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ustekinumab (Stelara): Psoriasis Drug Side Effects & Dosage

What is ustekinumab, and how does it work (mechanism of action)?

Ustekinumab is an injectable biologic drug that
suppresses the immune system and is used for the treatment of psoriasis. It is
an antibody that binds to interleukin (IL)-12 and IL-23, two chemicals produced
by cells in the body that stimulate immune reactions. Scientists believe that
psoriasis is caused by an increase in the production of T-lymphocytes in
response to the attachment of a stimulant, such as interleukin, to the
lymphocyte. Stimulated T-lymphocytes cause skin cells to grow rapidly, and the
rapid growth of the skin cells produces the skin plaques of psoriasis.
Ustekinumab reduces symptoms of psoriasis (inflammation and excessive production
of skin cells) by attaching to IL-12 and IL-23, preventing them from binding and
activating T-lymphocytes. In scientific studies, 59% to 73% of patients received an
assessment of cleared or minimal psoriasis after 12 weeks of treatment. Ustekinumab was approved by the FDA in September 2009.

What brand names are available for ustekinumab?

Stelara

Is ustekinumab available as a generic drug?

No

Do I need a prescription for ustekinumab?

Yes

What are the side effects of ustekinumab?

The most common side effects of ustekinumab are:

Ustekinumab may reduce the
ability the immune system to fight infections, increasing the risk of infections
such as tuberculosis (TB), and infections caused by bacteria, fungi, or viruses.
Ustekinumab also may increase the risk of certain types of cancer and cause
posterior leukoencephalopathy syndrome (RPLS). RPLS is a rare condition that
affects the brain and can cause death. The cause is unknown but if detected
early and treated, most people recover. Symptoms may include headache,
seizures,
confusion, and vision problems.

What is the dosage for ustekinumab?

Ustekinumab is injected under the skin.

  • Patients weighing <100 kg (220 lbs) should receive 45 mg initially, 45 mg 4
    weeks later then 45 mg every 12 weeks.
  • Patients weighing >100 kg (220 lbs) should receive 90 mg initially, 90 mg 4
    weeks later then 90 mg every 12 weeks.

Which drugs or supplements interact with ustekinumab?

Drug interaction studies have not been conducted with ustekinumab; however, since ustekinumab suppresses the immune system, it should
not be used with other drugs that also suppress the immune system.

Live vaccines
should not be administered to patients treated with ustekinumab because they may
develop active disease from the live viruses contained in the vaccine because of
their weakened immune system. Vaccine containing killed virus may not generate
an adequate immune response because ustekinumab suppresses the immune system.

Is ustekinumab safe to take if I’m pregnant or breastfeeding?

Use of ustekinumab during
pregnancy has not been evaluated.

Use of ustekinumab by nursing mothers has not been
adequately evaluated. Other proteins similar to ustekinumab are excreted in
human milk. Therefore, ustekinumab may be excreted in human milk.

What else should I know about ustekinumab?

What preparations of ustekinumab are available?

Single use vials: 45 mg/0.5 ml and 90 mg /1 ml.

How should I keep ustekinumab stored?

Ustekinumab should be refrigerated between 2 C and 8 C (36 F and 46 F).
It should not be frozen and should be kept in its original carton to protect it
from light until the time of administration.

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