7 Skyrizi Side Effects You Should Know About

At first glance, plaque psoriasis, psoriatic arthritis, and inflammatory bowel disease may seem like they don’t have much in common — but they do. All are autoimmune disorders that can be treated with a medication called Skyrizi (risankizumab-rzaa).

Skyrizi is an injectable medication that blocks a protein in your immune system, interleukin-23, from causing inflammation. This helps improve your symptoms, but it can also cause some side effects to be aware of.

Skyrizi side effects at a glance

Skyrizi's side effects range from mild, such as headaches, to rare but serious, such as liver damage. Skyrizi’s common and rare side effects are listed below.

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Common side effects:

• Upper respiratory infections

• Headaches

• Fatigue

• Injection site reactions

• Joint pain

• Stomach pain

• Urinary tract infections

• Fungal skin infections

Rare side effects:

• Allergic reactions

• Liver damage

• Skin rashes or itching

• Serious infections

• Antibodies to Skyrizi

Let’s take a closer look at seven Skyrizi side effects and how to manage them.

1. Higher risk of infections

Skyrizi lowers the activity of your immune system. This means it might not be able to fight off infections as well as it normally does. As a result, you have a greater chance of getting sick while taking Skyrizi. Upper respiratory infections, such as the common cold, are the most common infections reported by people taking Skyrizi.

Other infections are also possible while taking Skyrizi. In clinical studies, a higher risk of urinary tract infections (UTI) was seen with Skyrizi used for Crohn’s disease. And a higher risk of fungal skin infections, such as athlete’s foot, was seen with Skyrizi used for plaque psoriasis.

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Although it’s rare, Skyrizi can also reactivate previous infections, such as tuberculosis (TB). Because of this, your prescriber may check for latent (inactive) TB before you start treatment.

Call your healthcare team if you have symptoms of an infection, such as a fever, cough, or generalized fatigue. UTI symptoms may include pain when peeing and the urge to pee more often than usual. Fungal skin infections typically appear as red, peeling, or itchy skin.

Depending on your symptoms, your prescriber may have you hold off on your next Skyrizi dose until your infection clears. They may also recommend a medication to help treat your infection, if needed.

2. Headaches

Headaches are the second most common Skyrizi side effect. Here are steps you can take to help prevent and manage headaches at home:

• Stay hydrated

• Limit caffeine and alcohol

• Try meditation or breathing exercises

• Get a full night’s sleep

• Limit bright light and electronic devices

If needed, an over-the-counter (OTC) pain reliever such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may help. Just make sure your prescriber OKs it first. And keep in mind that nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aren’t recommended if you have Crohn’s disease.

If your headache doesn’t improve or worsens, let your healthcare team know. There may be a more serious cause that needs to be addressed.

3. Injection site reactions

Skyrizi is usually injected under your skin. So injection site reactions can occur in the area where you inject it. An injection site reaction can cause the following symptoms:

• Redness

• Swelling

• Itching

• Bruising

• Pain

These reactions should go away on their own. In the meantime, you can apply a warm or cold compress to the area. An OTC antihistamine may also help with itching.

You can help lower the chance of an injection site reaction by letting your Skyrizi dose come to room temperature before you inject it. Avoid injecting into bruised or broken skin. And keep in mind that injecting into the stomach is less painful than the thigh for some people.

If you’re having a lot of discomfort after injecting Skyrizi, talk to your prescriber or pharmacist. They can make sure you’re injecting it correctly. They can also suggest other options for treating your symptoms, if needed.

4. Joint pain

Sometimes, Skyrizi can cause new or worsening joint pain. This appears to be more common in those taking Skyrizi for Crohn’s disease. But it can happen to anyone taking Skyrizi at any time during their treatment.

You should report any new or worsening joint pain to your healthcare team. Keep in mind that body aches may also be a sign of infection. So keep an eye out for other infection symptoms, too, such as a fever. Your prescriber can help determine the cause of your pain and the best option for managing it.

5. Skin rashes

Skin rashes are another rare, but possible Skyrizi side effect. A rash can be just a mild inconvenience. But it can also be a sign of an allergic reaction, an underlying infection, or liver damage.

You should report any rash, even a mild one, to your healthcare team. They’ll help determine the cause and the best course of action. For mild rashes, they may suggest an OTC treatment, such as an antihistamine or a steroid cream for itching.

If you develop a rash and also experience trouble breathing or swelling of your mouth or throat, seek emergency medical care right away. This is a sign of a severe allergic reaction that needs medical attention as soon as possible.

6. Liver damage

It’s possible that Skyrizi may cause an increase in your liver enzymes (proteins) while you’re taking it. In most cases, this isn’t anything to be worried about. And it won’t affect your treatment with Skyrizi.

But in rare cases, Skyrizi may cause more serious liver damage. This seems to be more common when people are first starting Skyrizi for Crohn’s disease. If you have a history of liver problems, it may not be the best treatment option for you.

Your prescriber will likely check your liver function before starting you on Skyrizi and throughout treatment. This can help them identify liver damage early. But you should seek medical care right away if you notice any symptoms of liver damage, including:

• Unexplained skin rash

• Nausea or vomiting

• Yellowing of your skin and the white parts of your eyes (jaundice)

• Stomach pain

• Fatigue 

• Loss of appetite

• Dark urine

7. Drug resistance

Skyrizi is a biologic medication, meaning it’s made from a living organism. So when you inject it, your body may respond to Skyrizi as an intruder it needs to fight off. If this happens, your body may develop antibodies against Skyrizi over time.

This doesn’t happen often. But when it does, Skyrizi may stop working as well for your symptoms. So if you notice your symptoms returning, or it feels as though Syrizi isn’t working as well as it used to, let your healthcare team know. They can check to see if antibodies are making it less effective for you.

If this happens, you may need to switch to a different medication. Your prescriber will work with you to decide on the best option for your needs.

When should I contact my healthcare team about Skyrizi side effects?

Skyrizi is generally well tolerated, but side effects can still occur at any time during your treatment. You should report any new, worsening, or bothersome side effects to your healthcare team. Pay close attention to side effects that may indicate an infection or liver damage.

Allergic reactions to Skyrizi aren’t common, but they can happen. If you have a body rash, swollen mouth or throat, or trouble breathing after injecting Skyrizi, seek emergency care right away. You should also seek emergency care for any symptoms that feel severe or life-threatening.

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Written by:

Emilie White, PharmD

Emilie White is a clinical pharmacist with over a decade of hospital pharmacy experience. Her professional areas of interest include critical care as well as infectious and autoimmune diseases.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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