Interaction between Baricitinib and Guselkumab
Major
Others
| ID | DDInter165 and DDInter849 |
| Interaction | Coadministration of baricitinib with other immunosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies. Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving baricitinib, most of whom were taking concomitant immunosuppressants such as methotrexate or corticosteroids. The most common serious infections reported with baricitinib treatment include pneumonia, herpes zoster, and urinary tract infection. Opportunistic infections include tuberculosis, multidermatomal herpes zoster, esophageal candidiasis, pneumocystosis, acute histoplasmosis, cryptococcosis, cytomegalovirus, and BK virus. Lymphoma and other malignancies, including melanoma and non-melanoma skin cancers, have also been observed with the use of baricitinib and other Janus kinase inhibitors. |
| Management | Concomitant use of baricitinib with other Janus kinase (JAK) inhibitors, biologic disease-modifying antirheumatic drugs (DMARDs), or potent immunosuppressants (e.g., azathioprine, cyclosporine) is not recommended. Patients receiving baricitinib should be closely monitored for the development of signs and symptoms of infection during and after treatment, including the possible development of tuberculosis in patients who tested negative for latent tuberculosis infection prior to initiating therapy. If a serious infection, an opportunistic infection, or sepsis develops, baricitinib should be interrupted until the infection is controlled. |
| References | |
| Alternative for Baricitinib |
L04A
More
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| Alternative for Guselkumab |
L04A
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.