Does the Siliq (brodalumab) injection hurt?

Not commonly. In clinical studies, about 2% of participants experienced an injection site reaction. This reaction involved either itchy, redness, bruising, or bleeding to the skin. It didn't always involve pain and the reaction isn't unique to Siliq (brodalumab). In the same study, a similar number of people who used a placebo injection or a similar medication called [Stelara](https://www.goodrx.com/stelara/what-is) experienced some irritation at their injection site.

Siliq

Brodalumab

Used for Plaque Psoriasis

Siliq (brodalumab) is an under-the-skin injection that's approved for plaque psoriasis. After a couple of starter doses, you only need to inject it once every 2 weeks. Because there's a chance that Siliq (brodalumab) might raise your risk for mood problems, you must register with the Risk Evaluation and Mitigation Strategies (REMS) program for this medication. It's brand name only and can be very expensive.

Reviewed by:

Allison Gourley, PharmD

Michelle Nguyen, PharmD

Last reviewed on March 23, 2022

What is Siliq (brodalumab)?

What is Siliq (brodalumab) used for?

Moderate to severe plaque psoriasis (where people are candidates for systemic therapy or phototherapy, but haven't responded to other treatments)

How Siliq (brodalumab) works

Siliq (brodalumab) is a monoclonal antibody that binds to receptors (proteins) in your body to lower the number of cells that cause inflammation.

Drug facts

Common Brands	Siliq
Drug Class	Monoclonal antibody
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Siliq

Drug Class

Monoclonal antibody

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Siliq (brodalumab)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Joint pain (5%)
Headache (4%)
Feeling low energy (3%)
Diarrhea (2%)
Sore throat (2%)
Nausea (2%)
Muscle pain (2%)
Injection site reactions (2%)

Less Common Side Effects

Flu like symptoms
Low white blood cell count
Fungal infection of the skin

Siliq (brodalumab) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Serious infections: fever, difficulty breathing, cough that won't go away, night sweats, confusion, feeling very tired, diarrhea, chills
Suicidal thoughts and behaviors

Source: DailyMed

The following Siliq (brodalumab) side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
Thoughts of suicide or self-harm, worsening mood, feelings of depression

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

Diarrhea
Fatigue
Headache
Joint pain
Nausea
Pain, redness, or irritation at injection site
Sore throat

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Avg retail price

N/A

$12111.37

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Pros and cons of Siliq (brodalumab)

Pros

May be a good option if you haven't seen results with other psoriasis medications
After the three weekly starter doses, you only need to inject it once every 2 weeks
In clinical studies, most participants saw at least half of their plaque psoriasis go away in the first month of treatment.

Cons

Must inject more often that similar alternatives for plaque psoriasis
Only available as a brand name medication so it can be very expensive
Can cause some injection site reactions

Pharmacist tips for Siliq (brodalumab)

For your first dose of Siliq (brodalumab), it's best to get it done at your healthcare provider's office so they can coach and watch to make sure you inject yourself correctly. In case you need a refresher, check out these Instructions for Use.
Inject this medication into the fatty part of the skin either on top of your thigh, belly area, or back of your upper arm if someone else is helping you with your injection. If you're injecting into the belly area, stay 2 inches away from your belly button. Don't inject into areas that are tender, red, calloused (hard), bruised, scaly, or affected by psoriasis.
Before you give yourself Siliq (brodalumab), wash your hands with soap and warm water. Also, clean the area of skin where you're going to inject the medication with an alcohol wipe. Don't touch the area once you've cleaned it. Just allow it to air dry.
The liquid in the prefilled syringe should be either clear or have a slightly yellow color, and it shouldn't really have any particles (solid chunks) floating around in it. If you see cloudy or discolored liquid with large particles, don't give yourself the injection. Instead, call your provider or pharmacist to see if it's possible to get a replacement.
Make sure to inject yourself with the full amount of medication (about 1.5 mL). This amount will provide you with the dose of 210 mg that's needed each time.
It's possible that Siliq (brodalumab) might trigger thoughts of suicide or self-harm. If you experience suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking Siliq (brodalumab), call your provider right away.

Common questions about Siliq

If you've been using Siliq for more than 4 months and you don't see an improvement in your plaque psoriasis, this medication is unlikely working for you. Continuing this medication isn't recommended because doing so might put you at risk for side effects, such as Crohn's disease or infections. Talk with your provider about an alternative treatment.

Not commonly. In clinical studies, about 2% of participants experienced an injection site reaction. This reaction involved either itchy, redness, bruising, or bleeding to the skin. It didn't always involve pain and the reaction isn't unique to Siliq. In the same study, a similar number of people who used a placebo injection or a similar medication called Stelara experienced some irritation at their injection site.

