Select a medication above to begin.
Skyrizi (risankizumab-rzaa)
risankizumab
Adult Dosing .
Dosage forms: INJ (auto-injector): 150 mg; INJ (pre-filled syringe): 150 mg per mL; INJ (on-body injector): 180 mg, 360 mg; INJ (vial): various
Special Note
- [formulation clarification]
- Info: nonproprietary name = risankizumab-rzaa
psoriasis, moderate-severe plaque
- [150 mg SC q12wk]
- Start: 150 mg SC x1 on wk 0, 4, then q12wk
psoriatic arthritis
- [150 mg SC q12wk]
- Start: 150 mg SC x1 on wk 0, 4, then q12wk; Info: use alone or w/ non-biologic DMARDs
Crohn dz, moderate-severe
- [induction tx]
- Dose: 600 mg IV x1 on wk 0, 4, 8
- [maintenance tx]
- Dose: 180 mg or 360 mg SC q8wk; Start: 4wk after last induction dose; Info: use lowest effective dose
ulcerative colitis, moderate-severe
- [induction tx]
- Dose: 1200 mg IV x1 on wk 0, 4, 8
- [maintenance tx]
- Dose: 180 mg or 360 mg SC q8wk; Start: 4wk after last induction dose; Info: use lowest effective dose
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [Crohn dz]
- hepatic impairment: not defined; Info: consider alternative tx if cirrhosis
- [all other indications]
- hepatic impairment: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- infection, active
- TB infection, active
- caution: infection, chronic
- caution: infection, recurrent
- caution: infection risk
- caution: TB infection, latent
- caution: TB infection risk
- caution: cirrhosis (Crohn dz or ulcerative colitis use)
Drug Interactions .
Overview
risankizumab
IL-23 antagonist
- immunosuppressive effects
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- abrocitinib
- adalimumab
- anifrolumab
- cladribine oral
- deuruxolitinib
- etrasimod
- infliximab
- natalizumab
- pimecrolimus topical
- rabies vaccine
- ritlecitinib
- ruxolitinib topical
- upadacitinib
Monitor/Modify Tx
- anthrax vaccine
- carfilzomib
- chikungunya vaccine
- COVID-19 vaccine
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- ebola vaccine, live
- everolimus
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- influenza H5N1 vaccine
- influenza vaccine
- Japanese encephalitis vaccine
- meningococcal vaccine
- pneumococcal vaccine
- poliovirus vaccine
- respiratory syncytial virus vaccine
- sipuleucel-T
- smallpox/mpox vaccine, live
- temsirolimus
- tick-borne encephalitis vaccine
- typhoid vaccine
Caution Advised
- abatacept
- abemaciclib
- acalabrutinib
- afamitresgene autoleucel
- aldesleukin
- alemtuzumab
- anakinra
- anti-thymocyte globulin
- atidarsagene autotemcel
- avacopan
- axicabtagene ciloleucel
- azacitidine
- azathioprine
- baricitinib
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- belinostat
- bendamustine
- betamethasone
- bimekizumab
- blinatumomab
- bortezomib
- brentuximab vedotin
- brexucabtagene autoleucel
- brodalumab
- budesonide
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- busulfan
- cabazitaxel
- canakinumab
- carboplatin
- carmustine
- certolizumab pegol
- chlorambucil
- ciltacabtagene autoleucel
- cisplatin
- cladribine injection
- clobetasol ophthalmic
- clofarabine
- copanlisib
- corticotropin
- cortisone
- crovalimab
- cyclophosphamide
- cyclosporine
- cytarabine
- dactinomycin
- danicopan
- daratumumab
- daunorubicin
- decitabine
- deflazacort
- deucravacitinib
- dexamethasone
- dexamethasone ophthalmic
- difluprednate ophthalmic
- dimethyl fumarate
- dinutuximab
- diroximel fumarate
- docetaxel
- doxorubicin
- dupilumab
- duvelisib
- eculizumab
- efgartigimod alfa
- elivaldogene autotemcel
- elotuzumab
- elranatamab
- emapalumab
- epcoritamab
- epirubicin
- eribulin
- etanercept
- etoposide
- fingolimod
- floxuridine
- fludarabine
- fludrocortisone
