Key takeaways:
Skyrizi (risankizumab-rzaa) is an injectable biologic medication that treats certain autoimmune disorders. It’s generally well tolerated and has few interactions.
Skyrizi lowers the activity of your immune system, putting you at a higher risk for infection. So in most cases, it’s best to avoid giving Skyrizi with other medications that also have this effect. This includes corticosteroids, many other biologics, and certain supplements.
You shouldn't receive live vaccines while you’re receiving Skyrizi. Make sure your vaccinations are up to date before you start it. And check with your healthcare team before receiving a vaccine to make sure it’s safe.
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Skyrizi (risankizumab-rzaa) is an injectable medication that’s FDA approved to treat several autoimmune disorders in adults. This includes plaque psoriasis and psoriatic arthritis as well as Crohn’s disease and ulcerative colitis. These conditions put your immune system into overdrive, resulting in chronic inflammation.
Skyrizi blocks a cytokine (protein) in your immune system that helps cause inflammation. This helps reduce inflammation and improve your symptoms. The medication is usually well tolerated and is safe to take with most other medications. But there are some interactions you should be aware of before starting Skyrizi.
Skyrizi interactions at a glance
Below is a list of medications and supplements that can interact with Skyrizi:
Immunosuppressants (medications that weaken the immune system)
Supplements that affect your immune system
Other biologic medications
While Skyrizi doesn’t have many interactions, the best way to prevent any issues is to review your medication list with your healthcare team before you start receiving it. Be sure to include any over-the-counter (OTC) medications, vitamins, and supplements. And let your prescriber know if you begin taking another medication after you start Skyrizi.
The most common signs of a Skyrizi interaction are infections or an increase in your condition’s symptoms. So it’s best to let your prescriber know if you notice any changes in how you’re feeling. They’ll be able to determine if an interaction is the cause.
Let’s take a closer look at four Skyrizi interactions.
1. Live vaccines
Vaccines traditionally work by mimicking an infection without actually causing one. This causes your body’s natural defense mechanisms to kick in, including making antibodies. Antibodies help your body to identify and get rid of viruses and bacteria before they cause an infection. There are different types of vaccines, but the ones that interact with Skyrizi are live vaccines.
Live vaccines contain a weakened form of a live virus or bacteria. Injecting small amounts of a weakened live virus or bacteria into someone with a healthy immune system doesn’t usually cause an infection. But Skyrizi lowers the activity of your immune system. So if you receive a live vaccine while you’re receiving it, there’s a chance you could develop the infection the vaccine is trying to protect you against.
Examples of live vaccines include:
Influenza nasal spray (FluMist)
Measles, mumps, and rubella (MMR) vaccine (MMR II, Priorix)
Varicella (chickenpox) vaccine (Varivax)
Yellow fever vaccine (YF-VAX)
You should avoid receiving live vaccines while you’re receiving Skyrizi. So it’s best to make sure you’re up to date on your vaccines before starting it. If you need a vaccine and you’re unsure if it’s live, ask your healthcare team before receiving it.
Good to know: Infants exposed to Skyrizi while in the womb may also need to delay getting live vaccines. The manufacturer suggests waiting at least 5 months after birth before giving any live vaccines to your baby. This is based on how long Skyrizi lasts in the body. But in some cases, the benefit of the vaccine may outweigh the risk. Your infant’s pediatrician can help you decide on the right vaccine schedule for their needs. Just be sure they’re aware that you received Skyrizi while pregnant.
2. Medications that weaken your immune system
As mentioned, Skyrizi weakens your immune system. This helps manage symptoms of autoimmune disorders, but it also puts you at a greater risk of developing infections.
When you combine Skyrizi with other medications that weaken your immune system, your infection risk goes up. Commonly prescribed immunosuppressants include:
Corticosteroids such as prednisone
Methotrexate
Azathioprine (Imuran)
Sulfasalazine
How do you inject Skyrizi? Learn the steps involved in injecting Skyrizi, plus more pharmacist-backed tips to get the most from your medication.
Skyrizi dosages: Here’s a review of the approved Skyrizi dosages and how often you’ll need an injection.
How does Skyrizi make you feel? These first-hand accounts from people using Skyrizi for inflammatory bowel disease can help you know what to expect.
Keep in mind that in some cases, you’ll need to take one of these medications with Skyrizi to better manage your symptoms. Your prescriber will help decide if the benefits outweigh the risk of infection.
