Secukinumab subcutaneous injection

Secukinumab is used in the treatment of a number of conditions, including plaque psoriasis, psoriatic arthritis, and active ankylosing spondylitis.

Overview

Secukinumab injection is used to treat patients who are suffering from a variety of conditions, including psoriatic arthritis, severe-to-moderate plaque psoriasis, and active ankylosing spondylitis. This drug is especially effective in treating people who might find ultraviolet light treatment (phototherapy) beneficial to their plaque psoriasis.

Secukinumab is one of a number of drugs categorized as monoclonal antibodies. The drug acts by blocking the protein, interleukin-17A, which is responsible for symptoms including swelling and inflammation.

Secukinumab injection is sold under the brand name Cosentyx in the US and is only available with a prescription from your GP or dermatologist. The medicine is dispensed as a solution or powder for solution.

Conditions Treated

  • Plaque psoriasis
  • Active ankylosing spondylitis
  • Psoriatic arthritis

Type of Medicine

  • Monoclonal antibody
  • Subcutaneous injection

Side Effects

Together with the benefits that it offers to patients, secukinumab sometimes causes unwanted side effects of varying severity and intensity. Not all the effects mentioned here will occur, but if they do, you may need to seek further medical treatment.

If any of the following effects do occur, you should alert your GP immediately:

  • Unexpected weight loss
  • Swelling or puffiness affecting the eyes, eyelids, tongue, face, or lips
  • Sore throat
  • Severe stomach pain
  • Reddening of the skin
  • Rapid heartbeat
  • Problems with swallowing
  • Loss of voice
  • Itching, a skin rash, welts, or hives
  • Headaches
  • Fever
  • Feeling strangely tired or weak
  • Feeling of congestion in the ears
  • Feeling dizzy
  • Diarrhea
  • Cough
  • Chills
  • Chest tightness
  • Breathing difficulties
  • Blocked or runny nose
  • Bleeding from the rectum
  • Aching muscles
  • Aching all over your body

There may be some side effects that you notice that are not mentioned here. If you do notice anything else untoward, always consult your treating physician.

Dosage

Under normal circumstances, a trained health professional or nurse will administer this medication. You will usually receive the injection via a needle placed just under your skin. The injection site may be in the abdomen, thigh, or upper arm.

Sometimes, it may be more convenient for you to receive your secukinumab injection in your own home, rather than in a clinic or hospital. In this case, your nurse or GP will show you how to prepare the medicine and how to carry out the injection. Before you attempt to self-medicate with the drug, make sure that you are clear on how to do so. Secukinumab for home use is usually supplied as a Sensoready® pen or prefilled syringe.

When you receive your prescription for this drug, you will also be given a medication guide and instructions. Make sure that you read the guide and the instructions thoroughly, and always refer any queries that you have to your pharmacist or treating physician.

Secukinumab injection is dispensed in three different forms:

  • Sensoready® pen
  • Prefilled syringe
  • Powder for solution

Your GP or specialist will advise you as to what form of the medication you will be using. At this time, your doctor or nurse will show you whereabouts on your body you should place the injection. In order to avoid skin irritation, you should vary the injection site. For this reason, it can be helpful for patients to keep an injection diary, where each site can be noted.

Even though you may not use the full dose of medication that is contained in each pen or prefilled syringe, you should only use each device once. Do not keep an open syringe or pen. Before administering your injection, you must check the device to ensure that the solution it contains has not changed color and that it does not contain floating particles. If either is present, you should not use the medication. Do not try to fix the problem by shaking the medicine.

Inside the removable top of the prefilled syringe or Sensoready® pen, you will see a dry, natural rubber lining. This material is derived from latex, which could cause a severe allergic reaction in some people. If you know that you have a sensitivity to latex, tell your GP before commencing treatment with this medication.

The dose of secukinumab that you are prescribed will not be the same for everyone. You must follow the directions given to you by your GP or apply the instructions given on the product label. The information that follows is based on the average for this drug. If the dose that you are told to take is different, you must not change it unless you are expressly told to do so by your GP or dermatologist.

The dose that you will be told to take will depend on several factors, including the potency of the drug, your age, body weight, and the condition for which you are receiving treatment. There may also be variations in the time you should leave between doses, the number of daily doses you are told to take, and the duration of your course of treatment.

For the treatment of ankylosing spondylitis:

  • Adults: one four-weekly dose of 150 mg. Your doctor may prescribe ‘loading’ doses of 150 mg to be taken at one, two, three, and four weeks before you begin the four-weekly dosing schedule.
  • Children: your child’s doctor will determine the dose and use.

For the treatment of plaque psoriasis:

  • Adults: one four-weekly dose of 300 mg. Your doctor may prescribe ‘loading’ doses of 150 mg to be taken at one, two, three, and four weeks before you begin the four-weekly dosing schedule.
  • Children: your child’s doctor will determine the dose and use.

For the treatment of psoriatic arthritis:

  • Adults: one four-weekly dose of 150 mg. Your doctor may prescribe ‘loading’ doses of 150 mg to be taken at one, two, three, and four weeks before you begin the four-weekly dosing schedule. If you have moderate-to-severe plaque psoriasis or continuing active psoriatic arthritis your doctor might opt to give you a dose of 300 mg.
  • Children: your child’s doctor will determine the dose and use.

You must take this medication on a fixed weekly schedule that will be given to you by your treating specialist or GP. If you miss out a dose or inadvertently use it on the wrong day, give your doctor or dermatologist a call and ask for further instructions. Do not give a further injection to try to catch up.

