Olumiant (baricitinib) is a prescription drug used to treat severe alopecia areata. It’s typically used when hair loss from this condition affects more than 50% of the scalp. Olumiant is a brand-name drug that’s not available in a generic version.

Olumiant comes as an oral tablet. The active ingredient in Olumiant is baricitinib, and it belongs to a group of drugs called Janus kinase (JAK) inhibitors. To learn more about the drug, see this in-depth Olumiant article.

Olumiant has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should I know before taking Olumiant?” section.

Alopecia areata is an autoimmune condition that causes hair loss. With this condition, your immune system mistakenly attacks hair follicles. This commonly leads to hair loss on your scalp, but it may also affect your arms, legs, and other areas of your body.

What are the symptoms of alopecia areata?

Alopecia areata may cause other symptoms besides hair loss. Examples include discolored hair and a burning or itching sensation near the affected area.

Who is Olumiant prescribed for?

Doctors prescribe Olumiant to treat severe alopecia areata in adults. This condition is considered severe if hair loss affects more than 50% of the scalp.

Doctors typically will not prescribe Olumiant with certain other medications, including:

Olumiant is approved to treat severe alopecia areata in adults. Keep reading to learn how the drug works for this condition.

How does Olumiant work?

Olumiant works by targeting a group of proteins in your body called Janus kinase (JAK). These proteins play a role in your immune system.

By targeting JAK proteins, Olumiant may help stop your immune system from attacking hair follicles. In this way, the drug may help reduce symptoms of alopecia.

For more information about how Olumiant works, talk with your doctor or pharmacist.

Olumiant starts to work after your first dose, but it may take several months to ease your symptoms. In studies, many people had reduced symptoms of alopecia areata after 9 months of Olumiant treatment.

Your doctor will monitor your condition during your treatment to check whether Olumiant is working.

If you have other questions about what to expect from Olumiant treatment, talk with your doctor.

Olumiant has been shown to effectively treat alopecia areata. In studies, treatment with this medication led to fewer symptoms of the condition.

For more information about how Olumiant performed in these studies, talk with your doctor or pharmacist. You can also visit the manufacturer’s website or view the drug’s prescribing information.

Below are typical dosages of Olumiant for treating alopecia areata. But be sure to follow the instructions and dosage your doctor has prescribed.

What is the usual dosage for Olumiant?

For alopecia, the typical dosage of Olumiant is either 2 milligrams (mg) or 4 mg taken once daily.

Your doctor may begin your treatment by prescribing a daily dose of 2 mg. If this dose is not working well enough, they may increase it to 4 mg per day.

If you have complete or nearly complete hair loss on your scalp, your doctor may begin your treatment with a daily dose of 4 mg. Once your hair begins to regrow, they may lower the dosage to 2 mg per day.

Note: Olumiant has other uses in addition to treating alopecia area. The dosage may be different for these other uses. To learn more, see this Olumiant dosage article or talk with your doctor.

How do you take Olumiant?

Olumiant comes as an oral tablet. You can take each dose with or without food.

How often should I take Olumiant?

You’ll take Olumiant once per day.

Using Olumiant for alopecia areata* may cause side effects in some people. These side effects can be mild or serious.

The lists below include some of the main side effects that have been reported in people using Olumiant. For information about other possible side effects of this medication, talk with your doctor or pharmacist.

You can also learn more from the Olumiant side effects article or from the drug’s prescribing information.

* Olumiant is also approved to treat other conditions. Side effects of Olumiant when it’s used to treat other conditions are generally similar to those that may occur when it’s used for alopecia.

What are Olumiant’s mild side effects?

Olumiant may cause mild side effects in some people. These include:

In many cases, mild side effects from the drug can be temporary. Some side effects may be easy to manage too. But if side effects last for a longer time, bother you, or become severe, talk with your doctor or pharmacist.

What are Olumiant’s serious side effects?

Taking Olumiant may lead to rare but serious side effects. Examples include:

To learn more about the drug’s boxed warnings, see the “What should I know before taking Olumiant?” section.

