guselkumab at a glance
Medicine class
Biologic monoclonal antibody and selective interleukin-23 inhibitor
Licensed roles
Plaque psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis in adults.
Administration
Injected under the skin using a pre-filled pen or, for some bowel-disease treatment, infused into a vein in a clinic.
Key checks
Active infection and tuberculosis must be assessed before treatment; live vaccines require advance planning.
What is guselkumab used for?
Selected UK products support these licensed adult uses:
Moderate to severe plaque psoriasis in people who are candidates for systemic treatment.
Active psoriatic arthritis after an inadequate response or intolerance to a previous disease-modifying antirheumatic drug; it may be used alone or with methotrexate.
Moderately to severely active Crohn’s disease after an inadequate response, loss of response or intolerance to conventional or biologic treatment.
Moderately to severely active ulcerative colitis after an inadequate response, loss of response or intolerance to conventional treatment, a biologic or a JAK inhibitor.
How does guselkumab work?
Guselkumab binds selectively to interleukin-23 and prevents it activating its receptor. This reduces inflammatory signalling involved in skin, joint and bowel inflammation.
guselkumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 200 mg
Injection
Route: Parenteral
Strengths: 45 mg/0.45 mL, 100 mg, 200 mg
How to take guselkumab
Follow the instructions and training provided by the specialist team.
Inject the pre-filled pen under the skin of the thighs or lower abdomen. A caregiver may use the back of the upper arm.
Avoid tender, bruised, red, hard, thick or scaly skin and, where possible, areas affected by psoriasis.
Keep the pen in its carton while it reaches room temperature. Do not shake or artificially heat it. Do not use it if the liquid is cloudy, discoloured or contains large particles.
The infusion concentrate is diluted and given into a vein by a healthcare professional; patients should not prepare or handle it.
guselkumab side effects
Common or expected effects
- Respiratory tract infections
- Headache
- Joint pain
- Diarrhoea
- Rash
- Injection-site redness, irritation or pain
- Raised liver enzymes
Get urgent medical advice
- Serious allergic reaction, including anaphylaxis
- Clinically important or serious infection
- Possible liver injury, such as jaundice or dark urine, particularly with abnormal liver tests
guselkumab in pregnancy
Human pregnancy information is limited, so UK product information advises avoiding guselkumab during pregnancy as a precaution. Effective contraception is advised during treatment and for at least 12 weeks afterwards. Discuss pregnancy or pregnancy planning with the specialist team.
guselkumab while breastfeeding
It is unknown whether guselkumab enters human milk. The benefits of breastfeeding and maternal treatment require an individual specialist assessment, especially for a newborn or premature infant.
guselkumab interactions
Few pharmacokinetic interactions are expected, but vaccination and combined immune-modifying treatment require review.
Live vaccines
Live vaccines should not be given concurrently; plan vaccination timing with the treating team.
CYP450 substrates, including warfarin, omeprazole and midazolam
A clinical study found no clinically relevant change in exposure, making a significant CYP-mediated interaction unlikely.
Common questions about guselkumab
Answers are fully visible for fast scanning and source review.
Is guselkumab a steroid?
No. It is a biologic monoclonal antibody that selectively blocks interleukin-23.
Can I inject guselkumab myself?
A pre-filled pen may be self-injected when the prescriber considers this appropriate and training is complete. Healthcare professionals administer the infusion formulation.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.