Cosentyx dosage, forms, and strengths

Cosentyx is a brand-name biologic drug that treats various autoimmune diseases, including psoriasis, psoriatic arthritis, and ankylosing spondylitis. The active ingredient in Cosentyx is secukinumab, a monoclonal antibody that blocks the immune system’s inflammatory response. Other than at the start of therapy, Cosentyx injections are spaced four weeks apart. People can self-administer their injections, or a healthcare professional can give an intravenous injection if needed. Dosages will vary depending on the condition being treated. 

Cosentyx forms and strengths

Cosentyx comes in only one dosage form (injectable), but there are several ways to administer it. It can be self-administered at home as a subcutaneous injection using a prefilled syringe or an injector pen purchased at a pharmacy. If needed, intravenous infusions are performed by healthcare professionals. 

• Prefilled syringe: 75 mg/0.5 mL, 150 mg/mL, 300 mg/2 mL

• Cosentyx SensoReady injection pen: 150 mg/mL

• Cosentyx UnoReady injection pen: 300 mg/2 mL

• Vial (intravenous infusion): 125 mg/5 mL

Cosentyx dosage for adults

The U.S. Food and Drug Administration (FDA) has approved Cosentyx for treating adult patients with various autoimmune disorders, including plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and hidradenitis suppurativa, an autoimmune condition of the skin. 

Injections typically start weekly and then transition to once-monthly injections. For some conditions, the healthcare provider may start with an intravenous dose as a loading dose and then transition to monthly doses.

Hypersensitivity to secukinumab or other ingredients in Cosentyx is the only contraindication. Latex-sensitive individuals should not handle the natural rubber latex cap on the prefilled syringe or SensoReady pen. 

People with inflammatory bowel disease (Crohn’s disease or ulcerative colitis) or some types of active infections may not be suitable candidates for Cosentyx treatment.

Cosentyx dosage for moderate to severe plaque psoriasis

Psoriasis is a system-wide autoimmune disorder that primarily affects the skin. In plaque psoriasis, the immune system attacks healthy skin tissues, which causes rash, thickened skin (plaques), dry skin, cracked skin, pain, and discomfort. 

The FDA approves Cosentyx to treat moderate to severe psoriasis in people who are candidates for systemic therapy or phototherapy. Cosentyx blocks interleukin-17A, a part of the body’s inflammatory response. When psoriasis flares up, the skin tissues are flooded with IL-17A. This molecule acts like a fire alarm, mobilizing the immune system to attack.

At the start of therapy, people will administer injections under their skin once a week for a total of five injections. Then, they will transition to a maintenance dose injected once per month.

• Initial Cosentyx dosage for moderate to severe plaque psoriasis: 300 mg subcutaneous injection weekly on weeks zero, one, two, three, and four

• Standard Cosentyx dosage for moderate to severe plaque psoriasis: 300 mg subcutaneous injection every four weeks

• Standard Cosentyx dose for moderate to severe plaque psoriasis: 300 mg subcutaneous injection 

Cosentyx dosage for active psoriatic arthritis (PsA)

When psoriasis involves joint swelling, pain, and damage, this involvement with the joints is called psoriatic arthritis. It usually exists alongside plaque psoriasis and often occurs later in the disease. Cosentyx can be self-administered as under-the-skin injections at home. Healthcare providers also have the option of using intravenous injections.

• Initial Cosentyx dosage for active psoriatic arthritis: 150 mg subcutaneous injection on weeks zero, one, two, three, and four OR 6 mg/kg intravenous loading dose on week zero

• Standard Cosentyx dosage for active psoriatic arthritis: 150 mg subcutaneous injection every four weeks OR 1.75 mg/kg intravenous infusion every four weeks

• Maximum Cosentyx dose for psoriatic arthritis: 300 mg per dose

Cosentyx dosage for spinal arthritis or ankylosing spondylitis

Healthcare providers can use Cosentyx to treat inflammatory arthritis of the spine, either ankylosing spondylitis or non-radiographic axial spondyloarthritis (nr-axSpA). These two conditions are nearly identical in their symptoms and treatment. However, non-radiographic axial spondyloarthritis does not yet damage joints in the spine. Ankylosing spondylitis is diagnosed when there is evidence of spinal joint damage in X-rays or CT scans. Injections can be self-administered as subcutaneous injections or given as an intravenous infusion by a healthcare professional.

