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

Ustekinumab is a prescription medication that helps calm your immune system when it's overactive. It's a targeted therapy that blocks specific proteins in your body that cause inflammation, making it particularly helpful for people with autoimmune conditions like psoriasis, Crohn's disease, and ulcerative colitis.

This medication belongs to a class called monoclonal antibodies, which are lab-made proteins designed to target very specific parts of your immune system. Think of it as a precision tool rather than a broad-spectrum treatment, working to reduce inflammation without shutting down your entire immune response.

What is Ustekinumab Used For?

Ustekinumab treats several autoimmune conditions where your immune system mistakenly attacks healthy parts of your body. Your doctor might prescribe it when other treatments haven't worked well enough or when you need a more targeted approach to managing your condition.

The medication is most commonly used for moderate to severe plaque psoriasis, a skin condition that causes thick, scaly patches. It's also approved for psoriatic arthritis, which affects both your skin and joints, causing pain and swelling.

For digestive conditions, ustekinumab helps treat moderate to severe Crohn's disease and ulcerative colitis. These are inflammatory bowel diseases that cause persistent inflammation in your digestive tract, leading to symptoms like abdominal pain, diarrhea, and weight loss.

How Does Ustekinumab Work?

Ustekinumab works by blocking two specific proteins called interleukin-12 and interleukin-23. These proteins act like messengers in your immune system, telling it to create inflammation even when it's not needed.

By blocking these messengers, ustekinumab helps reduce the excessive inflammation that causes your symptoms. It's considered a moderately strong medication that provides targeted relief rather than broadly suppressing your immune system.

The effects don't happen immediately because your body needs time to clear out the existing inflammatory signals. Most people start noticing improvements within a few weeks, with maximum benefits typically appearing after several months of treatment.

How Should I Take Ustekinumab?

Ustekinumab comes in two forms: subcutaneous injections that go under your skin, and intravenous infusions that go directly into your bloodstream. The method depends on your specific condition and what your doctor determines will work best for you.

For subcutaneous injections, you'll typically receive them in your doctor's office or learn to give them to yourself at home. The injection sites usually rotate between your thigh, abdomen, or upper arm to prevent irritation in any one area.

If you're getting intravenous infusions, these are always done in a healthcare setting. You'll sit comfortably while the medication drips slowly into a vein, usually taking about an hour. Your healthcare team will monitor you during and after the infusion.

You don't need to take this medication with food, but staying well-hydrated on treatment days can help you feel more comfortable. Your doctor will give you specific instructions about timing and preparation based on your individual treatment plan.

How Long Should I Take Ustekinumab For?

The length of treatment with ustekinumab varies significantly depending on your condition and how well you respond to the medication. Many people need to continue treatment long-term to maintain their improvements, sometimes for years.

Your doctor will regularly assess how you're responding to determine if you should continue. For conditions like psoriasis, you might see dramatic improvements that make long-term treatment worthwhile. For inflammatory bowel diseases, the medication often becomes part of ongoing management.

Some people can eventually reduce their dosing frequency or take breaks from treatment, but this decision always requires close medical supervision. Stopping too early often leads to symptoms returning, sometimes more severely than before.

What Are the Side Effects of Ustekinumab?

Like all medications that affect your immune system, ustekinumab can cause side effects, though many people tolerate it well. Understanding what to expect can help you feel more prepared and know when to contact your healthcare provider.

The most common side effects you might experience include injection site reactions like redness, swelling, or tenderness where you received the shot. These reactions are usually mild and resolve on their own within a few days.

Here are the more common side effects that people report:

• Upper respiratory infections like colds or sinus infections
• Headaches that may occur especially after the first few doses
• Fatigue or feeling more tired than usual
• Nausea or mild stomach upset
• Back pain or muscle aches
• Dizziness, particularly right after injections

These side effects often improve as your body adjusts to the medication over the first few months of treatment.

More serious side effects can occur, though they're less common. Because ustekinumab affects your immune system, you might be more susceptible to infections. Your doctor will monitor you carefully for signs of serious infections.

Here are the more serious side effects that require immediate medical attention:

• Signs of serious infection like fever, flu-like symptoms, or unusual fatigue
• Skin changes including new growths or changes in existing moles
• Persistent cough or breathing difficulties
• Severe abdominal pain or changes in bowel habits
• Unusual bruising or bleeding
• Severe allergic reactions during or after injections

While these serious side effects are rare, being aware of them helps you seek appropriate care if needed.

Some very rare but serious conditions have been reported, including certain types of cancer and severe brain infections. Your doctor weighs these rare risks against the benefits of treating your condition when recommending ustekinumab.

Who Should Not Take Ustekinumab?

Ustekinumab isn't suitable for everyone, and your doctor will carefully evaluate whether it's safe for you. Certain health conditions and circumstances make this medication inappropriate or require special precautions.

You shouldn't take ustekinumab if you have an active infection, especially serious infections like tuberculosis or hepatitis B. Your doctor will test for these conditions before starting treatment and may need to treat them first.

People with certain medical histories need extra caution or may not be candidates for this medication:

• Current or recent cancer diagnosis, particularly skin cancers
• History of tuberculosis or exposure to tuberculosis
• Chronic or recurring infections
• Live vaccines received recently or planned during treatment
• Severe liver or kidney disease
• Pregnancy or breastfeeding without careful medical supervision

Your doctor will also consider your age, overall health, and other medications you're taking when determining if ustekinumab is appropriate for you.

Ustekinumab Brand Names

Ustekinumab is available under the brand name Stelara in most countries, including the United States. This is the original brand name developed by the manufacturer and is the most widely recognized name for this medication.

You might also encounter the specific formulation name "ustekinumab-ttwe" in some medical contexts, which refers to a particular version of the medication. However, when talking with your healthcare provider or pharmacist, "Stelara" is the name most commonly used.

Ustekinumab Alternatives

Several other medications work similarly to ustekinumab for treating autoimmune conditions. Your doctor might consider these alternatives if ustekinumab isn't suitable for you or if you don't respond well to it.

For psoriasis and psoriatic arthritis, other biologic medications include adalimumab (Humira), etanercept (Enbrel), and newer options like secukinumab (Cosentyx) or guselkumab (Tremfya). Each targets different parts of the immune system.

For inflammatory bowel diseases, alternatives include adalimumab, infliximab (Remicade), and vedolizumab (Entyvio). Your doctor will consider your specific condition, previous treatments, and individual factors when selecting the best option.

Non-biologic treatments like methotrexate, sulfasalazine, or corticosteroids might also be considered, depending on your situation and treatment history.

Is Ustekinumab Better Than Adalimumab?

Comparing ustekinumab to adalimumab isn't straightforward because both are effective medications that work differently in different people. The "better" choice depends on your specific condition, medical history, and how you respond to treatment.

Ustekinumab typically requires less frequent dosing, which some people find more convenient. It's usually given every 8-12 weeks after initial doses, while adalimumab is typically given every two weeks.

For psoriasis, both medications show similar effectiveness in clinical studies, with some people responding better to one than the other. For inflammatory bowel diseases, the choice often depends on your specific disease pattern and previous treatments.

Your doctor will consider factors like your lifestyle, injection preferences, insurance coverage, and other health conditions when helping you choose between these options.