumatic drugs (DMARDs)
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Available forms: Tablets 2 mg
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Administer: • Without regard to food
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Assess: • For pain, swelling in joints, ADLs, ag- gravating factors • CBC with differential, hemoglobin/ hematocrit, LFTs, serum cholesterol profile, serum creatinine/BUN, tubercu- lin skin test baseline and periodically • For new primary malignancies, skin cancer screening exam • Pregnancy/breastfeeding: do not use in pregnancy, breastfeeding
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Evaluate: • Therapeutic response: decreased pain, swelling of joints; slowing of destruction of joints; increased physical function
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • About the potential benefits and risk of this product • Infections: that infections are more common; to report any symptoms of in- fection to health care provider • New malignancies: that product may increase the risk of new cancers, includ- ing lymphoma; to notify health care provider • Thrombosis: that DVT and PE may oc- cur; to report any symptoms to health care provider • That lab work will be needed on a continuing basis • Pregnancy/breastfeeding: not to breastfeed during therapy
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PHARMACOKINETICS Protein binding 45%-50%, metabolized by CYP3A4, excreted 75% urine, 20% feces, half-life 24 hr
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• Adult: PO 2 mg daily; may give with or without methotrexate or other nonbio- logic disease-modifying antirheumatic drugs (DMARDs)
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