What is Ustekinumab: Uses, Dosage, Side Effects and More

Ustekinumab is a prescription medication that helps calm down your immune system when it's overactive. It's a type of medicine called a biologic that targets specific proteins in your body that cause inflammation, helping to treat certain autoimmune conditions where your immune system mistakenly attacks healthy tissue.

This medication comes as an injection that you or your healthcare provider gives under the skin. It's designed to provide long-lasting relief from symptoms by addressing the root cause of inflammation rather than just masking the symptoms.

What is Ustekinumab Used For?

Ustekinumab treats several autoimmune conditions where your immune system causes inflammation in different parts of your body. Your doctor prescribes this medication when other treatments haven't worked well enough or when you need stronger immune system control.

The main conditions it helps with include moderate to severe plaque psoriasis, which causes thick, scaly patches on your skin. It also treats psoriatic arthritis, where inflammation affects both your skin and joints, causing pain and stiffness.

Additionally, ustekinumab helps people with Crohn's disease, an inflammatory bowel condition that causes stomach pain, diarrhea, and other digestive problems. It can also treat ulcerative colitis, another inflammatory bowel disease that primarily affects the colon and rectum.

How Does Ustekinumab Work?

Ustekinumab works by blocking two specific proteins in your immune system called interleukin-12 and interleukin-23. These proteins normally help coordinate your immune response, but in autoimmune diseases, they become overactive and cause too much inflammation.

By blocking these proteins, ustekinumab essentially turns down the volume on your immune system's inflammatory response. This helps reduce the symptoms of your condition without completely shutting down your immune system's ability to fight real threats like infections.

This medication is considered a strong, targeted treatment that works differently from traditional medications. Instead of broadly suppressing your immune system, it specifically targets the pathways that cause problems in autoimmune diseases.

How Should I Take Ustekinumab?

Ustekinumab is given as an injection under the skin, usually in your thigh, stomach area, or upper arm. Your healthcare provider will teach you how to give yourself the injection at home, or they may administer it in their office.

You don't need to take this medication with food or avoid eating before your injection. However, you should store the medication in your refrigerator and let it come to room temperature before injecting it, which makes the injection more comfortable.

The injection site should be clean and dry before you give the shot. Rotate between different areas each time you inject to avoid irritation in one spot. Your healthcare provider will show you the proper technique and give you detailed instructions.

Always use a new, sterile needle and syringe for each injection. Dispose of used needles and syringes in a proper sharps container, which your pharmacy can provide.

How Long Should I Take Ustekinumab For?

Ustekinumab is typically a long-term treatment that you'll continue as long as it's helping your condition and not causing serious side effects. Most people need to stay on this medication for months or years to maintain their improvement.

Your doctor will monitor your response to the medication and may adjust your treatment plan over time. Some people see improvement within a few weeks, while others may need several months to experience the full benefits.

Never stop taking ustekinumab suddenly without talking to your doctor first. Stopping abruptly can cause your symptoms to return, sometimes worse than before. Your healthcare provider will help you create a plan if you need to discontinue the medication.

What Are the Side Effects of Ustekinumab?

Like all medications, ustekinumab can cause side effects, though not everyone experiences them. Most side effects are mild and manageable, but it's important to know what to watch for.

Common side effects that many people experience include reactions at the injection site, such as redness, swelling, or mild pain where you gave the shot. You might also experience headaches, fatigue, or cold-like symptoms as your body adjusts to the medication.

Some people develop upper respiratory infections, such as sinus infections or sore throats, because the medication affects your immune system's ability to fight off certain germs. These infections are usually mild and respond well to standard treatments.

More serious side effects can occur, though they're less common. These include severe infections that require immediate medical attention, such as pneumonia or infections that affect your whole body. You should contact your doctor right away if you develop a fever, persistent cough, or feel unusually unwell.

Very rarely, some people may experience serious allergic reactions, changes in their blood cell counts, or liver problems. Your doctor will monitor you with regular blood tests to catch any of these issues early.

Who Should Not Take Ustekinumab?

Ustekinumab isn't safe for everyone, and your doctor will carefully evaluate whether it's right for you. People with active infections shouldn't start this medication until their infection is completely treated and cleared.

If you have a history of certain types of cancer, particularly skin cancers or blood cancers, your doctor will weigh the risks and benefits very carefully. The medication can potentially increase your risk of developing certain cancers, though this is rare.

People with severe liver disease, kidney problems, or other serious chronic conditions may not be good candidates for ustekinumab. Your doctor will review your complete medical history and current health status before prescribing this medication.

If you're pregnant, planning to become pregnant, or breastfeeding, you'll need to discuss the risks and benefits with your healthcare provider. The effects of ustekinumab on pregnancy aren't fully understood, so alternative treatments might be safer.

Ustekinumab Brand Names

Ustekinumab is sold under the brand name Stelara in most countries. This is the most common name you'll see on your prescription bottle and in medical literature.

The medication comes in pre-filled syringes or vials, depending on your specific dose and your doctor's preference. All forms contain the same active ingredient, ustekinumab, regardless of the packaging.

Ustekinumab Alternatives

Several other medications work similarly to ustekinumab for treating autoimmune conditions. These include other biologic medications like adalimumab, etanercept, and infliximab, though they target different parts of the immune system.

For psoriasis specifically, alternatives might include secukinumab, ixekizumab, or guselkumab. For inflammatory bowel diseases, options could include vedolizumab or adalimumab.

Your doctor will choose the best medication for you based on your specific condition, how severe your symptoms are, your medical history, and how you've responded to other treatments. What works best can vary significantly from person to person.

Is Ustekinumab Better Than Humira?

Both ustekinumab and Humira (adalimumab) are effective biologic medications, but they work in different ways and may be better for different people. Ustekinumab blocks interleukin-12 and interleukin-23, while Humira blocks tumor necrosis factor (TNF).

Some people respond better to one medication than the other, and there's no way to predict which will work best for you without trying them. Your doctor will consider factors like your specific condition, other health problems you have, and your lifestyle when choosing between them.

Ustekinumab is given less frequently than Humira, which some people prefer. However, Humira has been available longer and is approved for more conditions, so it might be the first choice for certain situations.