Skyrizi dosage, forms, and strengths

Skyrizi is a brand-name prescription drug that treats plaque psoriasis, psoriatic arthritis, and Crohn’s disease. The active ingredient in Skyrizi, risankizumab-rzaa, is an antibody that blocks a molecule called interleukin-23 that provokes the inflammation that causes symptoms of psoriasis and Crohn’s disease. Skyrizi is self-injected or injected by a caregiver every eight or 12 weeks. The most common side effects of Skyrizi are injection site reactions, headache, back pain, abdominal pain, anemia, and a greater risk of infections.

Skyrizi forms and strengths

• Single-dose prefilled pen: 150 mg/mL

• Prefilled syringe: 90 mg/mL, 150 mg/mL

• Single-dose prefilled on-body injector: 180 mg/mL, 360 mg/mL

• Single-dose vial (for IV infusion): 600 mg/10 mL (60 mg/mL)

Skyrizi dosage for adults

Skyrizi is approved by the U.S. Food and Drug Administration to treat moderate to severe plaque psoriasis, active psoriatic arthritis, and moderate to severe Crohn’s disease flare-ups. Skyrizi can be prescribed to any adult with these medical conditions except those who have had hypersensitivity reactions to Skyrizi or who have active tuberculosis. Before prescribing Skyrizi, a healthcare provider will need to perform blood tests to measure liver function. Additionally, people prescribed Skyrizi should be up to date on their vaccinations following current immunization guidelines since live vaccines are a contraindication

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Skyrizi dosage for plaque psoriasis

Psoriasis is an autoimmune condition in which the immune system attacks skin tissues and sometimes joints and other tissues. Plaque psoriasis is characterized by the formation of scaly skin plaques. Healthcare professionals use a variety of treatments, including phototherapy, topical immune suppressants, or systemic therapy with disease-modifying antirheumatic drugs (DMARDs) and biologics that block the immune system. 

Skyrizi 150 mg doses are injected every 12 weeks after a four-week induction period. An initial dose of 150 mg is followed by a second dose of 150 mg four weeks later. After that, the 12-week dosing maintenance schedule begins. Under-the-skin injections are self-administered at home using a prefilled syringe or pen injector.

• Skyrizi dosage for moderate to severe plaque psoriasis in adults: 150 mg subcutaneous injection administered every 12 weeks 

Skyrizi dosage for psoriatic arthritis (PSA)

Psoriasis usually involves the skin tissues but can also attack joint tissues. About 20% of people with plaque psoriasis will eventually develop psoriatic arthritis, a potentially painful and debilitating condition. Treatment options range from nonsteroidal anti-inflammatory drugs (NSAIDs) for mild cases to immune-blocking antibodies (biologic drugs) for more severe cases. 

Skyrizi treatment for psoriatic arthritis follows the same dosage guidelines as for plaque psoriasis. After two starter doses of 150 mg in weeks 0 and 4, people will self-inject a 150 mg maintenance dose every 12 weeks.

• Skyrizi dosage for active psoriatic arthritis in adults: 150 mg subcutaneous injection administered every 12 weeks

Skyrizi dosage for Crohn’s disease

Crohn’s disease is an autoimmune condition in which the immune system attacks the digestive system, mainly the small and large intestines. Healthcare providers treat Crohn’s disease with immune-modulating treatments to prevent flare-ups and more aggressive immune-blocking treatments to manage flare-ups. 

Skyrizi dosages for Crohn’s disease are higher than those for psoriasis. The healthcare provider will start with a one-hour 600 mg dose via intravenous infusion. Four weeks later, there will be another 600 mg intravenous infusion, followed by another infusion four weeks after that. After the two initial doses, patients will self-administer Skyrizi using an on-body injector every eight weeks. Injections take about five minutes. Alternatively, people can take their injections using Skyrizi 90 mg prefilled syringes. They will administer two or four injections at the same time every eight weeks. 

