Ustekinumab (Stelara) is a biologic medication used to lower inflammation and help adult patients and patients six years or older with moderate to severe plaque psoriasis, adult patients with psoriatic arthritis, and adult patients with moderate to severe Crohn’s Disease and Ulcerative Colitis. This medicine is prescribed after not responding to other medications. It is taken as an at-home injection. Ustekinumab blocks inflammation proteins called IL-12 and IL-23. Ustekinumab is a biologic medication and can take several months to start working. Biologics are also often taken long term.
Ustekinumab injection is initially given, then 4 weeks later, followed by every 12 weeks. It is given as an injection under the skin and can initially be given as an infusion in the vein followed by an injection under the skin in Crohn’s disease. The dose for patients weighing less than 100 kg (220 lbs) is 45 mg, and the dose for patients weighing more than 100 kg is 90 mg. You will need a screening test for tuberculosis before starting this medication to reduce risk of infection. You should follow up with your doctor regularly while on this medication.
Ustekinumab lowers your immune system and can lead to infections. Ustekinumab rarely can lead to a nervous system condition called reversible posterior leukoencephalopathy syndrome (RPLS), which is reversible if the medication is stopped. Some people can get a reaction at the injection site, such as itching, swelling, and redness.
If you develop symptoms of an infection, such as a fever or cough, you should contact your rheumatology provider. If you are pregnant or considering pregnancy, let your provider know before starting this medication; ustekinumab has not been studied in pregnant or breastfeeding women. Be sure to talk with your rheumatology provider before receiving any vaccines or undergoing any surgeries while taking this medication. Live vaccines should be avoided while on this medication. Live vaccines contain a milder form of the virus or bacteria to help your body develop an immune response without you developing symptoms of the disease it is intended to prevent. These vaccines always carry a small chance a person could get the infection from the vaccine. Live vaccines include the nasal spray flu vaccine, and others such as the measles, mumps, rubella, and yellow fever vaccines. Tell your rheumatology provider right away if you have any new or worsening medical problems including: changes to your mental status, vision problems, seizures, or severe headaches.
Updated February 2022 by Lisa Carnago, FNP, and reviewed by the American College of Rheumatology Communications and Marketing Committee.
This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.