baricitinib + rifampicin

Baricitinib + rifampicin is a combination of two oral small molecule drugs, though there is no known marketed product or unique brand name for this exact combination. Baricitinib is a selective inhibitor of Janus kinase 1 (JAK1) and Janus kinase 2 (JAK2), used primarily as an immunomodulator for moderate-to-severe rheumatoid arthritis, alopecia areata, and COVID-19[1][2][3]. It works by blocking pro-inflammatory signaling pathways. Rifampicin is an antibiotic that inhibits DNA-dependent RNA polymerase in bacterial cells and is a cornerstone therapy for tuberculosis and other mycobacterial infections. When co-administered, rifampicin can substantially induce cytochrome P450 enzymes, resulting in increased metabolism and reduced plasma concentrations of baricitinib[3]. This can decrease baricitinib’s efficacy. No approved combination product or indication exists for baricitinib + rifampicin, but the interaction is clinically important for patients where both drugs may be required (e.g., arthritis with concurrent TB). Baricitinib was developed by Incyte and Eli Lilly[2][3], and rifampicin was developed by Ciba-Geigy (now Novartis), but is manufactured by multiple companies globally.