Ustekinumab Treatment: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Ustekinumab is a prescription medication used to treat several autoimmune conditions, including psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis. It works by targeting specific proteins in the immune system to reduce inflammation. Ustekinumab is administered via injection, typically under the supervision of a healthcare provider. Always consult your doctor before starting or adjusting your dose, and consider scheduling a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Stelara

Generic Name: Ustekinumab

The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this case, “Ustekinumab” is the generic name.

Pharmacologic Category

Interleukin-12 (IL-12) Inhibitor

Interleukin-23 (IL-23) Inhibitor

Ustekinumab Dosage

Ustekinumab is used to treat various autoimmune diseases in adults. The dosing schedule depends on the specific condition being treated. Always consult your healthcare provider before making any changes to your dose.

Ustekinumab for Psoriasis

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Ustekinumab for Psoriatic Arthritis

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Ustekinumab for Crohn’s Disease

Initial Dose: 260 mg, 390 mg, or 520 mg (based on body weight) as a single intravenous (IV) infusion.

Maintenance Dose: 90 mg subcutaneously every 8 weeks after the initial IV dose.

Ustekinumab for Ulcerative Colitis

Initial Dose: 260 mg, 390 mg, or 520 mg (based on body weight) as a single intravenous (IV) infusion.

Maintenance Dose: 90 mg subcutaneously every 8 weeks after the initial IV dose.

Ustekinumab for Ankylosing Spondylitis

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Ustekinumab for Atopic Dermatitis

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Ustekinumab for Hidradenitis Suppurativa

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Ustekinumab for Behçet’s Disease

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Ustekinumab for Systemic Lupus Erythematosus

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Ustekinumab for Multiple Sclerosis

Initial Dose: 45 mg or 90 mg (depending on body weight) as a single injection.

Maintenance Dose: 45 mg or 90 mg every 12 weeks after the initial dose.

Dosage Forms and Strengths

Injection, subcutaneous: 45 mg/0.5 mL, 90 mg/mL

Intravenous infusion: 130 mg/26 mL

Ustekinumab Administration Instructions

Ustekinumab is administered either as a subcutaneous injection (under the skin) or as an intravenous (IV) infusion, depending on the condition being treated. For subcutaneous injections, your healthcare provider may train you to administer the medication at home. Always follow the instructions provided by your doctor or pharmacist. If you miss a dose, contact your healthcare provider for guidance. Do not attempt to double up on doses to make up for a missed injection.

Contraindications for Ustekinumab

A contraindication is a specific situation or condition where a particular treatment or medication should not be used because it may cause harm to the patient. It’s important to know if you have any conditions that might make taking Ustekinumab unsafe for you.

Key Contraindications

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

History of Tuberculosis (TB): If you have a history of TB or have been exposed to someone with TB, Ustekinumab may reactivate the infection. You may need to be tested for TB before starting this medication.

Allergic Reactions: If you’ve had an allergic reaction to Ustekinumab or any of its ingredients, you should not take it. Allergic reactions can be serious and may include symptoms like rash, swelling, or difficulty breathing.

Immunocompromised Conditions: If you have a weakened immune system due to conditions like HIV/AIDS or cancer, Ustekinumab may increase your risk of infections or other complications.

Drug-to-Drug Interactions

Ustekinumab can interact with other medications, which may affect how well it works or increase your risk of side effects. Always inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements.

Medications That May Interact with Ustekinumab

Live Vaccines: Vaccines like the MMR (measles, mumps, rubella) or varicella (chickenpox) vaccines should be avoided while taking Ustekinumab. Live vaccines contain weakened viruses, and Ustekinumab can make it harder for your body to fight off these viruses.

Other Immunosuppressants: Medications like Methotrexate (Trexall) or Cyclosporine (Neoral) may increase the risk of infections or other complications when taken with Ustekinumab, as both suppress the immune system.

Biologic Therapies: Other biologic medications like Adalimumab (Humira) or Infliximab (Remicade) should not be taken with Ustekinumab, as this could increase the risk of serious infections or immune system suppression.

Ustekinumab in Pregnancy

Is it safe to take Ustekinumab when pregnant?

