These medications are not recommended for children
|INTERLEUKIN-12 AND INTERLEUKIN-23 ANTAGONIST1|
|ustekinumab||Stelara||12–17yrs: give SC at Weeks 0 and 4, then every 12wks thereafter. (<60kg): 0.75mg/kg; (60–100kg): 45mg; (>100kg): 90mg. ≥18yrs (≤100kg): initially 45mg SC once, then 4wks later, and then once every 12wks; (>100kg): initially 90mg once, then 4wks later, and then once every 12wks.|
|brodalumab||Siliq||210mg SC at Weeks 0, 1, and 2, then 210mg every 2wks.|
|ixekizumab||Taltz||160mg (given as two 80mg SC injections) at Week 0, then 80mg at Weeks 2, 4, 6, 8, 10, and 12, then 80mg every 4wks.|
|secukinumab||Cosentyx||300mg (given as two 150mg SC injections) at Weeks 0, 1, 2, 3, and 4 then 300mg every 4wks. For some patients, 150mg dose may be acceptable.|
|guselkumab||Tremfya||100mg SC at Weeks 0 and 4, then give every 8wks.|
|tildrakizumab||Ilumya||100mg SC at Weeks 0 and 4, then give every 12wks.|
|methoxsalen||8-MOP||Take Oxsoralen-Ultra 1½–2hrs or 8-MOP 2hrs before UVA exposure with low fat food or milk. (<30kg): 10mg; (30–50kg): 20mg; (51–65kg): 30mg; (66–80kg): 40mg; (81–90kg): 50mg; (91–115kg): 60mg; (>115kg): 70mg.|
|TUMOR NECROSIS FACTOR (TNF) BLOCKERS1|
|adalimumab||Humira||Initially 80mg SC, followed by 40mg every other week 1wk after initial dose.|
|certolizumab pegol||Cimzia||400mg (two 200mg inj at separate sites) SC every other week. ≤90kg: may consider 400mg on Day 1, then at Weeks 2 and 4, followed by 200mg every other week.|
|etanercept||Enbrel||Initially 50mg SC twice weekly for 3mos (also: initial doses of 25mg or 50mg per week were shown to be efficacious). Maintenance: 50mg once weekly.|
|infliximab||Remicade||5mg/kg IV infusion at Weeks 0, 2 and 6; then give every 8wks.|
|acitretin||Soriatane||25–50mg once daily with main meal; may discontinue when lesions resolve. May repeat if relapse occurs.|
|apremilast||Otezla||Starting on Day 1: 10mg in the AM. Day 2: 10mg in AM and 10mg in PM. Day 3: 10mg in AM and 20mg in PM. Day 4: 20mg in AM and 20mg in PM. Day 5: 20mg in AM and 30mg in PM. Following on Day 6 and thereafter: 30mg twice daily (AM & PM).|
|betamethasone dipropionate||Sernivo||Apply twice daily for up to max 4wks; discontinue when control is achieved.|
|calcipotriene + betamethasone dipropionate||Enstilar||Apply once daily for up to 4wks; discontinue when control is achieved; max 60g every 4 days.|
|clobetasol propionate||Impoyz||Apply twice daily; discontinue when control is achieved; max 50g/week and 2 consecutive weeks’ treatment per course.|
|cyclosporine||Gengraf3||1.25mg/kg twice daily; may increase after 4wks by 0.5mg/kg/day, then adjust at 2-week intervals; max 4mg/kg/day.|
|Neoral3||1.25mg/kg twice daily; may increase after 4wks by 0.5mg/kg/day, then adjust at 2-week intervals; max 4mg/kg/day.|
|halobetasol propionate||Bryhali||Apply once daily for up to 8wks; discontinue when control is achieved; max 50g/week.|
|Lexette||Apply twice daily for up to 2wks; max 50g/week. Discontinue when control is achieved.|
|methotrexate||Otrexup||10-25mg once weekly using an oral, IM, SC, or IV form; max 30mg/wk. Use alternative MTX form in patients requiring oral, IM, IV, intra-arterial, or intrathecal dosing, doses <7.5mg/week or >30mg/week, high-dose regimens, or dose adjustments <2.5mg increments.|
1 These medications should only be used under the guidance and supervision of a physician.
2 Intended to be administered only in conjunction with a schedule of controlled doses of long wave UV radiation. See full labeling for UVA exposure schedule.
3 Not bioequivalent to all other forms of cyclosporine; do not interchange without physician supervision.
Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.
This article originally appeared on MPR