Stelara

1 What is Stelara?

Brand: Stelara

Generic: Ustekinumab (Subcutaneous Route)

Stelara (Ustekinumab) is used to treat moderate-to-severe plaque psoriasis in patients who may benefit from receiving phototherapy (ultraviolet light treatment) or other treatments. Doctors prescribe Stelara to treat psoriasis and psoriatic arthritis. Stelara is a drug that suppresses the activity of the immune system to resolve symptoms of psoriasis. Stelara may be used alone or in combination with the drug Methotrexate to treat active psoriatic arthritis.

Stelara is an injectable drug, and it requires a prescription.

Stelara may cause serious side effects associated with depressed immune system. Stelara must be used only with doctor’s supervision. 

2 What to Know Before Using

The doctor will consider the following before prescribing Stelara.

Allergies

Make sure to mention to the doctor if you experienced allergies to Stelara before. You cannot use Stelara if you have allergies to it.

Tuberculosis and tuberculosis vaccine

You cannot use Stelara if you have active tuberculosis or if you have received BCG vaccine (Bacillus Calmette and Guérin, the vaccine against tuberculosis) within the past 12 months. Tell the doctor if someone in your household has tuberculosis, or recently travelled to an area where tuberculosis is endemic. Stelara may cause tuberculosis to worsen, or cause active tuberculosis if you recently received BCG vaccine. If you have these conditions, tell them to the doctor right away.

Other vaccines

Because Stelara cause your immune system to downgear in activity, vaccines will not work well while you are taking the drug. You must first receive necessary vaccines before starting on Stelara

Health conditions

Tell all your health problems to the doctor before taking Stelara. Certain health conditions may interact with Stelara and cause serious problems. The doctor needs to know if you have any of the following:

  • Signs of infection such as fever, chills, cough, muscle aches, diarrhea, pain when urinating, and feeling very tired.
  • History of chronic or long-term infections.
  • Latex allergies
  • New or changing lesions or moles on the skin.
  • If you recently received any vaccine.
  • If you have received phototherapy or light therapy.
  • If you have ever received allergy shots or used an Epi-pen

Risk of skin cancer

Use of Stelara may increase your risk of a type of skin cancer called cutaneous squamous cell carcinoma. Those who are affected tend to have pre-existing factors for the development of skin cancer, such as intense sun exposure, age above 60 years old, and having actinic keratosis. Discuss this risk with your doctor before starting on Stelara.

Pregnancy

Tell the doctor if you are pregnant before taking Stelara. Stelara is an FDA pregnancy category B drug, which means it poses minimal risk to the unborn baby when given to pregnant patients. However, in some cases, Stelara is used together with Methotrexate, which is very harmful to the fetus.

If you are pregnant and still used Stelara, your name will be listed on a registry. This is to help evaluate the effects of Stelara to pregnant patients.

Breastfeeding

Do not breastfeed when taking Stelara because it may be expressed into breastmilk.

Drug interactions

Tell the doctor all the medicines, including prescription drug, over-the-counter drugs, and supplements, you take before taking Stelara. Stelara may cause interactions with other drugs and cause serious side effects. The doctor needs to know if you take the following medicines before starting treatment with Stelara:

  • BCG vaccine
  • Belimumab
  • Coccidioides immitis skin test
  • Denosumab
  • Echinacea
  • Fingolimod
  • Infliximab
  • Leflunomide
  • Natalizumab
  • Pimecrolimus
  • Roflumilast
  • Sipuleucel-T
  • Tacrolimus skin cream or ointment
  • Tofacitinib
  • Trastuzumab
  • Any vaccines made from live or inactivated viruses

3 Proper Usage

Stelara is an injectable drug, and it is given by injecting under the skin (subcutaneous route). Follow your doctor’s prescription in taking Stelara. You must frequently be seen by your doctor when you are taking Stelara.

Stelara is given at day one and again 4 weeks later, and again every 12 weeks.

Stelara is available in prefilled syringes. The doctor will first perform the injections. If you are capable, the doctor may teach you to do injections yourself. The Stelara packaging itself contains step-by-step instructions in injecting Stelara. Understand the package instructions and doctor’s prescription first before injecting Stelara. If you become confused right before injecting Stelara, call your doctor immediately.

If you inject Stelara at home, inspect the vial or pre-filled syringe first before injection. Do not use if the liquid inside has become discolored, cloudy, or has particles in it. Do not inject Stelara twice on the same spot. You must inject Stelara at different places to prevent skin problems. Suitable places for injection are the upper arms, buttocks, thighs and abdomen. Make sure to observe strict cleanliness in injecting to prevent skin infections. Do not inject Stelara at skin areas that are bruised, have open wounds, or have inflammation.

It is important not to miss a dose of Stelara. If you missed a dose, go to your doctor right away.

Injecting too much Stelara can result in an overdose, which requires medical attention. If you injected too much Stelara, call emergency hotlines right away.

Store Stelara in the refrigerator, but not in the freezer.

4 Precautions to Take

You must frequently be seen by the doctor when having treatment with Stelara, even if you do injections at home. Make sure to keep up with doctor’s appointments and lab tests.

If you are injecting Stelara at home, make sure to dispose of used syringes and needles properly. You can put them in a large plastic bottle and seal using the cap, and then dispose of according to local waste regulations.

Note that Stelara prefilled syringes and vials are single-use only, which means you need to dispose them after use.

If you have symptoms of tuberculosis while taking Stelara, such as cough that lasts at least two weeks, chest pain, losing weight, fatigue, coughing up blood, losing appetite, night sweats, and chills, call the doctor right away.

If you are taking Stelara, it is important not to receive any live vaccines as they can cause an infection. Do not take any vaccines without your doctor’s approval. You also have to avoid persons who recently received live vaccines. 

5 Potential Side Effects

Stelara may cause serious side effects. Call your doctor if you experienced any of the following side effects:

  • Severe allergic reaction symptoms such as skin rash, difficulty breathing, swelling of the face, lips, tongue or throat.
  • Serious infection such as fever, chills, muscle pain, shortness of breath, weight loss, diarrhea, burning sensation while urinating, extreme fatigue, skin warmth and redness, painful skin sores, or coughing up blood.
  • Mole that changes in color and size
  • Swelling, pain, warmth or redness anywhere on the body
  • Severe, slow or sudden stomach pain, and changes in bowel habits (diarrhea or constipation)
  • A severe headache, confusion, unusual behavior, vision changes, and seizures
  • Stabbing chest pain, wheezing, and coughing up green or yellow mucus.

Stelara may cause minor side effects such as:

  • Symptoms of colds such as stuffy nose, sneezing and sore throat
  • Headache
  • Fatigue
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