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Cosentyx
secukinumab
Adult Dosing .
Dosage forms: INJ (Sensoready SC pen): 150 mg per injection; INJ (UnoReady SC pen): 300 mg per injection; INJ (SC pre-filled syringe): 150 mg per mL, 300 mg per 2 mL; INJ (IV vial): various
psoriasis, moderate-severe plaque
- [300 mg SC q4wk]
- Start: 300 mg SC qwk x5wk; Info: may consider 150 mg/dose in patients with less severe disease and wt <90 kg
psoriatic arthritis
- [SC route]
- Dose: 150 mg SC q4wk; Info: may load 150 mg SC qwk x5wk; consider incr. dose to 300 mg SC q4wk if active disease persists; use plaque psoriasis dosing for patients with coexisting disease
- [IV route]
- Dose: 1.75 mg/kg/dose IV q4wk; Max: 300 mg/maintenance dose; Info: may load 6 mg/kg/dose IV x1
ankylosing spondylitis
- [SC route]
- Dose: 150 mg SC q4wk; Info: may load 150 mg SC qwk x5wk; consider incr. dose to 300 mg SC q4wk if active disease persists
- [IV route]
- Dose: 1.75 mg/kg/dose IV q4wk; Max: 300 mg/maintenance dose; Info: may load 6 mg/kg/dose IV x1
axial spondyloarthritis, non-radiographic
- [SC route]
- Dose: 150 mg SC q4wk; Info: may load 150 mg SC qwk x5wk
- [IV route]
- Dose: 1.75 mg/kg/dose IV q4wk; Max: 300 mg/maintenance dose; Info: may load 6 mg/kg/dose IV x1
hidradenitis suppurativa, moderate-severe
- [300 mg SC q4wk]
- Start: 300 mg SC qwk x5wk; Info: consider incr. dose to 300 mg SC q2wk if inadequate response
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ (Sensoready pen): 150 mg per injection; INJ (UnoReady pen): 300 mg per injection; INJ (pre-filled syringe): 75 mg per 0.5 mL, 150 mg per mL, 300 mg per 2 mL
psoriasis, moderate-severe plaque
- [6 yo and older, <50 kg]
- Dose: 75 mg SC q4wk; Start: 75 mg SC qwk x5wk
- [6 yo and older, >50 kg]
- Dose: 150 mg SC q4wk; Start: 150 mg SC qwk x5wk
psoriatic arthritis
- [2 yo and older, 15-49 kg]
- Dose: 75 mg SC q4wk; Start: 75 mg SC qwk x5wk
- [2 yo and older, >50 kg]
- Dose: 150 mg SC q4wk; Start: 150 mg SC qwk x5wk
ankylosing spondylitis
- [12 yo and older, <50 kg]
- Dose: 75 mg SC q4wk; Start: 75 mg SC qwk x5wk
- [12 yo and older, >50 kg]
- Dose: 150 mg SC q4wk; Start: 150 mg SC qwk x5wk
enthesitis-related arthritis
- [4 yo and older, 15-49 kg]
- Dose: 75 mg SC q4wk; Start: 75 mg SC qwk x5wk
- [4 yo and older, >50 kg]
- Dose: 150 mg SC q4wk; Start: 150 mg SC qwk x5wk
hidradenitis suppurativa, moderate-severe
- [12 yo and older, 30-89 kg]
- Dose: 150 mg SC q4wk; Start: 150 mg SC qwk x5wk
- [12 yo and older, >90 kg]
- Dose: 300 mg SC q4wk; Start: 300 mg SC qwk x5wk
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- infection, serious
- viral hepatitis, active
- TB infection, active
- caution: hypersensitivity to latex (75 mg/0.5 mL or 150 mg/mL prefilled syringe or Sensoready pen form)
- caution: infection, chronic
- caution: infection, recurrent
- caution: infection risk
- caution: TB infection, latent
- caution: TB infection risk
- caution: inflammatory bowel disease
Drug Interactions .
Overview
secukinumab
IL-17 antagonist
- immunomodulatory effects
- caution advised with narrow therapeutic index drugs; chronic inflammatory conditions may alter metabolic enzyme formation; tx with immune modulators may reverse this effect, resulting in altered levels of concomitant drugs
Contraindicated
Avoid/Use Alternative
Monitor/Modify Tx
Caution Advised
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- angioedema
- eczematous eruption, severe
- pyoderma gangrenosum
- inflammatory bowel disease
- infection, serious
- opportunistic infection
- HBV reactivation
- tuberculosis
- neutropenia
- sepsis (adult patients)
- toxic shock syndrome (peds patients)
Common Reactions
- infection
- nasopharyngitis
- neutropenia
- diarrhea
- URI
Safety/Monitoring .
Monitoring Parameters
TB test at baseline, then active TB signs/symptoms during and after tx D/C
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; risk of fetal harm not expected based on animal data at up to 30x MRHD
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available, though risk of infant harm not expected based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for secukinumab: unknown; CYP450: unknown
Excretion: for secukinumab: unknown; Half-life: 22-31 days
Subclass: Interleukin-17 (IL-17) Antagonists ; Psoriasis, Systemic Agents ; Spondyloarthropathies
Mechanism of Action
for secukinumab: selectively binds to and inhibits interleukin-17A cytokine, reducing inflammation and altering immune response (monoclonal antibody)
Formulary .
No Formulary Selected
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