• Skyrizi dosage for moderately to severely active Crohn’s disease in adults: 

600 mg intravenous infusion in weeks 0, 4, and 8 followed by 180 mg or 360 mg subcutaneous injection administered every 8 weeks

Skyrizi dosage for children

Skyrizi is not FDA-approved for use in children.

Skyrizi dosage restrictions

Skyrizi has no dosage restrictions for people with kidney disease or liver impairment. However, healthcare professionals are cautious about using Skyrizi for the treatment of Crohn’s disease in people with liver cirrhosis.

How to take Skyrizi

Skyrizi is self-injected using a prefilled syringe, pen injector, or on-body injector. Each involves a different process that requires a healthcare provider to train to administer Skyrizi correctly.

• A healthcare provider will prescribe the exact dose and how often it should be given.

• A healthcare provider will show you how to give an injection. Do not self-administer injections until you understand the process.

• Alternatively, a nurse or other healthcare professional can administer the injections in a clinic or healthcare provider’s office.

• Before using Skyrizi, read the medication guide that comes with this medicine. It contains important safety information.

• Read and review the Instructions for Use before each injection.

• Store Skyrizi prefilled syringes, pen injectors, or the on-body injector in their original cartons in the refrigerator. Wait to remove them from the refrigerator until ready to administer an injection. Allow Skyrizi to reach room temperature before administration. Do not freeze. 

• Do not shake the Skyrizi syringe, pen injector, or on-body injector.

• Do not use a Skyrizi prefilled injection pen, prefilled syringe, or prefilled cartridge if:

  • The medicine appears cloudy, discolored or has flakes or large particles.

  • The expiration date has passed.

  • The medicine has been frozen.

  • The syringe, injector pen, or cartridge has been dropped or damaged.

• A healthcare provider will demonstrate the appropriate body areas for injections. Use a different body area for each injection. 

• Do not inject into areas where the skin is tender, bruised, red, hard, thick, scaly, or in areas with scars, stretch marks, or is affected by psoriasis. 

• After an injection, dispose of the syringe, pen injector, or on-body injector in a sharps container.

• How to use a Skyrizi pen injector

  • Remove the pen injector from the refrigerator and let it sit at room temperature for 30 to 90 minutes to warm up. Do not warm the medicine any other way. 

  • Skyrizi should be stored out of direct sunlight.

  • Check the expiration date, appearance of the medicine, and for any damage to the pen.

  • Choose an injection area and wipe it with an alcohol swab.

  • Remove the dark gray cap.

  • Pinch the skin and place the white needle cap against the pinched skin at a 90˚ angle.

  • Push the pen injector against the pinched skin and press and hold the green activator button for 15 seconds. The pen will click at the start of the injection.

  • The injection is complete when the pen clicks a second time or the yellow indicator fills the medicine window.

  • Slowly pull the pen from the skin and dispose of it in a sharps container.

  • Apply a cotton swab to the injection site for a few seconds.

• How to use a Skyrizi prefilled syringe

  • People using Skyrizi 150 mg prefilled syringes for plaque psoriasis or psoriatic arthritis need only one syringe.

  • People using Skyrizi 90 mg prefilled syringes will need two syringes (180 mg) or four syringes (360 mg). Choose a different spot on the skin for each injection. 

  • Remove the carton from the refrigerator and let it sit at room temperature for 15 minutes to warm up. Do not warm the medicine any other way.

  • Skyrizi should be stored out of direct sunlight.

  • Check the syringe to make sure it’s not damaged or expired, and check the medicine to make sure it’s clear.

  • Choose an injection area and wipe it with an alcohol swab.

  • Remove the syringe from the cardboard sleeve.

  • Remove the needle cover.

  • Pinch the skin.

  • Push the needle at a 45˚ angle into the pinched skin.

  • Slowly push the plunger until all the medicine is injected. 

  • Remove the needle. The needle protector will automatically cover the needle if all the medicine has been injected.

  • Dispose of the syringe in a sharps container.

• How to use a Skyrizi on-body injector (OBI)

  • Always read the Instructions for Use that come with this medicine before using the on-body injector.