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluorouracil
- fluticasone furoate
- fluticasone propionate
- fruquintinib
- gemcitabine
- gemtuzumab ozogamicin
- glofitamab
- golimumab
- guselkumab
- hydrocortisone
- hydrocortisone ophthalmic
- hydroxyurea
- ibritumomab tiuxetan
- ibrutinib
- idarubicin
- idecabtagene vicleucel
- idelalisib
- ifosfamide
- inebilizumab
- inotuzumab ozogamicin
- iptacopan
- irinotecan
- isatuximab
- ixabepilone
- ixekizumab
- lebrikizumab
- leflunomide
- lenalidomide
- lifileucel
- lisocabtagene maraleucel
- lomustine
- loncastuximab tesirine
- loteprednol ophthalmic
- lymphocyte immune globulin, anti-thymocyte globulin
- melphalan
- mercaptopurine
- methotrexate
- methylprednisolone
- mirikizumab
- mitoxantrone
- mogamulizumab
- momelotinib
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- nadofaragene firadenovec intravesical
- nelarabine
- obecabtagene autoleucel
- obinutuzumab
- ocrelizumab
- ofatumumab
- omacetaxine mepesuccinate
- oxaliplatin
- ozanimod
- paclitaxel
- panobinostat
- pegcetacoplan
- pentostatin
- pirtobrutinib
- polatuzumab vedotin
- pomalidomide
- ponatinib
- ponesimod
- pozelimab
- prednisolone
- prednisolone ophthalmic
- prednisone
- procarbazine
- quizartinib
- ravulizumab
- regorafenib
- rilonacept
- rituximab
- romidepsin
- ropeginterferon alfa-2b
- rozanolixizumab
- ruxolitinib
- sarilumab
- satralizumab
- secukinumab
- selinexor
- siltuximab
- siponimod
- sirolimus
- sirolimus albumin-bound
- spesolimab
- sulfasalazine
- sutimlimab
- tacrolimus
- tafasitamab
- talquetamab
- tarlatamab
- teclistamab
- temozolomide
- teplizumab
- teriflunomide
- thioguanine
- thiotepa
- tildrakizumab
- tisagenlecleucel
- tocilizumab
- tofacitinib
- topotecan
- tralokinumab
- triamcinolone
- tuberculin purified protein derivative
- ublituximab
- ustekinumab
- vamorolone
- vedolizumab
- venetoclax
- vilobelimab
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- zanubrutinib
- zilucoplan
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- infection
- hepatotoxicity (Crohn dz use)
- hepatic injury (Crohn dz use)
Common Reactions
- infection
- URI
- arthralgia
- abdominal pain
- headache
- injection site rxn
- fever
- anemia
- back pain
- rash
- arthropathy
- UTI
- fatigue
- hypersensitivity rxn
- ALT incr.
- cholesterol incr.
Safety/Monitoring .
Monitoring Parameters
Crohn Dz or Ulcerative Colitis: TB test before tx start; ALT, AST, bilirubin at baseline, then during induction tx for at least 12wk of tx, then as clinically indicated
All Other Indications: TB test before tx start
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available, though likely to cross placenta based on human data w/ other monoclonal antibodies; no known risk of teratogenicity, though risk of neonatal death based on animal data at 5-32x recommended human dose; possible risk of decr. neonatal immune response based on drug's mechanism of action; for infants exposed to risankizumab in utero, weigh risk/benefit before admin. live vaccines for at least 5mo after birth
Pregnancy Registry
encourage pts to enroll in Pregnancy Exposure Registry at 1-877-302-2161 or www.glowpregnancyregistry.com
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: catabolism; CYP450: unknown
Excretion: unknown; Half-life: 21 days (Crohn dz use), 28 days (psoriasis use)
Subclass: Inflammatory Bowel Disease (IBD) ; Interleukin-23 (IL-23) Antagonists ; Psoriasis, Systemic Agents ; Spondyloarthropathies
Mechanism of Action
selectively binds to p19 subunit of IL-23 and inhibits IL-23 cytokine-induced responses incl. release of pro-inflammatory cytokines and chemokines (monoclonal antibody)
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.