7 Olumiant Side Effects and How to Manage Them

Olumiant (baricitinib) is a medication that treats rheumatoid arthritis, COVID-19, and alopecia areata. It works by blocking proteins that are associated with inflammation. This allows it to help manage conditions that stem from an overactive immune response.

Olumiant may also cause side effects. Most are relatively common and manageable, but some  could become more serious.

Olumiant side effects at a glance

This list of common and rare side effects isn’t exhaustive. You may experience some of these side effects, or you may not experience them at all.

The most common Olumiant side effects include:

• Headache

• Acne

• Cold and flu symptoms

• Urinary tract infections

• Nausea

• Abdominal pain

• Altered laboratory values

Rare but serious Olumiant side effects include:

• Severe infections

• Increased risk of cancer

• Heart problems

• Blood clots

• Tears in the intestines or stomach

• Allergic reactions

Let’s review some helpful tips for managing seven of the most notable Olumiant side effects.

1. Respiratory infections

A number of people in Olumiant’s initial studies experienced upper respiratory tract infections, such as the common cold and flu. Symptoms to look for include:

• Sore throat

• Cough

• Fever

• Muscle aches

• Runny nose

These respiratory infections are more likely because of how Olumiant works. It calms your immune system and dampens certain inflammatory signals in your body.

To be safe, tell your healthcare professional (HCP) right away if you develop any symptoms of infection. In milder cases, they may tell you that you can self-manage your symptoms at home. They’ll likely make recommendations if you have cold and flu symptoms. For instance, acetaminophen (Tylenol) may help with aches and fever, and pseudoephedrine (Sudafed) can help treat a stuffy nose. In more serious cases, they may want you to come in for an evaluation.

Prevention is also key. Do your best to wash your hands regularly, wear a mask in crowded areas, and avoid contact with sick people.

2. Elevated liver enzymes (and other laboratory changes)

Your liver has a few jobs. One is breaking down (metabolizing) medications. But medications like Olumiant can also affect your liver.

In some cases, Olumiant may raise your liver enzyme (protein) levels. This elevation is a possible sign of liver injury. If this happens, your HCP may pause your Olumiant prescription until your levels settle down. The medication can also affect other laboratory measures, such as white blood cells and red blood cells.

Your HCP will regularly monitor your lab work while you’re taking Olumiant. They may adjust your Olumiant dosage depending on your results.

3. Headache

Some people taking Olumiant experience headaches. But it’s not common overall. Headaches also have many possible causes aside from medication.

If you experience a headache, ask your pharmacist for a headache medication recommendation that’s safe for you. Common headache treatments include ibuprofen (Motrin, Advil) and acetaminophen. Sleep hygiene, adequate hydration, and stress reduction can also help with your headaches.

4. Nausea

It doesn’t happen often, but Olumiant can sometimes contribute to nausea and stomach upset.

If your stomach gives you some trouble, a few things may help alleviate your symptoms. Try avoiding spicy or greasy trigger foods, staying hydrated, and taking Olumiant with food. You can also contact your pharmacist for medication recommendations to manage your symptoms.

In rare cases, stomach pain may be a sign of something more serious. Some people may develop tears in their stomach or intestines while taking Olumiant. To be safe, contact your HCP right away if you develop a fever, stomach pain that doesn’t go away, and a change in bowel habits. They can advise you on next steps.

5. Acne

Olumiant may cause acne or skin inflammation. It’s a relatively common side effect for this type of medication, but it doesn’t happen frequently with Olumiant.

Your HCP can help you manage acne if needed. Over-the-counter (OTC) medications, such as salicylic acid, can help stop acne. Diets that are low in sugar, known as low-glycemic diets, and good skin care hygiene can also help alleviate acne.

These measures may not always be enough, though. Contact a dermatologist if your acne doesn’t go away or gets worse. Prescription retinoid medications, such as tretinoin (Retin-A) or isotretinoin (Accutane, Claravis, others), are common treatments for more severe acne.

6. High cholesterol

Olumiant may affect your cholesterol levels. Your HCP will likely want to check your cholesterol 3 months after you start the medication to make sure it’s in check.

If your cholesterol is a bit too high, your HCP may recommend a few ideas to keep your cholesterol in its target range. This includes minor changes to your diet and lifestyle. A heart-healthy diet, consisting of whole grains, vegetables, and healthy protein sources, is one thing to prioritize. Exercising a few times per week is another.

Medication is another option if steps like these aren’t enough. Your HCP may recommend starting a cholesterol medication if your cholesterol levels are still high.

7. Serious infections (and other boxed warnings)

Olumiant has a few boxed warnings. This is the FDA’s most serious type of medication warning.

In very rare cases, Olumiant can cause or contribute to infections that result in hospitalization or death. Herpes infections are one example — specifically herpes simplex and herpes zoster (shingles) infections. It may also increase the risk of cancer and heart and blood vessel-related events, such as heart attacks and blood clots.

Here are some tips to keep in mind regarding Olumiant and infections:

• Serious infections: It’s important to tell your HCP if you develop any symptoms of an infection, such as fever, muscle aches, and difficulty breathing. Even if your symptoms seem minor, it’s a good idea to tell them about the situation as a precaution.

• Cancer risk: Your prescriber will monitor you for signs and symptoms of cancer. But there are some prevention steps you can take on your own. For instance, consider applying sunscreen and quitting smoking to reduce your risk of cancer.

• Heart-related events: Call 911 or go to the ER if you think you could be experiencing a heart attack or a blood clot. Heavy chest discomfort and breaking out in a cold sweat are potential symptoms of a heart attack. And if you suddenly develop swelling or pain in one of your legs, a blood clot may have formed.

When to contact a healthcare professional about Olumiant side effects

You should feel empowered to ask for help anytime you need it. If you’re experiencing side effects from Olumiant, the severity of your symptoms can help you determine whom to contact.

Milder side effects, such as a headache and an upset stomach, are often manageable at home after talking with your pharmacist. They may be able to recommend lifestyle changes or an OTC option. They can also screen your medication list for interactions and other potential medication-related issues.

In more serious cases, contact your prescriber. Olumiant can cause serious infections, so contact your HCP without delay if you develop symptoms of infection. They can also help you manage other symptoms that may develop, such as persistent acne or high cholesterol.

But if you experience fever, stomach pain that doesn’t go away, or a change in your bowel habits, you should seek emergency medical services immediately. These are possible signs of a stomach or intestinal tear that warrants prompt treatment.

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Written by:

Mandeep Sohal, PharmD

Mandeep Sohal, PharmD, has more than 7 years of experience in the pharmaceutical industry and is licensed in California. In his career, he’s had experience with specialty pharmacy, community pharmacy, pharmacy benefit management, and pharmaceutical manufacturers.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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