Skyrizi (Risankizumab-Rzaa) – Subcutaneous

What Is Skyrizi?

Skyrizi (risankizumab) contains the active drug risankizumab-rzaa, a monoclonal antibody. Risankizumab is an interleukin-23 (IL-23) inhibitor approved to treat plaque psoriasis, an autoimmune disorder in adults.

It works by binding to IL-23 proteins and blocking them from causing inflammation in the body. Skyrizi also prevents IL-23 proteins from turning on other immune system cells and improves your condition. 

It is a prescription medicine and is available as a subcutaneous injection. 

Drug Facts

Generic Name: Risankizumab-Rzaa

Brand Name(s): Skyrizi

Drug Availability: Prescription

Therapeutic Classification: Interleukin inhibitors/monoclonal antibodies

Available Generically: No

Controlled Substance: N/A

Administration Route: Subcutaneous

Active Ingredient: Risankizumab-Rzaa

Dosage Form(s): Injection

What Is Skyrizi Used For?

Skyrizi (risankizumab-rzaa) is approved to treat moderate to severe plaque psoriasis in adults who could benefit from systemic therapy (taking injections or pills) or phototherapy (light therapy). The Food and Drug Administration (FDA) recently approved Skyrizi to treat active psoriatic arthritis in adults.

The safety and effectiveness of Skyrizi have not yet been established in children under 18 years old.

Skyrizi (Risankizumab-Rzaa) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Skyrizi?

Read your medication guide before using Skyrizi. If you don't understand any part, ask your healthcare provider.

Skyrizi is given by injection under your skin (subcutaneously) in your upper arms, thighs, or abdomen (at least 2 inches away from your navel). It comes as a solution in a prefilled syringe and a prefilled pen to inject under the skin.

After the first dose of Skyrizi, the next dose is usually given after four weeks, followed by doses every 12 weeks. Your healthcare provider may give you the first dose in their office. Follow the guidelines carefully.

When preparing to take your medication:

  • Remove the prefilled syringe from the refrigerator 15–30 minutes before you inject it and allow it to reach room temperature.
  • If using the pen, take it out of the refrigerator 30–90 minutes before injecting it. Keep the pen or syringe in the carton until ready to use.
  • Check that the medicine is clear or yellow. It may also contain a few small, clear or white particles. Discard your solution if it's cloudy, has large particles, or discoloration.
  • Do not shake the medicine solution or use broken or leaked injecting devices. 

Before injecting each dose, wash your hands and clean your injection site on your skin with rubbing alcohol and let it dry. Do not inject at the same area for two consecutive doses. Change your injection site every time to lessen any chance of injury under your skin. Do not inject into areas that have psoriasis scars, stretch marks or sore, bruised, red or hardened skin. Do not reuse syringes.

Use Skyrizi regularly to get the most benefit from it. It may help to set up calendar reminders.

Storage

Store your Skyrizi in the refrigerator (between 36 degrees and 46 degrees Fahrenheit) in the carton that it came in. Keep it tightly closed, out of sight and reach of children and pets. Do not shake or freeze.

Do not keep unwanted or expired medicine with you. However, do not flush the medications down the toilet or throw them in the trash. Instead, the best way to dispose of unwanted medication is through a medicine take-back program. Contact your pharmacist or local garbage/recycling department to ask about this program in your community.

How Long Does Skyrizi Take to Work?

Skyrizi starts working immediately after injection. However, it may take a few doses to improve the symptoms. 

What Are the Side Effects of Skyrizi?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Some common side effects of Skyrizi may include:

  • Headache
  • Tiredness
  • Upper respiratory infections, including cold symptoms such as sore throat, sneezing, runny nose, or nasal congestion
  • Pain, bruising, redness, swelling, irritation, itching, and warmth at the injection site
  • Fungal infections

Call your healthcare provider if any of these side effects worsen or do not go away.

Severe Side Effects

Severe side effects from Skyrizi aren’t common but can occur. Call your healthcare provider right away if you have severe side effects such as:

  • Allergic reaction (skin rash, itching, swelling under the skin, typically in the eyelids, lips, hands, feet, tongue, mouth, or throat, trouble breathing).
  • Serious infections (fever, sweats, chills, cough, muscle pain, sores on the body, unexplained weight loss, abdominal pain, burning feeling while urinating).

Report Side Effects

Skyrizi may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Skyrizi Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injectable dosage form (prefilled pen or prefilled syringe):
    • For moderate to severe plaque psoriasis:
      • Adults—Two 75 milligrams (mg) prefilled syringes, or one 150 mg prefilled pen or syringe injected under your skin at different body areas at Weeks 0 and 4, and every 12 weeks after.
      • Children—Use and dose must be determined by your doctor.

Modifications

There is no difference in the overall efficacy and safety of Skyrizi in adults over the age of 65 years. However, the safety of Skyrizi is not established in patients younger than 18 years.

There is not enough data available on the effect of Skyrizi on the fetus or its passing into breast milk. Consult your healthcare provider if you are pregnant or breastfeeding.