Be sure to let your prescriber know if you have any signs and symptoms of an infection while you’re receiving Skyrizi, including:
Fever
Cough
Chills
Trouble breathing
Muscle aches
Warm, painful, or red skin
Your prescriber will advise you on what to do if you develop symptoms like these. This may include holding off on your next Skyrizi dose until you’re feeling better.
3. Supplements that can affect your immune system
Like prescription immunosuppressants, some supplements can also weaken your immune system. If you take them with Skyrizi, you are at a greater risk of developing infections. One example is glucosamine, a popular OTC supplement for joint pain.
On the other hand, some supplements enhance the activity of your immune system. While this may seem beneficial, supplements that ramp up your immune system could interfere with the effects of Skyrizi and worsen the symptoms of your autoimmune disorder.
It’s a good idea to check in with your healthcare team before taking any OTC herbs or supplements with Skyrizi. They can make sure it’s a safe option that won’t cause a Skyrizi interaction.
Good to know: The FDA doesn’t regulate supplements for safety and effectiveness the same way as prescription medications. Studies have shown that supplement labels aren’t always accurate. And there could be contaminants or other ingredients in the product that aren’t listed. So shop carefully, and look for supplements with a third-party certification, such as a United States Pharmacopeia (USP) seal.
4. Other biologic medications
Biologics are complex medications made from living organisms. Skyrizi is a biologic medication. Other biologics often prescribed for autoimmune disorders include:
Humira (adalimumab)
Cimzia (certolizumab pegol)
Enbrel (etanercept)
Stelara (ustekinumab)
Remicade (infliximab)
Pairing Skyrizi with other biologics raises the risk of side effects, including serious infections. If Skyrizi isn’t working for you, your prescriber may switch you to a different biologic medication. But it’s not common to take more than one biologic at the same time.
Frequently asked questions
Cancer isn’t a reported side effect of Skyrizi. There is some concern about an increased risk of melanoma, a type of skin cancer, with biologic treatments for psoriasis and psoriatic arthritis. But this doesn’t seem to be an issue with Skyrizi. That being said, Skyrizi is a newer biologic treatment. So researchers need more long-term studies to better understand the possibility of side effects, such as cancer, that can take time to develop.
Skyrizi is given by intravenous infusion (into a vein) for the first 3 doses when it’s used for inflammatory bowel disease. For Crohn’s disease, the recommended dosage is 600 mg infused over at least 1 hour. For ulcerative colitis, the recommended dosage is 1,200 mg infused over at least 2 hours. All other Skyrizi dosages can be injected under the skin and don’t require a prolonged infusion.
Yes, you can take antibiotics with Skyrizi. Antibiotics won’t interfere with how the medication works in your body. But Skyrizi weakens your immune system, which could make it harder for your body to clear an infection. So let your prescriber know if you’re taking antibiotics — they may want to hold off on your Skyrizi dose until your infection is resolved.
Cancer isn’t a reported side effect of Skyrizi. There is some concern about an increased risk of melanoma, a type of skin cancer, with biologic treatments for psoriasis and psoriatic arthritis. But this doesn’t seem to be an issue with Skyrizi. That being said, Skyrizi is a newer biologic treatment. So researchers need more long-term studies to better understand the possibility of side effects, such as cancer, that can take time to develop.
Skyrizi is given by intravenous infusion (into a vein) for the first 3 doses when it’s used for inflammatory bowel disease. For Crohn’s disease, the recommended dosage is 600 mg infused over at least 1 hour. For ulcerative colitis, the recommended dosage is 1,200 mg infused over at least 2 hours. All other Skyrizi dosages can be injected under the skin and don’t require a prolonged infusion.
Yes, you can take antibiotics with Skyrizi. Antibiotics won’t interfere with how the medication works in your body. But Skyrizi weakens your immune system, which could make it harder for your body to clear an infection. So let your prescriber know if you’re taking antibiotics — they may want to hold off on your Skyrizi dose until your infection is resolved.
The bottom line
Skyrizi (risankizumab-rzaa) is an injectable biologic medication that treats several autoimmune disorders. It works by lowering the activity of your immune system, which can increase your risk of infection.
It’s best to avoid combining Skyrizi with other medications that lower immune system activity, such as other biologics, corticosteroids, and certain supplements. You should also avoid receiving live vaccines and taking supplements that boost immune activity while receiving Skyrizi. Reach out to your healthcare team if you have questions about Skyrizi interactions.
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References
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