There is limited information regarding the safety of Ustekinumab during pregnancy. While animal studies have not shown harm to the fetus, there are no well-controlled studies in pregnant women. Ustekinumab should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, it is important to discuss this with your healthcare provider. They can help you carefully weigh the risks and benefits to determine the most appropriate treatment plan for you. You can also consult one of our providers via telemedicine to explore your options further.

Ustekinumab while Breastfeeding

Is it safe to take Ustekinumab while breastfeeding?

It is not yet clear whether Ustekinumab passes into breast milk. Since many medications can be transferred to a baby through breastfeeding, it is essential to consult your healthcare provider before continuing Ustekinumab while nursing. They may recommend monitoring your baby for any potential side effects or suggest alternative treatments. If you have concerns, you can speak with one of our providers through telemedicine to discuss your situation in more detail.

Estimated Cost of Ustekinumab

The cost of Ustekinumab can vary depending on your location and pharmacy. Without insurance, a 30-day supply using a GoodRx coupon is estimated to cost between $12,000 and $14,000. Prices may fluctuate, so it’s a good idea to check with your pharmacy or use a coupon service like GoodRx for the most up-to-date pricing.

Possible Alternatives to Ustekinumab Treatment

If Ustekinumab is not the right option for you, there are other treatments available for the conditions it is used to manage. Always consult your healthcare provider before making any changes to your treatment plan. You can also consult one of our providers via telemedicine to explore alternative options.

Psoriasis

1. Topical treatments, such as corticosteroids or vitamin D analogs
2. Phototherapy (light therapy)
3. Other biologics, including Adalimumab (Humira) or Etanercept (Enbrel)

Psoriatic Arthritis

1. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen (Advil)
2. DMARDs (disease-modifying antirheumatic drugs), such as Methotrexate (Trexall)
3. Other biologics, such as Secukinumab (Cosentyx) or Adalimumab (Humira)

Crohn’s Disease

1. Aminosalicylates, such as Mesalamine (Asacol)
2. Immunomodulators, such as Azathioprine (Imuran)
3. Other biologics, such as Infliximab (Remicade) or Vedolizumab (Entyvio)

Ulcerative Colitis

1. Aminosalicylates, such as Sulfasalazine (Azulfidine)
2. Corticosteroids, such as Prednisone (Deltasone)
3. Other biologics, such as Tofacitinib (Xeljanz) or Vedolizumab (Entyvio)

Ankylosing Spondylitis

1. NSAIDs, such as Naproxen (Aleve)
2. Physical therapy and exercise
3. Other biologics, such as Secukinumab (Cosentyx) or Adalimumab (Humira)

Atopic Dermatitis

1. Topical corticosteroids or calcineurin inhibitors
2. Phototherapy (light therapy)
3. Other biologics, such as Dupilumab (Dupixent)

Hidradenitis Suppurativa

1. Antibiotics, such as Clindamycin (Cleocin)
2. Hormonal therapy (for women)
3. Other biologics, such as Adalimumab (Humira)

Behçet’s Disease

1. Corticosteroids, such as Prednisone (Deltasone)
2. Immunosuppressants, such as Azathioprine (Imuran)
3. Other biologics, such as Infliximab (Remicade)

Systemic Lupus Erythematosus

1. Antimalarial drugs, such as Hydroxychloroquine (Plaquenil)
2. Corticosteroids, such as Prednisone (Deltasone)
3. Other biologics, such as Belimumab (Benlysta)

Multiple Sclerosis

1. Immunomodulators, such as Interferon beta-1a (Avonex)
2. Physical therapy and exercise
3. Other biologics, such as Ocrelizumab (Ocrevus)

Recent Updates on Ustekinumab Research

Recent studies continue to investigate Ustekinumab’s long-term safety and effectiveness. One area of research is its potential use in treating additional autoimmune conditions, such as systemic lupus erythematosus and multiple sclerosis. Researchers are also exploring whether Ustekinumab can be combined with other therapies to improve outcomes for patients with Crohn’s disease and ulcerative colitis.

Another focus of ongoing research is the possibility of administering Ustekinumab at longer intervals, which could make treatment more convenient for patients. Staying informed about the latest research is important, so be sure to discuss any new findings with your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to see how these updates might impact your treatment plan.

James Kingsley

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