• Initial Cosentyx dosage for active ankylosing spondylitis or nr-axSpA: 150 mg subcutaneous injection on weeks zero, one, two, three, and four OR 6 mg/kg intravenous loading dose on week zero

• Standard Cosentyx dosage for active ankylosing spondylitis or nr-axSpA: 150 mg subcutaneous injection every four weeks OR 1.75 mg/kg intravenous infusion every four weeks

• Maximum Cosentyx dose for active ankylosing spondylitis: 300 mg per dose

• Maximum Cosentyx dose for active nr-axSpA: 150 mg subcutaneous injection OR 300 mg intravenous injection

Cosentyx dosage for hidradenitis suppurativa (HS)

The FDA has recently approved Cosentyx to reduce skin bumps, abscesses, and other lesions caused by hidradenitis suppurativa (HS). HS is a lifelong autoimmune disease of the skin that affects about 1 in 100 people.

• Initial Cosentyx dosage for moderate to severe hidradenitis suppurativa: 300 mg subcutaneous injection weekly on weeks zero, one, two, three, and four

• Standard Cosentyx dosage for moderate to severe hidradenitis suppurativa: 300 mg subcutaneous injection every four weeks

• Maximum Cosentyx dose for moderate to severe hidradenitis suppurativa: 300 mg subcutaneous injection every two weeks

Cosentyx dosage for children

The FDA has approved Cosentyx for use in children:

• Age 6 and older for the treatment of moderate to severe plaque psoriasis

• Age 2 and older for the treatment of active psoriatic arthritis

• Age 4 and older for the treatment of enthesitis-related arthritis

Plaque psoriasis and psoriatic arthritis are discussed above. Enthesitis-related arthritis (ERA) is a rare form of juvenile idiopathic arthritis (JIA) that involves swelling of the joints and the connections between joints and soft tissues such as tendons. 

The subcutaneous injection dose of Cosentyx in children will vary based on body weight. Pediatric patients do not get intravenous injections. The recommended dose is the maximum allowable dose.

Cosentyx dosage restrictions

Cosentyx does not require dose modifications for people with kidney disease, liver impairment, or other medical conditions.

How to take Cosentyx

Cosentyx injections can be self-administered or performed by a caregiver. Children should not self-administer Cosentyx injections, so parents or another caregiver must perform them. Cosentyx can be injected at home using a prefilled syringe, a SensoReady pen injector, or a UnoReady pen injector. The two pen injectors look different and have different doses, but they work the same way. 

GENERAL TIPS:

• Take Cosentyx as directed by the prescriber. You will be told the exact dose and how often to take it.

• Please read the Medication Guide and Instructions for Use that come with this medicine.

• A healthcare provider will provide in-person instruction on proper injection techniques. 

• Please review the Instructions for Use before administering each injection. Follow these instructions to the letter.

• Cosentyx is injected under the skin. Do not inject the medicine into a vein.

PREPARING FOR THE INJECTION:

• The first step in administering an injection is to check the Cosentyx package to ensure the dose is correct and the medicine has not expired.

• Cosentyx can be self-injected into the skin on the lower stomach area or the front of the thighs.

• Caregivers can inject the medicine in the outer upper arms if desired.

• Pick a different area of the body for each injection.

• Do not inject skin that is red, hard, or bruised.

• Take the carton out of the refrigerator and let it sit unopened for 30 to 45 minutes. Do not heat it.

PREPARING FOR THE INJECTION:

• Wash your hands with soap and water.

