Psoriasis Systemic Medication Types & Prescriptions

Immunomodulating Agent: ustekinumab (Stelara™)

Blocks the action of 2 proteins called interleukin 12 and interleukin 23 that may be responsible for causing the immune system to attack parts of the patient’s body like the skin and nails.

The most common side effects (1% to 10%) are upper respiratory tract infection, sinus infection, sore throat, headache, fatigue, diarrhea, back pain, dizziness, a reaction at the injection site, itching, body aches and depression. The medication may lower the body’s ability to fight infections or increase the risk of cancer. Signs of an allergic reaction include a skin rash, swollen face or trouble breathing. Serious but rare side effects include bacterial, fungal and viral infections. This medication should not be used in patients with a chronic infection or a history of recurrent infections. Before beginning treatment, your doctor will examine or test you for tuberculosis.

Subcutaneous (under the skin) injections administered at weeks 0 and 4, and every 12 weeks thereafter.

T-cell Blockers: alefacept (Amevive®)

Blocks T-cell activation and reduces the number of activated T-cells. T-cells are a type of white blood cell that may be overactive in patients with psoriasis.

Most common (more than 5%) are headache, sore throat, accidental injury, runny nose, infection, flu-like symptoms, itch, chills, feeling tired, pain, diarrhea, nausea, viral infection, dizziness and sinusitis. You may experience a reaction at the injection site. These reactions are generally mild and usually occurred on single occasions and included pain, inflammation, bleeding, swelling, non-specific reaction, lump or skin hypersensitivity. Because of the way Amevive works, there may be a drop in the levels of certain types of blood cells that help to fight infections. It may increase the risk of some forms of cancer. You should inform your doctor as soon as possible if you develop an infection.

Injected once a week into a muscle (intramuscular), usually for 12 weeks.

TNF Alpha Blockers: adalimumab (Humira®), etanercept (Enbrel®), infliximab (Remicade®)

Blocks tumor necrosis factor or TNF-alpha. TNF-alpha is made by the body’s immune system and interferes with the body’s inflammatory response.

Most common (10% or more) is a reaction at the injection site. Less frequent (1% to 10%) are upper respiratory tract infections, headache, nausea, fatigue and joint pain. An allergic reaction can produce severe rash, swollen face or difficulty breathing and should be reported immediately to your doctor. Serious but rare side effects include infections such as tuberculosis (TB), sepsis due to bacterial or fungal infections, or hepatitis B infection relapse. There have been rare cases of nervous system disorders, such as numbness or tingling, vision problems, weakness in the legs and dizziness. Some patients have developed lupus-like symptoms that get better after treatment is stopped (symptoms include chest pains that do not go away, shortness of breath, joint pain or rash). This medication should not be used in patients with a chronic infection or a history of recurrent infections. It may increase the risk of some forms of cancer. Patients with congestive heart failure should be closely monitored by their doctor.

Adalimumab: self-injected under the skin (sub-cutaneously) every 2nd week.

Etanercept: self-injected sub-cutaneously 1-2 times per week.

Infliximab: 2-3 hour infusion in doctor’s office, 3 in first 6 weeks, then every 8 weeks.

acitretin

(Soriatane ®)

A synthetic form of vitamin A. Helps control how fast cells multiply, including how fast skin cells will grow and shed from the skin’s surface.

Most common (10% or more) are skin peeling/ scaling, hair loss, itching, sticky skin, nail disorder, dry skin, flushing or rash, skin thinning, increased sensitivity (hyperesthesia), dry lips, stuffy nose, dry mouth, dry eyes, joint pain, and stiffness (rigor). Less common (1% to 10%) include inflammation of the nail bed, abnormal touch sensations, rash, sensitivity to light, skin ulceration and infection, cold/clammy skin, increased sweating, abnormal hair texture, skin fissures, decreased sensitivity, infection, excessive skin and scalp excretion, thirst, stomach ulcers, bad breath, increased salvia, bleeding of the gums, nosebleed, cracks at the corner of the mouth, conjunctivitis or eye irritation, abnormal or blurred vision, inflammation of the eye lids, eye pain, sensitivity to light, muscle ache, bone pain, excessive group of the spinal bones, back pain, muscle tension arthritis, headache, pain, nausea, abdominal pain, ringing in the ear, taste changes, earache, excessive ear wax, insomnia, nervousness, fatigue, lack of appetite or increased appetite, impotence and swelling (edema). It is usually reserved for severe psoriasis which does not respond to other therapies or when patients cannot tolerate other therapies. Can cause severe birth defects. Women must use effective contraception while taking it. Must not be taken by women who are pregnant or planning to become pregnant within the next two years after discontinuation of therapy. It may cause liver damage and may worsen pre-existing, or lead to the development of, bone abnormalities.

Taken orally once a day.