For clinicians · Medication guide
Ustekinumab
anti-IL-12/23, Stelara
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Bottom linebDMARD blocking the shared p40 subunit of IL-12 and IL-23, used in PsA and psoriasis. Positioning to be set from primary guidance.
Dosing and administration[2]
Anti-IL-12/23 (p40) monoclonal antibody, used mainly for psoriatic arthritis. Screen for latent tuberculosis before starting.
| Indication | Starting dose | Titration and maximum |
|---|---|---|
| Psoriatic arthritis | 45 mg subcutaneously at weeks 0 and 4, then every 12 weeks. Use 90 mg for patients over 100 kg. | Maintenance every 12 weeks. |
Onset. Onset over about 4 to 16 weeks.
Monitoring
- Screen for latent tuberculosis before starting.
- Monitor for infection; ensure vaccinations are up to date (avoid live vaccines during treatment).
Contraindications
- Active serious infection, including active tuberculosis.
- Hypersensitivity to ustekinumab.
Key interactions
- Do not combine with other biologic DMARDs.
- Avoid live vaccines.
Clinical notes
Common side effects
Injection-site reactions and increased infection risk; generally well tolerated. Not sourced on this draft.
Tests and monitoring
Pre-treatment infection screening (including tuberculosis where indicated), with ongoing vigilance for infection. Specific screening to confirm from primary sources.
Important cautions
Infection risk; live-vaccine timing applies. To confirm from primary sources.
+Reproductive health. Pregnancy, breastfeeding, and paternal guidance for this agent is maintained on the same record and is verified separately.
Primary sources to be used
- Primary sources for general (non-pregnancy) use to be attached: product monograph and the relevant ACR/EULAR treatment guideline.
- STELARA (ustekinumab) Product Monograph. Health Canada authorized product monograph. https://health-products.canada.ca/dpd-bdpp/