Dosing & Uses
Dosage Forms & Strengths
solution for SC injection
- 150mg/mL single-dose Sensoready pen and single-dose prefilled syringe
- 300mg/2mL single-dose UnoReady pen and single-dose prefilled syringe
solution for IV infusion
- 125mg/5mL single-dose vial; requires dilution (adults only)
Plaque Psoriasis
Indicated for treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
300 mg SC at weeks 0, 1, 2, 3, and 4 and q4wk thereafter
For some patients, a dose of 150 mg may be acceptable
Psoriatic Arthritis
Indicated for active psoriatic arthritis (PsA) in adults
SC
- For PsA patients with coexistent moderate to severe plaque psoriasis, use dosage and administration for plaque psoriasis
- For other adults with PsA, administer with or without a SC loading dose
- With loading dose: 150 mg SC at weeks 0, 1, 2, 3, and 4 and q4wk thereafter
- Without a loading dose: 150 mg SC q4wk
IV
- With loading dose: 6 mg/kg IV at week 0, then 1.75 mg/kg IV q4Weeks (maintenance dose)
- Without a loading dose: 1.75 mg/kg IV q4Weeks
- Not to exceed 300 mg/dose for 1.75 mg/kg IV maintenance dose
Ankylosing Spondylitis
Indicated for adults with active ankylosing spondylitis
Administer with or without a loading dose
SC
- With loading dose: 150 mg SC at weeks 0, 1, 2, 3, and 4 and q4wk thereafter
- Without a loading dose: 150 mg SC q4wk
- If a patient continues to have active ankylosing spondylitis, consider increasing dose to 300 mg q4wk
IV
- With loading dose: 6 mg/kg IV at week 0, then 1.75 mg/kg IV q4Weeks (maintenance dose)
- Without a loading dose: 1.75 mg/kg IV q4Weeks
- Not to exceed 300 mg/dose for 1.75 mg/kg IV maintenance dose
Non-radiographic Axial Spondyloarthritis
Indicated for active non-radiographic axial spondylarthritis with objective signs of inflammation
Administer with or without a loading dose
SC
- With loading dose: 150 mg SC at Weeks 0, 1, 2, 3, and 4, THEN q4Weeks thereafter
- Without loading dose: 150 mg SC q4Weeks
IV
- With loading dose: 6 mg/kg IV at week 0, then 1.75 mg/kg IV q4Weeks (maintenance dose)
- Without a loading dose: 1.75 mg/kg IV q4Weeks
- Not to exceed 300 mg/dose for 1.75 mg/kg IV maintenance dose
Hidradenitis Supperativa
Indicated for moderate-to-severe hidradenitis suppurativa (HS)
300 mg SC at Weeks 0, 1, 2, 3 and 4, THEN q4Weeks thereafter
If response is inadequate, consider increasing dose to 300 mg q2Weeks
Each 300-mg dose is administered as 1 SC injection of 300 mg, or as 2 SC injections of 150 mg each
Dosage Modifications
Renal or hepatic impairment
- Studies have not been conducted to assess effect on pharmacokinetics
Dosing Considerations
Evaluate patients for tuberculosis infection prior to initiating treatment
Dosage Forms & Strengths
solution for SC injection
- 75mg/0.5mL single-dose prefilled syringe (pediatric patients only)
- 150mg/mL single-dose Sensoready pen and single-dose prefilled syringe
Plaque Psoriasis
Indicated for moderate-to-severe plaque psoriasis in patients aged ≥6 years who are candidates for systemic therapy or phototherapy
<6 years
- Safety and efficacy not established
≥6 years
- <50 kg: 75 mg SC at weeks 0, 1, 2, 3, and 4 followed by 75 mg SC q4week
- ≥50 kg: 150 mg SC at weeks 0, 1, 2, 3, and 4 followed by 150 mg SC q4week
Psoriatic Arthritis
Indicated for active psoriatic arthritis (PsA) in patients aged ≥2 years
<2 years: Safety and efficacy not established
≥2 years
- ≥15 kg to <50 kg: 75 mg SC at weeks 0, 1, 2, 3, and 4 followed by 75 mg SC q4week
- ≥50 kg: 150 mg SC at weeks 0, 1, 2, 3, and 4 followed by 150 mg SC q4week
Enthesitis-Related Arthritis
Indicated for active enthesitis-related arthritis (ERA) in patients aged ≥4 years
<4 years: Safety and efficacy not established
≥4 years
- ≥15 kg to <50 kg: 75 mg SC at weeks 0, 1, 2, 3, and 4 followed by 75 mg SC q4week
- ≥50 kg: 150 mg SC at weeks 0, 1, 2, 3, and 4 followed by 150 mg SC q4week
Dosage Modifications
Renal or hepatic impairment
- Studies have not been conducted to assess effect on pharmacokinetics
Dosing Considerations
Evaluate patients for tuberculosis infection prior to initiating treatment
Complete all age-appropriate vaccinations as recommended by current immunization guidelines before initiating
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (13)
- adenovirus types 4 and 7 live, oral
secukinumab decreases effects of adenovirus types 4 and 7 live, oral by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- BCG vaccine live
secukinumab decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- influenza virus vaccine quadrivalent, intranasal
secukinumab decreases effects of influenza virus vaccine quadrivalent, intranasal by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- measles (rubeola) vaccine
secukinumab decreases effects of measles (rubeola) vaccine by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- measles mumps and rubella vaccine, live
secukinumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- measles, mumps, rubella and varicella vaccine, live