Call your doctor right away if you have any serious side effects while taking Olumiant. If the side effects seem life threatening or if you think you’re having a medical emergency, call 911 or your local emergency number immediately.

Allergic reaction

For some people, Olumiant can cause an allergic reaction. This side effect wasn’t reported in the drug’s studies, but it has been reported since the drug was approved.

In general, symptoms of allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Olumiant treatment.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Olumiant, they may have you switch to a different treatment.

Before you take Olumiant, there’s some important information to keep in mind. The drug may not be a safe option for you if you have certain medical conditions or other factors that affect your health. Some of these are mentioned below.

Boxed warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Risk of serious infection: Taking Olumiant may increase your risk of developing a serious infection. Examples include tuberculosis (TB), shingles (herpes zoster), and pneumonia. In rare cases, serious infections may be fatal.

Symptoms may vary depending on the specific infection. But symptoms to watch for include cough, fever, and shortness of breath.

Certain factors can increase your risk of serious infection during Olumiant treatment. These include:

  • having a current or past infection that keeps coming back or lasts a long time
  • having a condition that weakens your immune system, such as HIV
  • taking medications that weaken your immune system, such as corticosteroids
  • living in or traveling to places with a higher risk of certain fungal infections
  • being exposed to TB

Before you start taking Olumiant, your doctor may test you for TB. If the test shows that you have this bacterium in your body, your doctor will likely treat it before you start Olumiant treatment.

If you have symptoms of an infection during your Olumiant treatment, talk with your doctor. They can test you for an infection and treat it if needed. They may also temporarily stop your Olumiant treatment until your infection clears.

Risk of cancer: Taking Olumiant may increase your risk of certain cancers, such as skin cancer.

Symptoms of skin cancer may include skin patches or growths that are irregularly shaped or discolored.

If you have symptoms of cancer during your Olumiant treatment, talk with your doctor. They can order tests to check for cancer. If the test results show that you have cancer, your doctor will discuss your treatment plan with you, including whether it’s safe for you to continue taking Olumiant.

Risk of blood clots: Taking Olumiant may increase your risk of blood clots. These may occur in your lungs, an artery, or a deep vein.

Symptoms of a blood clot could include:

  • chest pain
  • shortness of breath
  • pain, swelling, or discolored skin near the affected area

If you have symptoms of a blood clot during Olumiant treatment, call 911 or seek emergency medical care right away. If you have a blood clot, your doctor may stop your Olumiant treatment and suggest a different treatment instead.

Risk of serious cardiovascular events: Taking Olumiant may increase your risk of serious cardiovascular (heart and blood vessel) events such as stroke, heart attack, and death related to a heart problem.

Symptoms of a stroke can include weakness in one side of your body and difficulty speaking. Symptoms of a heart attack can include discomfort or pain in your jaw, neck, chest, or arms.

Certain factors can increase your risk of experiencing a cardiovascular event during Olumiant treatment. These include:

If you have symptoms of a stroke or heart attack during Olumiant treatment, call 911 or a local emergency number right away.

If you have a cardiovascular event while taking Olumiant, your doctor will likely have you stop taking the drug. They can suggest other treatment options for your condition.

Risk of death: Taking Olumiant may increase the risk of death for certain people. This risk may be greatest for adults ages 50 years and older who have at least one condition that raises their risk of heart disease. Examples include high blood pressure and high cholesterol.

To learn more about these warnings, talk with your doctor.

What other warnings should I know about?

In addition to boxed warnings, Olumiant has other warnings. If any of the following medical conditions or other health factors apply to you, talk with your doctor before taking Olumiant:

  • if you’ve ever had TB, herpes virus, or hepatitis
  • if you have liver or kidney problems
  • if you have problems with your digestive system, such as diverticulitis
  • if you’ve had an allergic reaction to the drug or any of its ingredients
  • if you’re pregnant, breastfeeding, or considering either

The price of Olumiant depends on several factors. These can include your treatment plan, your insurance plan, the pharmacy you use, and your location.

Olumiant is a brand-name drug. It’s not available as a generic. (Generics usually cost less than brand-name drugs.)

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.