Siliq is only approved for plaque psoriasis that's moderate or severe in people who are candidates for systemic therapy (injections or pills) or phototherapy (treatment using ultraviolet or UV light). It's also only recommended if you haven't responded or have lost a response to another treatment. If your provider says your plaque psoriasis is a mild form or you haven't tried another medication before Siliq, talk to them about alternative treatment options for your condition.

If you forget to store the syringe in the fridge when you're not using it, it can stay at room temperature for 2 weeks. Keep in mind though, that once the syringe is left out at room temperature, you can't put it back in the fridge. If it's been left outside the fridge for longer than two weeks, throw it away because it may affect how the medication works.

Talk to your provider before drinking alcohol with this medication. Especially since alcohol can worsen your plaque psoriasis symptoms.

Risks and warnings for Siliq (brodalumab)

Siliq (brodalumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Suicidal thoughts and behavior

Risk factors: History of suicidal thoughts or behaviors

Black Box Warning Although rare, a few people who took Siliq (brodalumab) have commited suicide. But there's no clear evidence that shows this medication caused the suicides. To be cautious, people who've a history of depression or suicidal thoughts should only take Siliq (brodalumab) if their provider think the benefit is greater than the risk. If you experience suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking Siliq (brodalumab), call your provider right away.

Black Box Warning Because of this risk, Siliq (brodalumab) is only available through a restricted program under Risk Evaluation and Mitigation Strategies (REMS) called the SILIQ REMS Program. Your provider, pharmacy, and you must all be registered with this program in order to prescribe, dispense, or take this medication. This program will help your provider monitor you for mood changes, new or worsening anxiety or depression, or abnormal thoughts.

Serious infections

Risk factors: Active, long-term, or frequent infection | Conditions that can raise your risk for infection

Siliq (brodalumab) can raise your risk of serious or life-threatening infections. Serious infections are more likely to happen if you have other long-term conditions. If you develop any symptoms of an infection, such as fever, difficulty breathing, a cough that won't go away, night sweats, or confusion, contact your provider right away. Don't take Siliq (brodalumab) if you have an active infection.

Make sure your provider knows your medical history before starting Siliq (brodalumab), especially if you've ever had tuberculosis (TB). This medication can cause new or old TB infections to come back. For this reason, you'll need to get tested for TB before starting Siliq (brodalumab) and during treatment. If you test positive (meaning that you’re infected), you’ll likely have to get treated for TB before starting or continuing Siliq (brodalumab).

To help avoid getting sick, your provider will make sure that you're all up-to-date with your vaccines before you start Siliq (brodalumab). Once you start treatment with this medication, you won't be able to get live vaccines, like the measles, mumps, and rubella vaccine (MMR), FluMist (nasal flu vaccine), or Varivax (varicella vaccine). This is because there's a chance that you might get sick from the live vaccines since Siliq (brodalumab) cause your immune system to not work as well.

Crohn's disease

Risk factors: Crohn's disease

People with Crohn's disease shouldn't take Siliq (brodalumab) because it could make symptoms worse. This medication can even cause Crohn's disease to develop if you've never had it before. If you experience unexplained diarrhea, fever, stomach pain, weight loss, and a loss of energy, call your provider because you may need to stop taking this medication.

Siliq (brodalumab) dosage

The average cost for 3 cartons of 2 syringes of 210mg/1.5ml of Siliq (brodalumab) is $12,111.37 with a free GoodRx coupon.

Carton

Dosage	Quantity	Price as low as	Price per unit
2 syringes of 210mg/1.5ml	3 cartons	$12,111.37	$4,037.12

Typical dosage for Siliq (brodalumab)

The typical dose of Siliq (brodalumab) starts out with three starter doses at weeks 0, 1, and 2, and then you'll take it every 2 weeks. Siliq (brodalumab) comes in a single-dose prefilled syringe that contains 210 mg (1.5 mL) of medication.

Week 0 (beginning of treatment): Inject 210 mg under the skin once
Week 1: Inject 210 mg under the skin once
Week 2: Inject 210 mg under the skin once
Week 4 and on: Inject 210 mg under the skin once every 2 weeks

How much does Siliq (brodalumab) cost?

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Siliq (brand)

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$12,111.37

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Siliq (brodalumab) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Siliq (brodalumab) will not be safe for you to take.

Crohn's disease

What are alternatives to Siliq (brodalumab)?

There are a number of medications that your doctor can prescribe in place of Siliq (brodalumab). Compare a few possible alternatives below.

Siliq (brodalumab)

Used for:

Moderate to severe plaque psoriasis (where people are candidates for systemic therapy or phototherapy, but haven't responded to other treatments)

$12,111.37Lowest GoodRx priceView prices

Stelara (ustekinumab)

Used for:

Moderate-to-severe plaque psoriasis (Ps) - adults and children 6 years and older
Psoriatic arthritis (PsA) - adults and children 6 years and older
Moderate-to-severe Crohn's disease (CD) - adults only
Moderate-to-severe ulcerative colitis (UC) - adults only