Drug interactions
Baricitinib + Smallpox vaccine live
Severity: Major
Baricitinib and Smallpox vaccine live: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
The live vaccinia vaccine may spread uncontrollably in an immunosuppressed patient, causing serious vaccine-related complications. Baricitinib may also reduce the protective response.
What this interaction means in plain words
Baricitinib and Smallpox vaccine live can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
JAK inhibition impairs immune control of live vaccinia virus replication.
What to do
Avoid live smallpox vaccine during baricitinib therapy unless exposure risk clearly outweighs harm. Consider non-replicating vaccine alternatives where available.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Baricitinib
- Adenovirus types 4 and 7 live + Baricitinib Contraindicated
- Baricitinib + Bcg vaccine live Contraindicated
- Baricitinib + Tofacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Abatacept + Baricitinib Major
- Adalimumab + Baricitinib Major
Frequently asked questions
Can I take Baricitinib with Smallpox vaccine live?
MediHelp rates the interaction as major. Baricitinib and Smallpox vaccine live can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. The live vaccinia vaccine may spread uncontrollably in an immunosuppressed patient, causing serious vaccine-related complications. Baricitinib may also reduce the protective response.
How serious is the interaction between Baricitinib and Smallpox vaccine live?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid live smallpox vaccine during baricitinib therapy unless exposure risk clearly outweighs harm. Consider non-replicating vaccine alternatives where available.
What other medicines interact with Baricitinib?
MediHelp also lists interactions of Baricitinib with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Tofacitinib. The full list is on the Baricitinib page.
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