secukinumab decreases effects of measles, mumps, rubella and varicella vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- rotavirus oral vaccine, live
secukinumab decreases effects of rotavirus oral vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- smallpox (vaccinia) vaccine, live
secukinumab decreases effects of smallpox (vaccinia) vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- typhoid polysaccharide vaccine
secukinumab decreases effects of typhoid polysaccharide vaccine by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- typhoid vaccine live
secukinumab decreases effects of typhoid vaccine live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- varicella virus vaccine live
secukinumab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- yellow fever vaccine
secukinumab decreases effects of yellow fever vaccine by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
- zoster vaccine live
secukinumab decreases effects of zoster vaccine live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.
Serious - Use Alternative (34)
- anthrax vaccine adsorbed
secukinumab decreases effects of anthrax vaccine adsorbed by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- axicabtagene ciloleucel
secukinumab, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- brexucabtagene autoleucel
secukinumab, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- ciltacabtagene autoleucel
secukinumab, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- diphtheria & tetanus toxoids
secukinumab decreases effects of diphtheria & tetanus toxoids by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- diphtheria & tetanus toxoids/ acellular pertussis vaccine
secukinumab decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine
secukinumab decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- hepatitis A vaccine inactivated
secukinumab decreases effects of hepatitis A vaccine inactivated by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- hepatitis a/b vaccine
secukinumab decreases effects of hepatitis a/b vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- hepatitis b vaccine
secukinumab decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- human papillomavirus vaccine, nonavalent
secukinumab decreases effects of human papillomavirus vaccine, nonavalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- human papillomavirus vaccine, quadrivalent
secukinumab decreases effects of human papillomavirus vaccine, quadrivalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- idecabtagene vicleucel
secukinumab, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- influenza A (H5N1) vaccine
secukinumab decreases effects of influenza A (H5N1) vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- influenza virus vaccine (H5N1), adjuvanted
secukinumab decreases effects of influenza virus vaccine (H5N1), adjuvanted by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- influenza virus vaccine quadrivalent
secukinumab decreases effects of influenza virus vaccine quadrivalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- influenza virus vaccine quadrivalent, cell-cultured
secukinumab decreases effects of influenza virus vaccine quadrivalent, cell-cultured by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- influenza virus vaccine quadrivalent, recombinant
secukinumab decreases effects of influenza virus vaccine quadrivalent, recombinant by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- influenza virus vaccine trivalent
secukinumab decreases effects of influenza virus vaccine trivalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- influenza virus vaccine trivalent, recombinant
secukinumab decreases effects of influenza virus vaccine trivalent, recombinant by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- Japanese encephalitis virus vaccine
secukinumab decreases effects of Japanese encephalitis virus vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- lisocabtagene maraleucel
secukinumab, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- meningococcal A C Y and W-135 diphtheria conjugate vaccine
secukinumab decreases effects of meningococcal A C Y and W-135 diphtheria conjugate vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- meningococcal A C Y and W-135 polysaccharide vaccine combined
secukinumab decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- meningococcal group B vaccine
secukinumab decreases effects of meningococcal group B vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- pneumococcal vaccine 13-valent
secukinumab decreases effects of pneumococcal vaccine 13-valent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- pneumococcal vaccine polyvalent
secukinumab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- poliovirus vaccine inactivated
secukinumab decreases effects of poliovirus vaccine inactivated by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .
- rabies vaccine
secukinumab decreases effects of rabies vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- rabies vaccine chick embryo cell derived
secukinumab decreases effects of rabies vaccine chick embryo cell derived by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- tetanus & reduced diphtheria toxoids/ acellular pertussis vaccine
secukinumab decreases effects of tetanus & reduced diphtheria toxoids/ acellular pertussis vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- tetanus toxoid adsorbed or fluid
secukinumab decreases effects of tetanus toxoid adsorbed or fluid by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.
- tisagenlecleucel
secukinumab, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- upadacitinib
secukinumab, upadacitinib. Either increases effects of the other by immunosuppressive effects; risk of infection. Contraindicated.
Monitor Closely (28)
- carbamazepine
secukinumab, carbamazepine. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- clonidine
secukinumab, clonidine. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- cyclosporine
secukinumab, cyclosporine. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- dengue vaccine
secukinumab decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.
- disopyramide
secukinumab, disopyramide. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- efgartigimod alfa
efgartigimod alfa will decrease the level or effect of secukinumab by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.
- efgartigimod/hyaluronidase SC
efgartigimod/hyaluronidase SC will decrease the level or effect of secukinumab by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.
- ethosuximide
secukinumab, ethosuximide. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- fosphenytoin
secukinumab, fosphenytoin. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- haemophilus influenzae type b vaccine
secukinumab decreases effects of haemophilus influenzae type b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued if immune competence has been restored. .
- isavuconazonium sulfate
secukinumab and isavuconazonium sulfate both decrease immunosuppressive effects; risk of infection. Use Caution/Monitor.
- lomustine
lomustine and secukinumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.
- mechlorethamine
mechlorethamine, secukinumab. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.
- ofatumumab SC
ofatumumab SC, secukinumab. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.
- phenobarbital
secukinumab, phenobarbital. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- phenytoin
secukinumab, phenytoin. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- primidone
secukinumab, primidone. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- quinidine
secukinumab, quinidine. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- quinine
secukinumab, quinine. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- rozanolixizumab
rozanolixizumab will decrease the level or effect of secukinumab by receptor binding competition. Use Caution/Monitor. Coadministration of rozanolixizumab with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing rozanolixizumab and using alternative therapies.
- sirolimus
secukinumab, sirolimus. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- tacrolimus
secukinumab, tacrolimus. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- theophylline
secukinumab, theophylline. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- trastuzumab
trastuzumab, secukinumab. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy.
- trastuzumab deruxtecan
trastuzumab deruxtecan, secukinumab. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy.
- ublituximab
ublituximab and secukinumab both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered
- valproic acid
secukinumab, valproic acid. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, secukinumab could normalize the formation of CYP450 enzymes. Upon initiation or discontinuation of secukinumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.
