Pausing baricitinib whilst on antibiotics ?

[Mermaid11]

Hello everyone, hope you all had a good Christmas 🎄 ❤

I have been away for a while, occasionally being on in the evening reading all your posts. I have been doing really well on my Jak inhibitor (baricitinib) since starting in June, and started a new Job 🙂

It's working really well for me but I've been given antibiotics today for a chest infection. No one seems to know if I should stop baricitinib (nor the nurse practitioner or the pharmacist) he said well I'd keep taking it. I said I'm sure I should pause it 🤔 I tried to call rheumatology dept and they are closed until 5th of January.

I know a few of you are on the same medication. Has anyone been told to pause it whilst on antibiotic please?

What would happen if I didnt stop it and started the antibiotics tonight?

[KittyJ]

I’m surprised that they couldn’t look it up for you if they didn’t know, Have you checked the Patient information leaflet to see if that says? Failing that I’d check online for interactions with the specific antibiotic you’ve been given. Sorry I can’t be more help. I hope you get it sorted.

[Mermaid11 in reply to KittyJ]

Thank you! I'm silly and threw the leaflet away, I always do 🙈 as its my last box I now don't have any others to check. I had a look online but can't find much under searching baricitinib. I will try and search under the antibiotic name, thank you for replying x

[Oshgosh in reply to Mermaid11]

Perhaps you could search on the net for the information leaflet. It may help if you research drug interactions . I hope this helps

[KittyJ in reply to Mermaid11]

Was just going to suggest what Oshgosh has. It’s bound to be online 😊

[Madmusiclover]

Yes STOP! You should have been given a patient leaflet in addition to the one in the box. They underlined and highlighted the ones about stopping for infection for me. I got 2 chest infections in the first year: which is text book. None since but did succumb to shingles. It’s not being on the antibiotic that’s a problem but that you have a chest infection; might be viral might be bacterial. Your own immune response needs to be allowed to do its thing; and the Bari is stopping that. You can go back on the Bari when you feel better.

[Mermaid11 in reply to Madmusiclover]

That's great, thank you. I threw away the leaflet as I can never get it back in the pack 🙈 I'm on my last pack as waiting for a delivery. I've taken antibiotics tonight as I can't keep coughing like I am, and I've not taken the baricitinib. The pharmacist googled on his phone and then said DO not stop taking baricitinib, I said im sure I remember being told to stop of I ever had an infection 🤷‍♀️

[Madmusiclover in reply to Mermaid11]

You are right! Outside the specialists not many medics know much about JAKs. You find yourself educating them. Even spelling BARICITINIB for them! 😂

[Mermaid11 in reply to Madmusiclover]

Yes!! I found this out today... I was shocked he had never heard of it 🤣

[Madmusiclover]

To be clear take the antibios and stop Bari till you feel well.

[wishbone]

I was told to stop baricitinib when I had a sinus infection. Think I was off it for 3 or 4 weeks. It worked great for me too and my RA did get a bit worse when I stopped taking it, but it wasn't long after restarting it that normal service was resumed. Best check with your rheumy though.

[Mermaid11 in reply to wishbone]

Thank you for replying, I've only got a week's worth of antibiotics. But im dreading stopping the baricitinib as it's working so well, but I need I shift this chest infection as its making me feel so unwell now x

[Madmusiclover in reply to Mermaid11]

Yeah sadly it won’t go away whilst you stay on Bari. I made the same mistake first time. Carried on until a dim light bulb went on. 💡🥴

[Sheila_G]

Sorry. I have had a good trawl through the internet and can't find anything on baricitinib and antibiotics. Maybe another pharmacist. You could try Boots.

[Mermaid11 in reply to Sheila_G]

Thank you! I had a good Google too 🤣 there was no definite answer, I have paused it but will see how I feel in a couple of day x

[sylvi]

When you are on antibiotics you much stop the biologicals. I am not on any biological now due to being so ill on them with infections. I rely on on sulpha and leflunomide and it seems to be helping my ra now thak goodness. xxxx

[Mermaid11 in reply to sylvi]

Thank you for replying, happy new year to you xx

[oldtimer]

The general consensus seems to be that we generally stop the medication that suppresses our immune system when we have an infection in the hope that our immune system will fight off the infection better.

However, there is only a very little actual evidence that this works and then not in everyone. This leads to variable advice from our medical teams.

So I think it is a matter of balance. if you are likely to have a bad flare stopping it, then don't stop. If the infection is not clearing and you feel it reasonable to risk a flare, then stop.

[Mermaid11 in reply to oldtimer]

Thank you, its a fine line between getting rid of this chest infection but also not wanting a flare up if I stop my RA meds. It's been 24 hours since I paused it to start antibiotics so I wil see how I go the next couple of days.. if its making me feel worse I will start again x

[Green230461]

I was told to stop baricitinib until after I had finished antibiotics for pneumonia recently. They wanted to give my T cells a boost and baricitinib flattens them. I was able to chat with rheummy so it depends on your illness I expect. Try to get in contact again best of luck a nd get better soon

[Blodynhaul]

I just started Filgotinib, another JAK, 3 weeks ago and asked the rheumy this question, as to whether to stop it if I get an infection. She said if it's a mild infection don't stop it, but if a serious one then stop it. I suppose it's a bit vague where to draw the line. It's not right for me to give advice (!), but sympathise with you not wanting to stop something that is working, so if it was me I'd perhaps carry on with the JAK unless you get worse? Sorry if this is wrong to suggest. Could you phone the NRAS helpline where they give advice? perhaps that's shut too for a few days!