Missed Dose

If you miss a dose, inject it as soon as you remember. Inject the following doses at the regular time. Do not inject a double dose of Skyrizi to make up for the missed one.

Overdose: What Happens If I Take Too Much Skyrizi?

If someone has overdosed on Skyrizi, monitor the person for signs and symptoms of adverse reactions and seek immediate medical help.

What Happens If I Overdose on Skyrizi?

If you think you or someone else may have overdosed on Skyrizi, call a healthcare provider or the Poison Control Center (800-222-1222). 

If someone collapses or isn't breathing after taking Skyrizi, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

You will need to have a skin test for tuberculosis before you start using this medicine. Tell your doctor if you or anyone in your home has ever had a positive reaction to a tuberculosis skin test.

It is important to check with your doctor if you have any symptoms of an infection, including fever or chills, cough or hoarseness, lower back or side pain, painful or difficult urination.

Do not have any live vaccines (immunizations) while you are being treated with risankizumab-rzaa injection. Be sure to ask your doctor if you have any questions about this.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Skyrizi?

Skyrizi may not be suitable to take if you have certain medical conditions such as:

  • If you're allergic to Skyrizi or any of the ingredients in it or the injector
  • If you have an infection that does not go away or keeps coming back
  • If you have active tuberculosis (TB), with symptoms, or latent TB, with no symptoms (your healthcare provider may ask for a TB test before starting the treatment; do not take Skyrizi if you have active TB)
  • If you have had or are scheduled for a live vacine
  • If you're pregnant or breastfeeding, as it's not known if Skyrizi is safe to use during pregnancy or if it passes into breast milk

Speak with your healthcare provider to discuss any risk factors or questions you may have before starting treatment with Skyrizi.

What Other Medications Interact With Skyrizi?

Skyrizi may interact with live vaccines. Avoid receiving live vaccines to avoid serious infections.

These vaccines include:

Skyrizi has not been reported to interact with herbs and supplements. However, do speak with your healthcare provider before using any supplements or products containing herbs or plants while taking Skyrizi.

What Medications Are Similar?

Patients with psoriasis need more effective, safe and convenient treatments to help improve their quality of life. In addition to Skyrizi, other drugs have been approved by the FDA to treat psoriasis include:

In a review of studies, brodalumab, guselkumab, ixekizumab and risankizumab-rzaa, the active ingredient in Skyrizi, helped reduce psoriasis symptoms in adults with moderate to severe psoriasis.

In a comparison study of risankizumab and adalimumab, risankizumab was more effective than adalimumab in improving plaque psoriasis symptoms. In another study, risankizumab showed superior efficacy and safety with less frequent dosing than secukinumab.

The clinical benefits of these novel treatments for psoriasis are well established. However, each person is different and has different needs. Discuss your options with your healthcare provider. 

Frequently Asked Questions

  • What is Skyrizi?

    Skyrizi is used to treat moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. It has also been approved by the FDA to treat psoriatic arthritis in adults. 

  • How does Skyrizi work?

    Skyrizi blocks interleukin-23 (IL-23) from binding with its receptor. This helps to prevent inflammation.

  • Will Skyrizi cure my plaque psoriasis?

    Skyrizi does not cure plaque psoriasis. However, it can help to relieve psoriasis symptoms such as reducing redness and plaque scales.

  • How long does Skyrizi take to work?

    Skyrizi starts to show an improvement in psoriasis and psoriatic arthritis in four weeks for some patients, while others notice a reduction in symptoms over 16 weeks and beyond.

  • What are the side effects of Skyrizi?

    Some common side effects of Skyrizi are headache, fungal infections, tiredness, and abdominal pain. These side effects do not normally require medical attention and may go away on their own.

  • Is Skyrizi available in generic form?

    Skyrizi is available as a brand-name medicine only. Currently there is no generic version of this medicine available.

  • What drugs should not be taken with Skyrizi?

    Avoid taking any live vaccines such as typhoid, measles, mumps, rotavirus, chicken pox, shingles and others while using Skyrizi. Taking these vaccines with this medication can increase your risk of infection.

How Can I Stay Healthy While Taking Skyrizi?

Psoriasis is a chronic T‐cell‐mediated inflammatory skin disease that affects more than 100 million individuals worldwide. It requires long‐term treatment. The safety and tolerability of any therapy, particularly over time, is critical. The medicines approved by the FDA for psoriasis treatment, including Skyrizi, have been proven to be beneficial in easing symptoms in people with psoriasis. However, because Skyrizi weakens the immune system, it can raise your risk of infection.

You should also avoid taking this medicine if you have tuberculosis, as well as if you're planning to get a live vaccination. An infection can develop if you take Skyrizi under these conditions. Your provider may order a TB test before starting Skyrizi.

You can take steps to help prevent infections during your treatment with Skyrizi. This includes staying updated on vaccines, practicing good hand hygiene, and avoiding prolonged contact with people who may have infections as much as possible. 

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.


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