Gemfibrozil with Baricitinib Interaction Details
Brand Names Associated with Gemfibrozil
- Gemfibrozil
- Lopid®
Brand Names Associated with Baricitinib
- Baricitinib
- Olumiant®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Increased baricitinib exposure
Interaction Summary
Coadministration of baricitinib (OAT3 substrate) with probenecid (strong OAT3 inhibitor) resulted in a 2-fold increase in baricitinib AUC during a pharmacokinetic study. If coadministration of baricitinib and a strong OAT3 inhibitor is necessary in patients with rheumatoid arthritis, reduce baricitinib dose to 1 mg once daily. If coadministration is required in patients with COVID-19, reduce a recommended dose of 4 mg once daily to 2 mg once daily, and reduce a dose of 2 mg once daily to 1 mg once daily. If the recommended dosage is 1 mg once daily, consider discontinuing the OAT3 inhibitor (probenecid) .
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Coadministration of baricitinib and a strong OAT3 inhibitor may increase baricitinib exposure. If coadministration is necessary in patients with rheumatoid arthritis, reduce baricitinib dose to 1 mg once daily . If coadministration is required in patients with COVID-19, reduce a recommended dose of 4 mg once daily to 2 mg once daily, and reduce a dose of 2 mg once daily to 1 mg once daily. If the recommended dosage is 1 mg once daily, consider discontinuing the OAT3 inhibitor (probenecid) .
Mechanism Of Interaction
Inhibition of OAT3-mediated efflux transport of baricitinib
Literature Reports
A) During a pharmacokinetic study, coadministration of baricitinib with probenecid (strong OAT3 inhibitor) resulted in an approximately 2-fold increase in baricitinib AUC (0 to infinity) with no effect on Cmax and Tmax .
Gemfibrozil Overview
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Gemfibrozil is used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and triglycerides (other fatty substances) in the blood in certain people with very high triglycerides who are at risk of pancreatic disease (conditions affecting the pancreas, a gland that produces fluid to break down food and hormones to control blood sugar). Gemfibrozil is also used in people with a combination of low high-density lipoprotein (HDL; 'good cholesterol') levels and high low-density lipoprotein (LDL; 'bad cholesterol') and triglyceride levels to reduce the risk of heart disease. Gemfibrozil is in a class of lipid-regulating medications called fibrates. It works by reducing the production of triglycerides in the liver.
Baricitinib Overview
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Baricitinib is used alone or with other medications to treat rheumatoid arthritis (condition in which the body attacks its own joints causing pain, swelling, and loss of function) in adults who have not responded well to one or more tumor necrosis factor (TNF) inhibitor medication(s). It is also used for the treatment of coronavirus disease 2019 (COVID-19 infection) in hospitalized adults who require supplemental oxygen, a ventilator, or who need extracorporeal membrane oxygenation (ECMO; a device that adds oxygen to the blood). Baricitinib is also used to treat alopecia areata (a condition in which the body attacks hair follicles and causes hair loss) in adults. Baricitinib is in a class of medications called Janus kinase (JAK) inhibitors. It works by decreasing the activity of the immune system.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.