• Clean the injection site with an antiseptic wipe. 

• Carefully remove the pre-filled syringe or the pen injector from the package without touching the plunger.

• Do not shake the syringe or the injector.

• Inspect the medicine to make sure it is clear to light yellow. Do not use the injector or syringe if the medicine is discolored, cloudy, or contains large particles. 

• Do not use the syringe or injector if it appears damaged.

HOW TO USE THE PREFILLED SYRINGE:

• Carefully remove the needle cap. Do not touch the plunger while removing the needle cover.

• Hold the syringe by the barrel. Keep your fingers away from the plunger until you are ready to inject the medicine into the skin.

• Pinch the skin on the injection site.

• Holding the syringe barrel with the index finger and thumb, quickly push the needle at a 45˚ angle into the pinched skin.

• Using your thumb, push the plunger down to inject the medicine.

• Continue pressing down on the plunger for five seconds after injecting all the medicine.

• Remove the needle from the skin with your thumb still pushing the plunger down.

• Remove your thumb slowly. The plunger will return to its original position, and the needle guard will automatically cover the needle.

• Dispose of the syringe in a sharps container.

HOW TO USE THE SENSORY OR UNOREADY PEN:

• The pens look different but work in the same way.

• Carefully remove the cap and throw it out. Do not try to put the cap back on.

• Hold the pen barrel in your fist. Make sure you can see the medicine window.

• Position the injector at a 90˚ angle above the injection site with the needle facing the skin.

• Press and hold the injector firmly onto the skin’s surface.

• The pen will click when the injection starts.

• A green indicator in the medicine window will show the progress of the injection.

• The pen will click a second time when the injection is almost finished.

• When the green indicator fills the window, the injection is finished.

• Remove the pen and dispose of it in a sharps container.

STORING COSENTYX:

• Store Cosentyx in the refrigerator in its original carton. Do not freeze.

• Keep the medicine protected from light.

• Do not put the package back in the refrigerator if it has been taken out of the refrigerator and warmed to room temperature.

• Cosentyx can be stored in its original package at room temperature for up to four days. 

• Do not shake the carton.

Cosentyx dosage FAQs

How long does it take Cosentyx to work?

It may take weeks or months to start noticing improvements in the objective signs of inflammation, such as swelling, pain, redness, or skin lesions. It will depend on the condition being treated. Clinical trials lasted between 12 and 24 weeks before participants showed dramatic symptom improvements. 

What happens if I miss a dose of Cosentyx?

Ask the healthcare provider how to manage a missed dose. In most cases, a missed dose can be taken when remembered. 

Call the prescribing healthcare provider for medical advice if the green indicator does not completely fill the window during a self-administered injection.

If an intravenous injection appointment is missed, schedule a new appointment as soon as possible.

What interacts with Cosentyx?

Cosentyx only has significant drug interactions with drugs called CYP450 substrates. These drugs are broken down by the same liver enzyme that breaks down Cosentyx. Combining them will increase the risk of experiencing serious side effects of Cosentyx. Make sure the prescriber knows about all the prescription drugs and over-the-counter medications being taken.

People taking Cosentyx should not receive live vaccines. There is a risk they will evolve into a serious infection.

Is it safe to take Cosentyx during pregnancy?

There are no studies concerning the safety of Cosentyx use in pregnant women. Animal studies show no evidence that it harms the fetus or affects pregnancy. Women should seek medical advice if they are pregnant or plan to become pregnant.

Is it safe to take Cosentyx when breastfeeding?

Prescribers use Cosentyx cautiously in women who are breastfeeding. Healthcare professionals are uncertain if it is present in breast milk, affects lactation, or causes adverse reactions in a nursing infant.

Sources

• Cosentyx, Novartis AG

• Cosentyx drug summary, Prescriber’s Digital Reference (PDR)

• Cosentyx secukinumab injections prescribing information, DailyMed (NIH National Library of Medicine)