Interactions

Some drugs should never be used together at the same time. In other cases, it may be possible to use a combination of drugs, even though there may be an interaction between them. If this applies to your current drug regimen, your GP may decide to change the dose or frequency of dose of one or more of your medicines. You must tell your doctor about any medicines that you are taking, including any non-prescription products, herbal preparations, and vitamin food additives.

You should note that it is not generally recommended that the following drugs are used together with secukinumab, although this may be necessary in some instances:

  • Yellow Fever Vaccine
  • Warfarin
  • Varicella Virus Vaccine
  • Typhoid Vaccine
  • Theophylline
  • Terfenadine
  • Tacrolimus
  • Smallpox Vaccine
  • Sirolimus
  • Rubella Virus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Quinidine
  • Poliovirus Vaccine, Live
  • Pimozide
  • Phenytoin
  • Paclitaxel
  • Mumps Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Lumefantrine
  • Influenza Virus Vaccine, Live
  • Iloperidone
  • Fosphenytoin
  • Fentanyl
  • Ergotamine
  • Dihydroergotamine
  • Cyclosporine
  • Cisapride
  • Carbamazepine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Astemizole
  • Artemether
  • Aminophylline
  • Alfentanil
  • Adenovirus Vaccine Type 7, Live
  • Adenovirus Vaccine Type 4, Live

You should be aware that some drugs will interact with some foodstuffs, with tobacco products, or with alcohol. Be sure to discuss this aspect of your drug treatment program with your GP.

Warnings

Certain medical conditions may have an effect on the use of secukinumab. Be prepared to have a full and frank discussion about your medical history with your GP, before you begin your course of treatment with this medication.

Secukinumab must be used with caution in patients who have a history of inflammatory bowel disease, including ulcerative colitis and Crohn’s disease. This medication can make these conditions worse.

Secukinumab is not recommended for use in patients who have an active infection, such as TB (tuberculosis). If you have a longstanding infection or a history of recurrent infections, this medication should be used with caution.

If you are suffering from inactive tuberculosis infection, you must first be treated for this condition before beginning therapy with secukinumab.

If you have ever noticed an odd reaction to secukinumab or any other prescription or non-prescription medicines, you must tell your doctor. In addition, tell your GP if you are allergic to any food additives, preservatives, animal by-products, food colorings, or particular food groups.

As far as can be determined from medical studies, secukinumab does not present a risk to the fetus. However, you should weigh the pros and cons of using this drug if you are pregnant, and ask your treating physician for advice.

Similarly, there have been no studies to determine whether secukinumab can be passed into breast milk and thus to a nursing infant. If you are breastfeeding, you should discuss the potential risks and benefits of using this drug.

You must attend regular check-ups with your specialist while you are taking secukinumab. Your GP may want to take blood tests, in order to check that the medication is working correctly.

Always mention to your treating physician if you begin to show signs of an infection, such as chills or fever, hoarseness or a cough, painful or problematic urination, or pain in your lower back or side.

Before you begin a course of treatment with this drug, you will be asked to have a skin test for tuberculosis. If you or anyone in your household has ever reacted positively to a TB test or been exposed to TB, you must tell your doctor.

You can be vulnerable to contracting inflammatory bowel disease while you are being treated with secukinumab. Be sure to alert your GP immediately if you begin to suffer with rectal bleeding, severe diarrhea, stomach or abdominal pain.

Secukinumab can cause anaphylaxis in some patients. This is a potentially life-threatening condition, which always demands prompt emergency medical assistance. If, within a few minutes of using the medication, you notice a rash, itchy skin, swellings around your face, mouth or hands, breathing problems, or difficulty swallowing, call 911.

It is important that you do not have any vaccinations without prior approval from your GP while you are being treated with this medication. Secukinumab can lower some people’s resistance to infection, which could mean that the vaccine will not work properly or you may even contract the disease that the shots are supposed to prevent.

Try to avoid coming into contact with people who may have an infection or who have recently been vaccinated with live virus vaccine, as there is a very real possibility that the virus could be passed on to you. Allow at least two weeks following treatment with secukinumab before mixing with these people. For more information and advice on this, ask your treating physician.

Do not take any other form of medication unless you have discussed it first with your GP. This should include all prescription and over-the-counter medication, vitamin or herbal supplements.

Storage

You must keep your supply of secukinumab injections well out of reach of children and pets. If a pet does consume any of your medication, contact your emergency vet immediately.

Do not use your medicine if it has exceeded the use-by date that is shown on the packaging. Do not use any medication that appears cloudy or has a sediment settled at the bottom of the container. Do not shake the medication.

You should keep this medication in your refrigerator, but do not allow it to freeze. Keep the medication well away from direct sunlight or from other heat sources.

Leave the injections in their original packaging until you are ready to administer them. You must use the injection within one hour of removing it from the fridge.

Never use needles and syringes more than once. You will be given a sharps box in which to dispose of your used needles and syringes. Keep the box out of reach of children and return it to your pharmacist or GP clinic when the container is full.

Return any unused supplies of secukinumab injections to your pharmacy or doctor’s clinic for safe disposal.

Summary

Secukinumab injection is used in the treatment of people who have certain medical conditions, including severe-to-moderate plaque psoriasis, psoriatic arthritis, and active ankylosing spondylitis.

You may receive the injections in the hospital or at your doctor’s clinic, or you may be able to self-administer the medication at home, following instruction from your treating physician.

There are few side-effects recorded in patients using this medication, but there is a large list of prescription and over-the-counter medication that should not be used at the same time as secukinumab. It is very important that you discuss your medical history in detail with your doctor before you begin a course of treatment with this drug.

You will need to attend regular check-ups and have blood tests to ensure that all is well during your treatment. You will also be required to have a skin test for tuberculosis.

Resources
Last Reviewed:
January 29, 2018
Last Updated:
February 10, 2018