  • AbbVie, the manufacturer, has video instructions you can review before using the on-body injector.

  • Remove the carton from the refrigerator and let it sit at room temperature for 45–90 minutes to warm up. Do not warm the medicine any other way.

  • Open the carton. The carton contains the on-body injector (OBI), medicine cartridge, and Instructions for Use.

  • Remove the OBI from its plastic tray.

  • Check the OBI for damage.

  • Never touch the back of the OBI, the needle cover, or the gray start button. If you press the gray start button before you’re ready to give a dose, the OBI cannot be used.

  • Remove the Skyrizi cartridge from its carton and check the medicine's expiration date and appearance. Check to see if the cartridge is damaged.

  • Clean the tip of the cartridge with an alcohol swab.

  • Open the gray door on the OBI device. Load the cartridge into the OBI, firmly press it in until it clicks, and then close the gray door.

  • Choose an injection area and wipe it with an alcohol swab.

  • Without touching the needle cover, pull the green tab on the larger adhesive cover and peel it away to expose the adhesive.

  • Do the same for the smaller adhesive cover. Removing this strip will turn on the OBI. The OBI will beep, and the status light will flash blue to signal that the device has been activated.

  • Place the OBI on a flat piece of skin and run a finger along the outside of the adhesive to ensure it’s firmly attached.

  • Press the gray start button. The device will beep, and you should feel a pinprick on the skin.

  • The status light flashes green when the injection starts. 

  • If the status light flashes red, the OBI is not working. Call the phone number in the instructions.

  • The injection lasts as long as the green light flashes, and it could take up to five minutes to complete. Do not touch the device until the green light stops flashing.

  • The device will beep a third time, and the status light will change to solid green when the injection is finished.

  • Remove the OBI by slowly peeling the adhesive off your skin from one corner.

  • Check that the status light is off and the plunger completely fills the medicine window.

  • Dispose of the OBI in a sharps container.

Skyrizi dosage FAQs

How long does it take Skyrizi to work?

Skyrizi is a long-term treatment. In placebo-controlled clinical trials, Skyrizi injections significantly improved plaque psoriasis and psoriatic arthritis in 24 weeks. Symptoms continued to improve over three years. For Crohn’s disease, 45% of participants taking Skyrizi in placebo-controlled clinical studies showed clinical remission after 12 weeks. In that same period, 40% showed significant improvement (>50% over baseline) in endoscopic exams. After 52 weeks, 61% of participants on Skyrizi experienced clinical remission.

How long does Skyrizi stay in your system?

It takes the body about 21 to 28 days to clear half a dose of risankizumab-rzaa from the body. Given its extended half-life, it would take approximately four months for the body to completely clear a dose of Skyrizi.

What happens if I miss a dose of Skyrizi?

If a dose of Skyrizi is missed, take it as soon as possible. Return to the dosing schedule and take the next dose as scheduled.

How long can you take Skyrizi?

Skyrizi is intended for long-term use. Skyrizi clinical trials lasted up to three years without evidence of long-term side effects. 

How do I stop taking Skyrizi?

Skyrizi injections can be stopped at any time without causing withdrawal. However, don’t stop taking Skyrizi until getting medical advice from a healthcare provider. The healthcare provider may agree that the drug needs to be stopped if serious side effects are experienced, such as allergic reactions, liver poisoning (hepatotoxicity), active TB, or chronic or recurring infections such as upper respiratory infections or urinary tract infections. A suitable therapy may include another biologic drug, immunosuppressants, corticosteroids, or other treatments.

Sources

• Crohn's Disease, National Institute of Diabetes and Digestive and Kidney Diseases

• Psoriatic arthritis, StatPearls

• Psoriasis, National Institute of Arthritis and Musculoskeletal and Skin Diseases

• Skyrizi prescribing information, DailyMed (NIH National Library of Medicine)

• Skyrizi, AbbVie Inc.

• Skyrizi HCP, AbbVie Inc.