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Stelara
Stelara (generic name: ustekinumab) is a biologic medication used to treat certain autoimmune conditions, including moderate to severe plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis. It works by targeting specific proteins involved in the inflammatory process, interleukin-12 (IL-12) and interleukin-23 (IL-23), to help reduce inflammation and suppress the overactive immune response associated with these conditions.
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Frequently Asked Questions
How long does it take for Stelara to start working?
Most patients start to notice improvements in their symptoms after 3 to 6 weeks, but it can take several months to achieve the full therapeutic effect, depending on the condition being treated.
Can Stelara be used long-term?
Yes, Stelara is often used as a long-term treatment for chronic autoimmune conditions like psoriasis, Crohn’s disease, and ulcerative colitis. Regular monitoring by your healthcare provider is important to assess its effectiveness and any potential side effects.
What should I do if I miss a dose of Stelara?
If you miss a dose of Stelara, contact your healthcare provider as soon as possible to reschedule your next injection. Missing a dose could lead to a flare-up of symptoms or reduced effectiveness of the medication.
Can I take Stelara with other medications?
Stelara can interact with other medications, especially other immunosuppressants or biologics. Always inform your healthcare provider of all the medications and supplements you are taking to avoid potential interactions.
Is Stelara safe during pregnancy?
There is limited information on the safety of Stelara during pregnancy. If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits with your healthcare provider.
Comprehensive Drug Guide
How Does Stelara Work?
Stelara works by targeting and blocking the activity of interleukin-12 (IL-12) and interleukin-23 (IL-23), which are proteins involved in the inflammatory response. These proteins are associated with the abnormal immune system activation seen in autoimmune diseases like psoriasis, Crohn’s disease, and ulcerative colitis. By inhibiting these proteins, Stelara helps reduce inflammation and prevent immune cells from attacking healthy tissues.
Common Dosages
- For plaque psoriasis and psoriatic arthritis: Stelara is administered as a subcutaneous injection.
- For Crohn’s disease and ulcerative colitis: Stelara is given as an intravenous (IV) infusion for the initial dose, followed by subcutaneous injections for maintenance.
Typical dosing includes:
- Plaque Psoriasis: The initial dose is 45 mg (or 90 mg for patients weighing over 100 kg) via subcutaneous injection, followed by another dose at week 4, then every 12 weeks thereafter.
- Crohn’s Disease/Ulcerative Colitis: An initial IV infusion based on weight (260 mg, 390 mg, or 520 mg) followed by 90 mg subcutaneously every 8 weeks.
Typical Dosing
- Plaque psoriasis and psoriatic arthritis: The standard maintenance dose is 45 mg or 90 mg every 12 weeks, depending on the patient's weight and response.
Crohn’s disease and ulcerative colitis: After the initial IV infusion, the maintenance dose is 90 mg administered subcutaneously every 8 weeks.
Typical Dosing
FDA Approved Indications
- Moderate to severe plaque psoriasis in adults and children aged 6 years and older.
- Active psoriatic arthritis in adults.
- Moderate to severe Crohn’s disease in adults.
- Moderate to severe ulcerative colitis in adults.
Who Shouldn't Take Stelara?
- Known hypersensitivity to ustekinumab or any component of the formulation.
- Active infections: Patients with serious infections should not receive Stelara until the infection is resolved.
Advice From The Pharmacist
- Stelara is administered via subcutaneous injection, usually in the thigh, abdomen, or upper arm. If you're self-administering, make sure you receive proper training on injection techniques.
- Keep track of your dosing schedule, as missing doses can reduce the effectiveness of the treatment.
- Before starting Stelara, your doctor may test you for tuberculosis (TB) or other infections. Make sure to inform your healthcare provider if you have any symptoms of infection, such as fever, chills, or persistent cough.
Side Effects of Stelara
Common Side Effects
- Upper respiratory infections
- Headache
- Fatigue
- Injection site reactions (redness, itching, swelling)
Uncommon/Severe Side Effects
- Infections: Stelara can increase the risk of serious infections, including tuberculosis (TB), bacterial, fungal, or viral infections.
- Allergic reactions: Symptoms may include rash, swelling, or difficulty breathing.
- Malignancies: There have been reports of cancers, including skin cancer, in patients taking Stelara.
Risks and Warnings of Stelara
- Infection Risk: Stelara can suppress the immune system, increasing the risk of infections. Patients with a history of recurrent infections or those with conditions that predispose them to infections should be monitored closely.
- Cancer Risk: Some patients on Stelara may have an increased risk of developing cancers such as non-melanoma skin cancer. Patients should have regular skin checks while on Stelara.
- Hypersensitivity: Serious allergic reactions, including anaphylaxis, have been reported. If you experience symptoms like swelling or difficulty breathing, seek immediate medical attention.
Interactions with Stelara
Common Drug Interactions
- Live vaccines: Patients should avoid receiving live vaccines (such as the measles, mumps, and rubella vaccine) while taking Stelara, as the immunosuppressive effects may make live vaccines unsafe.
- Other immunosuppressants: Using Stelara with other immunosuppressants or biologic medications can increase the risk of infections and other immune-related issues.
Alternatives to Stelara
- Cosentyx (secukinumab): A biologic targeting IL-17, used to treat plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis.
- Humira (adalimumab): A TNF inhibitor used for treating similar autoimmune conditions, including Crohn's disease, psoriasis, and ulcerative colitis.
- Taltz (ixekizumab): Another IL-17 inhibitor used to treat psoriasis and psoriatic arthritis.
- Entyvio (vedolizumab): A biologic used for treating moderate to severe ulcerative colitis and Crohn's disease.
