Guselkumab Treatment: Uses, Dosage & Side Effects Guide

Key Points About Guselkumab Treatment

Guselkumab is a prescription medication used to manage various inflammatory conditions, including psoriasis and psoriatic arthritis. It works by targeting specific proteins in the immune system to help reduce inflammation. Guselkumab is typically administered via injection and is available in different strengths. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are also available to assist with any questions or concerns you may have.

Names of Medication: Guselkumab (Tremfya)

US Brand Name: Tremfya

Generic Name: Guselkumab

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name will be shown in parentheses.

Pharmacologic Category: IL-23 Inhibitor

Guselkumab belongs to a class of medications known as Interleukin-23 (IL-23) inhibitors, which are used to treat inflammatory conditions such as psoriasis and psoriatic arthritis.

Guselkumab Dosage and Administration

Guselkumab is prescribed for several conditions in adults, and the dosing schedule may vary depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. If you have any questions, our telemedicine providers are available to help.

Guselkumab for Psoriasis

Initial Dose: 100 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 100 mg every 8 weeks thereafter.

Guselkumab for Psoriatic Arthritis

Initial Dose: 100 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 100 mg every 8 weeks thereafter.

Guselkumab for Ankylosing Spondylitis

Initial Dose: 100 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 100 mg every 8 weeks thereafter.

Guselkumab for Crohn’s Disease

Initial Dose: 200 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 200 mg every 8 weeks thereafter.

Guselkumab for Ulcerative Colitis

Initial Dose: 200 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 200 mg every 8 weeks thereafter.

Guselkumab for Atopic Dermatitis

Initial Dose: 100 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 100 mg every 8 weeks thereafter.

Guselkumab for Rheumatoid Arthritis

Initial Dose: 100 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 100 mg every 8 weeks thereafter.

Guselkumab for Systemic Lupus Erythematosus

Initial Dose: 200 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 200 mg every 8 weeks thereafter.

Guselkumab for Multiple Sclerosis

Initial Dose: 100 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 100 mg every 8 weeks thereafter.

Guselkumab for Asthma

Initial Dose: 100 mg injected subcutaneously at week 0 and week 4.

Maintenance Dose: 100 mg every 8 weeks thereafter.

Dosage Forms and Strengths of Guselkumab

Guselkumab is available in the following forms:

1. Pre-filled syringe: 100 mg/mL
2. Single-dose vial: 100 mg/mL

How to Administer Guselkumab Injection

Guselkumab is administered as a subcutaneous injection, meaning it is injected just under the skin. Your healthcare provider will demonstrate how to properly inject the medication if you are administering it at home. Be sure to rotate injection sites to minimize irritation. If you miss a dose, take it as soon as you remember, but do not double up on doses. Always follow your healthcare provider’s instructions carefully.

Guselkumab Side Effects and Adverse Reactions

Like all medications, Guselkumab can cause side effects. It’s important to be aware of these and contact your healthcare provider if you experience any concerning symptoms. You can also reach out to one of our telemedicine providers for guidance.

Common Guselkumab Side Effects (1-10% of Patients)

1. Upper respiratory infections: Symptoms may include cough, sore throat, or runny nose.
2. Headache: Mild to moderate headaches may occur.
3. Injection site reactions: Redness, swelling, or discomfort at the injection site.

Less Common Guselkumab Side Effects (Less Than 1% of Patients)

1. Serious infections: Guselkumab may increase the risk of infections, including tuberculosis.
2. Allergic reactions: Symptoms such as rash, itching, or swelling may occur.
3. Liver problems: Signs include yellowing of the skin or eyes, dark urine, or abdominal pain.

Contraindications for Guselkumab Treatment

A contraindication is a specific situation or condition where a particular medication should not be used because it may cause harm. If you have any of the following conditions or risk factors, you should not take Guselkumab. Always consult with your healthcare provider before starting or stopping any medication.

Active Infections

Guselkumab can weaken your immune system, making it harder for your body to fight infections. If you have an active infection, taking Guselkumab could worsen it.

History of Tuberculosis (TB)

If you have a history of TB or have been exposed to someone with TB, Guselkumab may cause the infection to become active again. Your doctor may screen you for TB before starting treatment.

Severe Allergic Reactions

If you have had a severe allergic reaction to Guselkumab or any of its components, you should not take this medication. Allergic reactions can be life-threatening.