- zoster vaccine recombinant
secukinumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
Minor (0)
Adverse Effects
>10%
Adult Plaque Psoriasis
- Infections (28.7%)
- Nasopharyngitis (11.4%)
Adult PsA
- Infections (29%)
1-10%
Adult Plaque Psoriasis
- Diarrhea (4.1%)
- Upper respiratory tract infection (2.5%)
- Rhinitis (1.4%)
- Oral herpes (1.3%)
- Pharyngitis (1.2%)
- Rhinorrhea (1.2%)
<1%
Adult Plaque Psoriasis
- Urticaria (0.6%)
Postmarketing Reports
Skin and subcutaneous tissue disorders: Eczematous eruptions (atopic dermatitis-like eruptions, dyshidrotic eczema, and erythroderma), pyoderma gangrenosum
Warnings
Contraindications
Hypersensitivity
Cautions
May increase risk of infections; caution when considering use in patients with chronic infection or a history of recurrent infection
In the postmarketing setting, serious and some fatal infections reported; instruct patients to seek medical advice if signs or symptoms suggestive of an infection occur; if a patient develops a serious infection, monitor the patient closely and discontinue therapy until infection resolves
Evaluate patients for tuberculosis (TB) infection before initiating; do not administer with active TB; for latent TB, initiate anti-TB therapy prior to initiation of secukinumab in patients with a history of latent or active TB in whom an adequate course of treatment cannot be confirmed; monitor patients closely for signs and symptoms of active TB during and after treatment
May exacerbate Crohn disease
Anaphylaxis and cases of urticaria reported; if this occurs, discontinue secukinumab immediately and initiate anaphylaxis treatment
The removable caps of the 150 mg/mL Sensoready pen and the 1 mL and 0.5 mL prefilled syringes contain natural rubber latex, which may cause allergic reaction in latex-sensitive individuals; the safe use of 150 mg/mL Sensoready pen or 1 mL and 0.5 mL prefilled syringes in latex-sensitive individuals not studied
Use caution when prescribing drug to patients with inflammatory bowel disease; exacerbations, in some cases serious, reported in clinical trials in plaque psoriasis, psoriatic arthritis, ankylosing spondylitis and non-radiographic axial spondyloarthritis
Eczematous eruptions
- In postmarketing reports, cases of severe eczematous eruptions, including atopic dermatitis-like eruptions, dyshidrotic eczema, and erythroderma, reported in patients receiving therapy; some cases resulted in hospitalization; the onset of eczematous eruptions was variable, ranging from days to months after first dose of therapy
- Treatment may need to be discontinued to resolve eczematous eruption; some patients were successfully treated for eczematous eruptions while continuing therapy
Drug interaction overview
-
Immunizations
- Prior to initiating therapy, consider completion of all age-appropriate immunizations according to current immunization guidelines
- Patients treated with secukinumab should not receive live vaccines
- Nonlive vaccines received during a course of secukinumab may not elicit an immune response sufficient to prevent disease
- Therapy may alter a patient`s immune response to live vaccines; avoid use of live vaccines in patients receiving treatment
-
CYP450 substrates
- CYP450 enzymes are suppressed by increased levels of cytokines (eg, IL-1, IL-6, IL-10, TNF-alpha) during chronic inflammation
- Results from a drug-drug interaction study in patients with moderate-to-severe psoriasis showed no clinically relevant interaction for drugs metabolized by CYP3A4.
