ustekinumab at a glance
Medicine class
Biological immunosuppressant; interleukin inhibitor monoclonal antibody
Main targets
The shared p40 subunit of interleukin-12 and interleukin-23
Administration
Under-the-skin injection; an intravenous infusion is used to start licensed inflammatory bowel disease treatment
Vaccines
Avoid live vaccines during treatment; non-live vaccines may be given
What is ustekinumab used for?
Selected products are licensed for:
Moderate to severe plaque psoriasis.
Active psoriatic arthritis in adults.
Moderately to severely active Crohn’s disease.
Moderately to severely active ulcerative colitis in adults.
How does ustekinumab work?
Ustekinumab binds to the p40 component shared by interleukin-12 and interleukin-23, reducing immune activity involved in inflammatory skin, joint and bowel disease.
ustekinumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 130 mg
Injection
Route: Parenteral
Strengths: 45 mg, 90 mg
How to take ustekinumab
The infusion formulation is diluted and given into a vein by healthcare professionals. The injection formulation is given under the skin; patients or caregivers may administer it only after training and when the specialist considers this appropriate.
Follow the instructions for the prescribed device or vial.
Avoid injecting into skin that is tender, bruised, red, hard or affected by psoriasis where possible.
Do not shake the product or use it if frozen, cloudy, discoloured or containing foreign particles.
Use each container once and place used needles or devices in an approved sharps container.
ustekinumab side effects
Common or expected effects
- Upper-airway infections, including colds, sore throat or sinusitis
- Headache or dizziness
- Diarrhoea, nausea or vomiting
- Tiredness
- Itching
- Back, muscle or joint pain
- Redness or pain at an injection site
Get urgent medical advice
- Severe allergic reaction, including anaphylaxis or angioedema
- Serious or opportunistic infection, including tuberculosis reactivation
- Persistent cough, breathlessness or fever suggesting inflammatory lung disease
- Widespread redness, blistering or peeling of the skin
- Sun-exposed scaly rash with joint pain suggesting a lupus-related reaction
ustekinumab in pregnancy
Pregnancy exposure data have not shown an increased rate of major congenital malformations, but experience remains limited. Product information advises precautionary avoidance, although a specialist may consider use appropriate when disease control is important. Tell maternity and paediatric teams about exposure because live-vaccine planning for the baby may need adjustment.
ustekinumab while breastfeeding
Only very small amounts appear to enter breast milk, but infant safety data remain limited. A specialist should weigh breastfeeding and disease-control benefits against uncertain infant risk, particularly if the baby is premature or unwell.
ustekinumab interactions
Important considerations include vaccines and treatments that further alter immune function.
Live vaccines
Do not give concurrently; arrange vaccine planning with the specialist team.
Other immunosuppressants or biological therapies
Combined immune suppression may increase risk; specialist review is required.
Allergen immunotherapy
Its interaction with ustekinumab is unknown; relevant specialists should coordinate treatment.
Common questions about ustekinumab
Answers are fully visible for fast scanning and source review.
Is ustekinumab a steroid?
No. It is a biological monoclonal antibody that blocks interleukin-12 and interleukin-23 signalling.
Can I inject ustekinumab myself?
Potentially, but only after training and approval from the treating clinician.
Can I have vaccines while taking ustekinumab?
Non-live vaccines may be given, but live vaccines should not be given concurrently. Check with the specialist team before vaccination.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.