Drug to Drug Interactions

Guselkumab may interact with other medications, potentially altering its effectiveness or increasing the likelihood of side effects. It’s important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs, supplements, and herbal products. Below are some medications that may interact with Guselkumab:

1. Abatacept (Orencia): Using Guselkumab alongside Abatacept may increase the risk of infections, as both medications suppress the immune system.
2. Adalimumab (Humira): Combining Guselkumab with other biologics like Adalimumab can heighten the risk of serious infections.
3. Infliximab (Remicade): Similar to Adalimumab, using Infliximab with Guselkumab may raise the risk of infections.
4. Live Vaccines: Vaccines containing live viruses (e.g., MMR, varicella) should not be administered while taking Guselkumab, as it can weaken your immune response, increasing the risk of infection from the vaccine.

Guselkumab in Pregnancy

Is it Safe to Take Guselkumab When Pregnant?

The safety of Guselkumab during pregnancy has not been fully established. While animal studies have not shown harm to the fetus, there are no well-controlled studies in pregnant women. If you are pregnant or planning to become pregnant, it’s essential to discuss the potential risks and benefits of continuing Guselkumab treatment with your healthcare provider. They will guide you in making the best decision for both your health and your baby’s well-being.

Guselkumab While Breastfeeding

Is it Safe to Take Guselkumab While Breastfeeding?

It is unclear whether Guselkumab passes into breast milk. Due to the potential for serious side effects in a nursing infant, it’s important to consult your healthcare provider before using Guselkumab while breastfeeding. Together, you can weigh the potential benefits and risks to determine the best course of action for both you and your baby.

Estimated Cost of Guselkumab

The cost of Guselkumab without insurance can be significant. Using a GoodRX coupon, the estimated cost for a 30-day supply ranges from approximately $5,000 to $6,000. Prices may vary depending on the pharmacy and location. It’s a good idea to check with your pharmacy for the most accurate pricing or explore patient assistance programs that may help reduce the cost of Guselkumab treatment.

Possible Alternatives to Guselkumab

If Guselkumab is not the right treatment for you, there are other options available depending on your condition. Always discuss any changes to your treatment plan with your healthcare provider, or schedule a telemedicine appointment with one of our providers for personalized advice.

1. Psoriasis: Alternatives include biologics like Secukinumab (Cosentyx) or Ustekinumab (Stelara). Topical treatments, phototherapy, and lifestyle changes, such as reducing stress and avoiding skin irritants, can also help manage symptoms.
2. Psoriatic Arthritis: Medications like Methotrexate or biologics like Etanercept (Enbrel) may be considered. Physical therapy and regular exercise can improve joint function and reduce pain.
3. Ankylosing Spondylitis: NSAIDs like Ibuprofen or biologics like Adalimumab (Humira) may be used. Stretching exercises and maintaining good posture can help manage symptoms.
4. Crohn’s Disease: In addition to biologics, corticosteroids or immunosuppressants like Azathioprine may be considered. Dietary changes, such as avoiding trigger foods, can also help manage symptoms.
5. Ulcerative Colitis: Alternatives include Mesalamine (Asacol) or biologics like Vedolizumab (Entyvio). A low-fiber diet and stress management techniques may help reduce flare-ups.
6. Atopic Dermatitis: Topical corticosteroids, moisturizers, and antihistamines may be effective. Avoiding allergens and irritants can also help manage symptoms.
7. Rheumatoid Arthritis: DMARDs like Methotrexate or biologics like Tocilizumab (Actemra) may be alternatives. Regular exercise and physical therapy can help maintain joint flexibility.
8. Systemic Lupus Erythematosus: Hydroxychloroquine (Plaquenil) or corticosteroids may be used. Avoiding sun exposure and managing stress can help reduce symptoms.
9. Multiple Sclerosis: Disease-modifying therapies like Interferon beta-1a (Avonex) or Glatiramer acetate (Copaxone) may be alternatives. Physical therapy and a healthy diet can support overall well-being.
10. Asthma: Inhaled corticosteroids or biologics like Omalizumab (Xolair) may be alternatives. Avoiding allergens and irritants, along with regular exercise, can help manage asthma symptoms.

Recent Updates on Guselkumab Research

Recent studies continue to demonstrate that Guselkumab is an effective treatment for moderate to severe plaque psoriasis and psoriatic arthritis. Ongoing research is also exploring its potential use in other autoimmune conditions, such as Crohn’s disease and ulcerative colitis. Early findings suggest that Guselkumab may help reduce inflammation in these conditions, but further studies are needed to confirm its effectiveness. As research progresses, it’s important to stay informed and discuss any new treatment options with your healthcare provider. If you have questions about Guselkumab or are interested in exploring new treatments, schedule a telemedicine appointment with one of our providers today.

James Kingsley

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