Names and pronunciation
(ris′an-kiz′ue-mab) R Skyrizi
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Drug reference
(ris′an-kiz′ue-mab) R Skyrizi
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Func. class.: Systemic antipsoriasis agents
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ACTION: A humanized immunoglobulin G1 (IgG1) monoclonal antibody that selectively binds to the p19 subunit of human interleukin-23 (IL-23), thereby inhibiting its interaction with the IL-23 receptor; human IL-23 is a naturally occurring cytokine involved in inflammatory and immune responses; by blocking IL-23 from binding to its receptor, prevents the release of proinflammatory cytokines and chemokines
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USES: Moderate to severe plaque psoriasis, Crohn’s disease, psoriatic arthritis
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CONTRAINDICATIONS Hypersensitivity Precautions: Pregnancy, breastfeeding, TB, infection, immunosuppression
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SIDE EFFECTS CNS: Headache, fatigue, asthenia EENT: Sinusitis, nasal congestion, pharyngitis INTEG: Inj site reaction MISC: Flulike symptoms, antibody devel- opment to this drug; risk of infection (TB, invasive fungal infections, other opportunistic infections)
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INTERACTIONS Avoid use with live virus vaccines
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DOSAGE AND ROUTES Plaque psoriasis • Adult: SUBCUT 150 mg (two 75-mg injections) at wk 0, 4, and q12wk thereafter Crohn's disease • Adult: IV 600 mg over 1 hr at wk 0, 4, 8; maintenance: SUBCUT 360 mg at wk 12 and q8wk thereafter Psoriatic arthritis • Adult: SUBCUT 150 mg at wk 0, 4, then 150 mg q12wk
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Available forms: Prefilled syringe solution for injection 75 mg/0.83 mL 2-pack, 150 mg/mL, 360 mg/2.4 mL, 600 mg/10 mL
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Administer: Subcut route • Keep in the original carton to protect from light until time of use • Do not shake the carton or prefilled syringe • Before use, allow to reach room tem- perature out of direct sunlight (15-30 min); do not use other methods to speed warming process • Visually inspect parenteral products for particulate matter and discoloration; solu- tion should be clear to slightly opalescent, colorless to slightly yellow; solution may contain a few translucent white particles • Do not use if solution contains large particles or is cloudy or discolored; solu- tion has been frozen; syringe has been dropped or damaged; syringe tray seal is broken or missing • Only an individual trained in subcut drug delivery should administer the injection • Wash and dry hands • Select an injection site (right or left thigh, abdomen at least 2 inches from the navel) and wipe with an alcohol swab; do not in- ject into skin that is tender, bruised, red, hard, or affected by psoriasis; do not inject into a scar or stretch mark; administer in- jections at different sites at least 1 inch apart • Remove needle cover from the 1st prefilled syringe • With 1 hand, gently pinch cleaned in- jection site; use the other hand to insert needle at a 45-degree angle using a quick short movement • Slowly push plunger until all the solu- tion is injected • Pull needle out of skin; release plunger and allow prefilled syringe to move up until the entire needle is covered by needle guard • Apply cotton ball or gauze pad over injec- tion site for 10 sec; do not rub injection site • To obtain the full dose, repeat the in- jection process using 2nd prefilled sy- ringe; select and cleanse an alternative injection site that is at least 1 inch away from first site; do not inject into the same site as the 1st syringe • If a dose is missed, administer as soon as possible; then resume dosing at the regularly scheduled time
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Assess: • Plaque psoriasis: red, raised, inflamed patches of skin; whitish-silver scales or plaques on the red patches; dry skin that may crack and bleed; soreness around patches; itching and burning sen- sations around patches; thick, pitted nails; painful, swollen joints • For inj site pain, swelling, redness— usually occur after 2 inj (4-5 days); use cold compress to relieve pain/swelling • Infections (fever, flulike symptoms, dys- pnea, change in urination, redness/swelling around any wounds): stop treatment if present; some serious infections including sepsis may occur; patients with active infec- tions should not be started on this product • Latent TB before therapy; treat before starting this product; TB test before use • Monitor hepatitis B serology, LFTs, plasma hepatitis CRNA, plasma HIV RNA baseline, periodically • Pregnancy/breastfeeding: use only if clearly needed; no well-controlled stud- ies; cautious use in breastfeeding, no data Evaluate • Therapeutic response: decreasing plaques; painful, swollen joints
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • About self-administration if appropri- ate: inj should be made in thigh, abdo- men, upper arm; rotate sites at least 1 inch from old site; do not inject in areas that are bruised, red, hard • To refrigerate in container that prod- uct was received in; to dispose of needles and equipment as instructed • That if medication is not taken when due, inject dose as soon as remembered and inject next dose as scheduled • Not to take any live virus vaccines dur- ing treatment • To report signs of infection, allergic re- action, or TB, immediately
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PHARMACOKINETICS Bioavailability 89%, peak 3-14 days
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• Adult: SUBCUT 150 mg (two 75-mg injections) at wk 0, 4, and q12wk thereafter Crohn's disease
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• Adult: IV 600 mg over 1 hr at wk 0, 4, 8; maintenance: SUBCUT 360 mg at wk 12 and q8wk thereafter Psoriatic arthritis
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• Adult: SUBCUT 150 mg at wk 0, 4, then 150 mg q12wk
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