Psoriatic disorders happen when the immune system attacks itself, which then causes inflammation in the body. Cosentyx contains secukinumab, an active ingredient that belongs to the monoclonal antibody drug class. Secukinumab works on the immune system and targets interleukin-17A (IL-17A), a protein in the body that causes inflammation.
Cosentyx binds to the IL-17A to stop it from triggering your immune system. It is a monoclonal antibody and an effective and safe treatment choice for people with psoriatic diseases.
Cosentyx is available as an injectable solution (subcutaneous) in a single-use Sensoready pen and a single-use prefilled syringe.
What Is Cosentyx Used For?
Cosentyx is used in adults to treat:
Brand Name(s): Cosentyx
Drug Availability: Prescription
Therapeutic Classification: Immunosuppressant
Available Generically: No
Controlled Substance: N/A
Administration Route: Subcutaneous
Active Ingredient: Secukinumab
Dosage Form(s): Solution
Moderate to severe plaque psoriasis: A chronic autoimmune disease causing patches of thick, red, scaly skin (prescribed for psoriasis that’s too severe to be treated by topical medications alone) Psoriatic arthritis: Arthritis affecting some people with psoriasis Ankylosing spondylitis: An inflammatory disease that causes vertebrae (spinal bones) to fuse, leading to pain, swelling, and damage Active non-radiographic axial spondyloarthritis: A chronic condition causing inflammation of the spine and the sacroiliac (SI) joint linking the spine and pelvis that is not visible in X-rays
How to Take Cosentyx
Always follow the guidelines on your prescription label and ask your healthcare provider about anything that you don’t understand.
Cosentyx injections come as a dosing pen, a prefilled syringe, or powder to mix with liquid. Secukinumab injections should be given under the skin (subcutaneous). You can inject yourself or someone else can inject you. Healthcare providers may ask you to take the first dose in their office to check your accuracy of the procedure. When injecting at home, read the label and follow the manufacturer’s patient guidelines.
The usual dose of Cosentyx is once per week for the first five weeks and then once every four weeks for psoriatic arthritis, ankylosing spondylitis, and axial spondyloarthritis. Inject your dose exactly as prescribed.
Do not inject more, less, or more often than prescribed. Use each syringe or dosing pen only once and inject all the solution in the syringe or pen. Dispose of syringes and pens in a puncture-resistant container after use.
If you’re using a prefilled syringe or a dosing pen that has been kept in the refrigerator, allow it to come to room temperature (up to 86 degrees Fahrenheit) before using. Keep the uncapped syringe or pen on a flat surface at room temperature 15 to 30 minutes before injecting the medication.
Do not warm the solution by heating it in a microwave, placing it in hot water, or by any other method. It’s better to use the injection at least one hour after taking it out of the refrigerator. And you may need two prefilled syringes to meet your dose. Be sure to follow your healthcare provider’s instructions.
The solution of the injection should be clear and free of any particles. Observe the solution closely before injecting. Use the complete solution in a syringe or pen.
It is important to remember not to:
Reuse a pen or a syringeShake a Cosentyx syringe or dosing penUse a broken or expired syringe or dosing pen in which the solution has changed color
You can inject Cosentyx anywhere on the front part of your thighs (upper leg), upper outer arms, or abdomen (stomach) except in the navel (belly button) and the area 2 inches around it. Inject at a different site for each injection to reduce the chances of soreness or redness. Avoid injecting the medicine into a tender, bruised, red, itchy, or scaly area of the skin.
Storage
Keep the injection in the container that it came in. Store the injection in the refrigerator (between 36 and 46 degrees), but do not freeze. Keep the vials, prefilled syringes, and dosing pens in the original cartons to protect them from light. Keep all medications out of sight and reach of children and pets. Always lock safety caps to avoid accidental poisoning.
Do not keep unwanted or expired medications. However, don’t throw out medicines by flushing them down the toilet or throwing them in the trash. The best way to discard unwanted medication is through a medicine take-back program. Talk to your pharmacist or contact your local waste disposal department about take-back programs.
Off-Label Uses
Cosentyx is not approved for–but is used as an off-label treatment for–the following conditions:
Familial Mediterranean fever (inherited autoinflammatory disease causing recurrent fevers and inflammation in the abdomen, joints, or chest) Rheumatoid arthritis (autoimmune disease causing inflammation mainly in the joints) Systemic lupus erythematosus (an autoimmune disease affecting many body parts) Tumor necrosis factor receptor-associated periodic syndrome (TRAPS, a multisystem inherited disorder causing periodic fevers and muscle pains, red and swollen eyes, and a rash)
What Are the Side Effects of Cosentyx?