- Upon initiation or discontinuation of secukinumab in patients taking CYP450 substrates with narrow therapeutic indices, consider monitoring for therapeutic effect or drug concentration; adjust dose as needed
Pregnancy & Lactation
Pregnancy
Limited available human data regarding use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes
Animal data
- No adverse developmental effects were observed in infants born to pregnant monkeys after SC administration of secukinumab during organogenesis at doses up to 30 times the maximum recommended human dose (MRHD)
Lactation
Unknown if excreted in human milk or absorbed systemically after ingestion; data are unavailable regarding effects on breastfed children or milk production
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Human IgG1 monoclonal antibody that selectively binds to and neutralizes the proinflammatory cytokine interleukin 17A (IL-17A)
IL-17A is a naturally occurring cytokine that is involved in normal inflammatory and immune responses and plays a key role in the pathogenesis of plaque psoriasis
Absorption
Peak plasma time: 6 days (single dose); 31-34 days (weekly dosing during first month)
Peak plasma concentration (single dose, day 6): 13.7 mcg/mL (150 mg) and 27.3 mcg/mL (300 mg)
Steady-state: By 24 weeks with monthly dosing
Steady-state trough levels: 16.7 mcg/mL (150 mg) to 34.4 mcg/mL (300 mg)
At the 300-mg dose at week 4 and week 12, the mean trough concentrations resulting from the Sensoready pen were 23-30% higher than those from the lyophilized powder and 23-26% higher than those from the prefilled syringe based on cross-study comparisons
Distribution
Vd: Low; 7.1-8.6 L (IV administration)
Concentrations in interstitial fluid in lesional and nonlesional skin: 27-40% of those in serum at weeks 1 and 2
Metabolism
Expected to be metabolized in the same manner as any endogenous IgG via intracellular catabolism, following fluid phase or receptor-mediated endocytosis and degraded into small peptides and amino acids
Elimination
Half-life: 22-31 days
Systemic clearance: Slow; 0.14-0.22 L/day
Clearance and distribution increases with body weight
Administration
IV Incompatibility
Do not infuse IV concomitantly in same IV line with other drugs (compatibility studies not conducted)
IV Compatibility
0.9% NaCl
SC Preparation
Pens and prefilled syringes
- Remove pen or prefilled syringe from refrigerator and allow reach room temperature (15-30 minutes) without removing needle cap
- The removable cap of pen and prefilled syringe contains natural rubber latex and should not be handled by latex-sensitive individuals
- Visually inspect for particulate matter and discoloration before administering; solution is clear to slightly opalescent, colorless to slightly yellow solution; discard if liquid contains visible particles, is discolored, or is cloudy
- Discard any unused product
IV Preparation
Available as 125mg/5mL single-dose vial for IV use
Must dilute before IV infusion
Volume calculation
- Calculate total volume of IV solution and number of vials required based on actual body weight
- Loading dose (6 mg/kg) is 0.24 mL/kg
- Maintenance dose (1.7 mg/kg) is 0.07 mL/kg
Dilution
- Remove from refrigerator and allow solution in vial(s) to sit for ~20 minutes at room temperature 20-25ºC (68-77ºF)
- Inspect visually for particulate matter and discoloration before administration; discard if particulates or discolorations observed
- Withdraw and discard a volume of 0.9% NaCl from infusion bag equal to calculated dosage volume
- From the vial(s), withdraw calculated dosage volume and add slowly to 0.9% NaCl infusion bag
- Mix solution by gently inverting bag to avoid foaming; do NOT shake
- Discard unused product in vials (does not contain preservatives)
- Administer the diluted solution as soon as possible, or store as directed (see below)
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Infusion bag size
- Weight >52 kg: 100 mL for loading or maintenance dose
- Weight ≤52 kg: 100 mL for loading dose and 50 mL for maintenance dose
SC Administration
Adults: May self-administer or may be injected by a caregiver after proper training in SC injection technique using pen OR prefilled syringe
Each 300-mg dosage is given as 1 SC injection of 300 mg or as 2 SC injections of 150 mg
Pediatric patients: Not to be self-administered; pen or prefilled syringe is prepared and administered by an adult caregiver
Administer each injection at a different anatomic location (eg, upper arms, thighs, any quadrant of abdomen) than the previous injection, and not into areas where the skin is tender, bruised, erythematous, indurated, or affected by psoriasis
Administration in the upper, outer arm may be performed by a caregiver or healthcare provider
IV Administration
Use only an infusion set with an in-line, sterile, non-pyrogenic, low protein-binding filter (pore size 0.2 micrometer)
After dilution, infuse IV at rate of ~3.3 mL/minute for a 100-mL bag or 1.7-mL/min for a 50 mL bag (total administration time: 30 minutes)
Flush IV line with ≥50 mL of 0.9% NaCl to guarantee that all solution has been administered
Storage
Unopened vials, pens, and prefilled syringes
- Refrigerate at 2-8ºC (36-46ºF)
