Baricitinib is a Formulary Restricted medication.  Ordering restricted to Infectious Disease approval 8am-5pm. ID consult team will assess the patient for appropriate inclusion/exclusion criteria. Recommend baricitinib for patients who meet the following criteria (to replace tocilizumab when unavailable):

Inclusion Criteria

• • Laboratory confirmed COVID-19
  • Age ≥ 18 years old
  • Receiving concomitant corticosteroid therapy (at least dexamethasone 6mg daily or equivalent)
  • Recent hospitalization (within 3 days) and/or ICU admission within 24 hours
  • Rapidly increasing oxygen needs (must require ≥5 L of supplemental O2 to maintain SaO2 ≥ 92%)
  • CRP ≥ 75 mg/L (ONE time value only at time of decompensation, do not recheck)
  • Limit to 14 days or until hospital discharge, whichever is sooner

Exclusion Criteria

• • On other JAK inhibitor or biologic DMARD, previous receipt of tocilizumab during admission
  • Uncontrolled bacterial, fungal or non-SARS-CoV-2 viral infection
  • History of untreated latent tuberculosis or active tuberculosis infection
  • eGFR < 15 mL/min/1.73m2 or HD
  • ALC < 200 cells/µL or ANC < 500 cells/µL
  • Elevated AST/ALT > 5x ULN
  • Requiring high flow oxygen or non-invasive ventilation for longer than 48 hours
  • Mechanical ventilation or ECMO

As of 2021, Baricitinib is authorized for use in COVID-19 patients under Emergency Use Access; see Fact Sheet for Healthcare Providers​

Nursing information for Baricitinib: See Nursing Pearls

Pharmacist information for Baricitinib: See Pharmacy Pearls

Provider information for Baricitinib: See Provider Pearls

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