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at www.fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
Cosentyx (secukinumab) may cause some side effects. These are not severe and usually do not require medical attention. These side effects include:
Diarrhea Minor upper respiratory infections, such as runny, stuffy nose, and sneezing Skin rash Sore throat Itching
These side effects may go away within a few days. If you have severe symptoms or symptoms that don’t go away, talk with your healthcare provider immediately.
Severe Side Effects
Cosentyx may sometimes cause severe side effects in some people. These are not common but require immediate medical attention. These include:
Severe respiratory infections Allergic reactions (such as trouble breathing, hives, or swelling of the lips or face) Colitis (swelling of the large intestine)
If you have these severe symptoms, immediately seek medical attention.
Dosage: How Much Cosentyx Should I Take?
Modifications
The safety of Cosentyx is not established in children younger than 6 years old. It’s also not approved for use in pediatric patients less than 2 years old or who weigh less than 33 pounds. However, clinical studies have shown that no changes in dosage are required in patients over 65 years of age.
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).
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 injection dosage form: For ankylosing spondylitis: Adults—150 milligrams (mg) every 4 weeks. Some patients may first receive “loading” doses of 150 mg at weeks 0, 1, 2, 3, and 4 and then begin the every-4-weeks regimen. Patients with continuing active ankylosing spondylitis may receive a dose of 300 mg every 4 weeks. Children—Use and dose must be determined by your doctor. For enthesitis-related arthritis: Adults and children 4 years of age and older weighing 50 kilograms (kg) or more—150 milligrams (mg) injected under your skin at weeks 0, 1, 2, 3, and 4. Followed by 150 mg every 4 weeks. Children 4 years of age and older weighing 15 kg to less than 50 kg—75 milligrams (mg) injected under your skin at weeks 0, 1, 2, 3, and 4. Followed by 75 mg every 4 weeks. Children younger than 4 years of age or weighing less than 15 kg—Use and dose must be determined by your doctor. For non-radiographic axial spondyloarthritis: Adults—150 milligrams (mg) every 4 weeks. Some patients may first receive “loading” doses of 150 mg at weeks 0, 1, 2, 3, and 4 and then begin the every-4-weeks regimen. Children—Use and dose must be determined by your doctor. For plaque psoriasis: Adults—At first, 300 milligrams (mg) injected under your skin at weeks 0, 1, 2, 3, and 4. Followed by 300 mg every 4 weeks. Some patients may receive a dose of 150 mg. Children 6 years of age and older weighing 50 kilograms (kg) or more—150 milligrams (mg) injected under your skin at weeks 0, 1, 2, 3, and 4. Followed by 150 mg every 4 weeks. Children 6 years of age and older weighing less than 50 kg—75 milligrams (mg) injected under your skin at weeks 0, 1, 2, 3, and 4. Followed by 75 mg every 4 weeks. Children younger than 6 years of age—Use and dose must be determined by your doctor. For psoriatic arthritis: Adults—150 milligrams (mg) injected under your skin every 4 weeks. Some patients may first receive “loading” doses of 150 mg at weeks 0, 1, 2, 3, and 4, and then begin the every-4-weeks regimen. Patients with continuing active psoriatic arthritis may receive a dose of 300 mg every 4 weeks. Patients who also have moderate to severe plaque psoriasis should receive the dose for plaque psoriasis. Children 2 years of age and older weighing 50 kilograms (kg) or more—150 milligrams (mg) injected under your skin at weeks 0, 1, 2, 3, and 4. Followed by 150 mg every 4 weeks. Children 2 years of age and older weighing 15 kg to less than 50 kg—75 milligrams (mg) injected under your skin at weeks 0, 1, 2, 3, and 4. Followed by 75 mg every 4 weeks. Children younger than 2 years of age or weighing less than 15 kg—Use and dose must be determined by your doctor.
Missed Dose
It is essential to take Cosentyx as scheduled. If you miss a dose, call your healthcare provider for a new dosing schedule. Never take an additional dose to make up for the missed one.
Overdose: What Happens If I Take Too Much Cosentyx?
In case of an overdose on Cosentyx (secukinumab), seek medical attention immediately.
Precautions
What Are the Reasons I Should Not Take Cosentyx?
You should avoid using Cosentyx:
If someone collapses or isn’t breathing after taking Cosentyx, call 911 immediately.