- Keep in the original carton to protect from light until the time of use
- Do not freeze
- To avoid foaming, do not shake
- Does not contain a preservative; discard any unused portion
Unopened pens and prefilled syringes (room temperature)
- May stored up to 4 days at room temperature not to exceed 30ºC (86ºF)
- Write date removed from and returned to refrigerator in space provided on carton
- Discard if stored outside of refrigerator >4 days
- May be returned to refrigerator once and must be stored at 2-8ºC (36-46ºF) until used or expired
Diluted solution for IV
- Storage times include from start of preparation (piercing of the first vial) to completion of infusion
- Refrigerate at 2-8ºC (36-46ºF) for up to 24 hr; protect from light, OR
- Room temperature at 20-25ºC (68-77ºF) for up to 4.5 hr
- Allow to reach room temperature (15-30 minutes) before administration
Images
Patient Handout
secukinumab subcutaneous
SECUKINUMAB - INJECTION
(SEK-ue-KIN-ue-mab)
COMMON BRAND NAME(S): Cosentyx
USES: This medication is used to treat plaque psoriasis and certain types of arthritis (such as arthritis of the spine, psoriatic arthritis, axial spondyloarthritis, enthesitis-related arthritis). Secukinumab belongs to a class of drugs known as monoclonal antibodies. It works by blocking a certain natural protein in your body (interleukin-17A) that may cause inflammation and swelling.
HOW TO USE: Read the Medication Guide and the Instructions for Use leaflet provided by your pharmacist before you start using secukinumab and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Before treatment with this medication, your doctor will make sure that you have received all your vaccinations and also test you for tuberculosis (TB). Your doctor should monitor you for symptoms of TB during and after treatment with this drug. If needed, treatment for tuberculosis or other infections should be given before receiving this medication.This medication is given by injection under your skin as directed by your doctor. The injection is given in the upper arms, thighs, or abdomen (at least 2 inches from your belly button). The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on their weight. Follow your doctor's instructions carefully.If you are using this medication at home, learn all preparation and usage instructions from your health care professional and the product instructions. Wash your hands before using this medication. Follow the directions in the Instructions for Use leaflet to remove the medication from the refrigerator and bring it to room temperature for the stated amount of time before you inject it. Do not shake the medication. The medication should be clear or slightly yellow. Before using, check this product visually for cloudiness, particles, or discoloration. If you see any of these things, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin. Do not inject the drug into areas of the skin with scars or stretch marks or into skin that is irritated, sore, bruised, red, hardened, or affected by psoriasis. To lessen bruising, do not rub the injection site after a shot. Learn how to store and discard medical supplies safely. Do not reuse syringes.Use this medication regularly to get the most benefit from it. It may help to mark your calendar with a reminder.Tell your doctor if your condition does not improve or if it worsens.
SIDE EFFECTS: Diarrhea may occur. If this effect lasts or gets worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may lower your ability to fight infections. This may make you more likely to get a serious infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as sore throat that doesn't go away, fever, chills, white patches in the mouth, cough).Tell your doctor right away if you have any serious side effects, including: stomach/abdominal pain, diarrhea with blood/mucus.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using secukinumab, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as latex found in the needle cover on the prefilled syringe/pen), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: current/recent/returning infection (such as tuberculosis, herpes), bowel disease (such as Crohn's disease, ulcerative colitis).Secukinumab can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.Tell your health care professional that you are using secukinumab before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as complete blood count) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.
STORAGE: Store in the refrigerator. Do not freeze. Keep the product in the original carton to protect from light until the time of use. Some forms of this medication may be kept at room temperature for up to 4 days. Check the product package to see if that applies to your product. Otherwise, the medication should be used within 1 hour after taking it out of the refrigerator. Discard any unused portion after use.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised July 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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- View the formulary and any restrictions for each plan.
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