This medicine may cause you to get infections more easily (eg, mouth, skin, or upper respiratory tract infections). It is important to check with your doctor if you have fever or chills, cough or hoarseness, lower back or side pain, painful or difficult urination, runny or stuffy nose, skin itching or scaling, or sores or white patches on your lips, mouth, or throat.
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 test or been exposed to tuberculosis.
Inflammatory bowel disease may occur while you are using this medicine. Tell your doctor right away if you have rectal bleeding, severe stomach pain, or severe diarrhea while using this medicine.
This medicine may cause serious allergic reactions including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
While you are being treated with secukinumab, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor’s approval. Secukinumab may lower your body’s resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.
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.
If you are allergic to the secukinumab injection or any of its ingredients. If you are using the prefilled syringe or dosing pen, tell your healthcare provider if you or the person injecting you are allergic to rubber or latex. The caps on the Cosentyx Sensoready pen and prefilled syringe have natural rubber latex in them. There are no studies of allergic reactions to the Cosentyx pen or prefilled syringe. However, talk with your healthcare provider before using Cosentyx, to see if it’s safe for you to use. If you have a severe infection like tuberculosis, Cosentyx may affect the immune system and increase the risk of infection.
Pregnant and breastfeeding people should only use secukinumab after consulting their healthcare provider. It’s unknown whether Cosentyx is safe to take during pregnancy or while breastfeeding.
What Other Medications Interact With Cosentyx?
Drug interaction trials are lacking with Cosentyx. However, some drugs may interact with secukinumab and require monitoring:
Secukinumab may alter the formation of special liver enzymes (CYP450 enzymes) and may increase the levels of certain proteins that the body produces during chronic inflammation (cytokines like IL-1, IL-6, IL-10, TNFα, IFN). Secukinumab may interact with other drugs that impact your CYP450 enzymes. Always mention drugs such as Jantoven (warfarin) and cyclosporine (brands are Gengraf, Neoral, and Sandimmune) to your healthcare provider before starting treatment with Cosentyx. People treated with secukinumab should avoid live vaccines, such as those for chicken pox, measles, rotavirus, smallpox, typhoid fever, and yellow fever. Do not take Cosentyx at the same time as other biologic medications, such as Humira (adalimumab), Enbrel (etanercept), or Stelara (ustekinumab). Taking more than one biologic medication increases your risk for side effects, such as severe infections.
This may not be a complete list. Tell your healthcare provider about all other multivitamins, prescription and nonprescription medicines, supplements, and herbal medicines that you take.
What Medications Are Similar?
Several other drugs can treat the same conditions as Cosentyx. Speak with your healthcare provider first before changing your medicine.
Examples of other drugs that are used to treat plaque psoriasis, psoriatic arthritis, or ankylosing spondylitis include:
Enbrel (etanercept) Humira (adalimumab) Remicade (infliximab) Stelara (ustekinumab) Taltz (ixekizumab)
Cosentyx and Humira have different FDA-approved uses, but both treat plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. Various studies found that Cosentyx was more effective in treating plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis than Humira.
Like Humira, Stelara also has uses similar to Cosentyx, such as treating plaque psoriasis and psoriatic arthritis in adults. Stelara is also approved to treat Crohn’s disease, as well as moderate to severe plaque psoriasis in children age 12 years and older. In a clinical study, Cosentyx was more effective than Stelara in treating plaque psoriasis.
In a cost-effectiveness analysis (comparing medications for both cost and health outcomes), Remicade was more cost-effective in treating plaque psoriasis than Cosentyx.
The choice of medicine is a sensitive matter and something that you can discuss with your healthcare provider. Follow your prescription and the directions of your healthcare provider. Avoid switching brands.
How Can I Stay Healthy While Taking Cosentyx?
Psoriasis is a chronic inflammatory disorder that can have a significant impact on health-related quality of life and may cause disability. Secukinumab is an antibody (a protein that your immune system uses to protect itself) approved by the FDA in 2015 to manage plaque psoriasis.
It was later approved to treat psoriatic arthritis and ankylosing spondylitis in 2016 and non-radiographic axial spondyloarthritis in 2020. Cosentyx has a good safety profile. Its availability as a self-injecting device makes it easy to use without having to go to your provider’s office for every dose. Follow the manufacturer’s guidelines while injecting the medicine.
However, there are a few limitations with its use. Cosentyx affects the immune system and can make you more prone to infections. Try to complete any live vaccines (including booster shots) before starting Cosentyx. Call your healthcare provider if you have signs of infection like:
FeverMuscle achesSkin soresStomach painDiarrheaDifficulty in urinationWeight lossCoughShortness of breath
Keep regular laboratory test appointments to see if the drug is working for you.