How Do You Inject Stelara? Plus 4 More FAQs

Stelara (ustekinumab) is an injectable medication that treats psoriasis and psoriatic arthritis in adults and children ages 6 and older. It also treats inflammatory bowel disease in adults.

After your first dose or two, you can inject Stelara yourself at home. But how do you inject Stelara? And what’s the best way to store it? We’ve got you covered with answers to these and more common questions about Stelara.

1. How do you inject Stelara?

Your first dose or two of Stelara is given into a vein or under the skin by a healthcare provider. But after that, you can inject Stelara under your skin at home. It comes in two forms: a prefilled syringe or a vial of liquid. Both contain a single dose of Stelara and should only be used one time. In some cases, you may need to inject more than one syringe or vial to get your full Stelara dose. In that case, you’ll follow the injection steps a second time using a different injection site and a new needle.

Getting started

Gather your Stelara dose, alcohol swabs, and a sharps container. A cotton ball or bandage is also good to have. If you’re using a vial of Stelara, make sure you also have a syringe and needle.

Check the medication to make sure the expiration date hasn’t passed. Examine the syringe or vial for damage. The liquid inside should be clear to light yellow and shouldn’t have any large particles floating in it (a few small particles are OK). If the expiration date has passed or the medication is cloudy, don’t use it. Choose a new dose from the refrigerator or contact your pharmacist or the manufacturer for a replacement.

Wash your hands with soap and water. Then clean the injection site with an alcohol swab using a circular motion. You can inject Stelara into your stomach, buttocks, or upper thighs. If someone else is injecting Stelara for you, they can also inject it into your upper arm. Let the area you’ve chosen dry naturally — don’t blow on it or wave at it to speed up the drying process.

Prepare your dose

The injection process differs slightly depending on whether you use a prefilled syringe or vial.

Prefilled syringe 

Hold the middle of the syringe in one hand, and gently pull the needle cover off with the other. Don’t worry if a drop of liquid is at the end of the needle — that’s normal. Once the needle cover is off, avoid touching the needle.

Vial

Set the vial on a flat surface. Remove the plastic cap, then wipe the rubber stopper with an alcohol swab and allow it to dry naturally. Holding the syringe in one hand, pull back on the plunger to fill the syringe with air. You’ll want the amount of air to be the same as the amount of liquid you’ll measure for your dose. Then remove the needle cap and insert the needle into the vial. Press down on the plunger to inject the air into the vial.

Leave the needle inside the vial, holding the vial with one hand and the syringe with the other. Then turn the vial upside down so the syringe is pointing upward. Gently pull back on the plunger to draw the liquid out of the vial. Keep the needle tip under the top of the liquid to prevent air bubbles. But if bubbles appear, gently tap the syringe to make them rise to the top, and press on the plunger to remove the air from the syringe. Remove the needle from the vial once you’re measured your dose. Be careful not to touch the exposed needle, and don’t try to recap it.

Inject your dose

Pinch the cleaned injection site with your free hand. Insert the needle at a 45-degree angle using a quick, dart-like motion. Slowly push the plunger down to inject the dose. Then remove the needle and let go of the pinched skin. For the prefilled syringe, keep pressing the plunger as you pull the needle out of the skin. Once the needle is out, let go of the plunger. This will release the needle guard to cover the exposed needle. Dispose of the syringe and vial in your sharps container.

You may have a small amount of bleeding at the injection site. If needed, apply pressure with a cotton ball or bandage. But avoid rubbing or massaging the area.

2. How long does it take Stelara to work?

Stelara starts working as soon as you receive your first dose. But it takes longer to see the full effects of the medication.

In clinical studies, Stelara improved skin appearance by at least 75% in about 60% to 70% of people treated for psoriasis after 12 weeks. And over half of people who were new to biologic treatment had noticeable symptom improvement after one dose of Stelara for inflammatory bowel disease.

Keep in mind that Stelara can also help prevent symptoms and complications from your health condition. So some of its effects are the symptoms you don’t experience.

3. How can you make Stelara injections less painful?

Stelara injections can cause discomfort. But there are ways to reduce your pain:

• Allow Stelara syringes to come to room temperature. Injecting a cold solution can be uncomfortable. You can take the prefilled syringe out of the fridge and let it come to room temperature naturally before you inject it. The vial can’t be left out of the fridge, so if the cold liquid is causing discomfort, talk to your provider about switching to the prefilled syringe.

• Ice the injection site. Apply ice to the injection site to help numb the skin before an injection.

• Rotate injection sites. Injecting into the same area over and over can raise the risk of pain and injection-site reactions. Be sure to change the injection site with each dose. And keep in mind that your stomach may be less painful than your thigh.

• Watch your injection speed. Pushing the plunger down really fast might make the injection go quicker, but it can also cause more pain. Try to use a slow, steady pace.

If you’re still struggling with injection pain, talk with your healthcare provider.

4. How should you store Stelara?

You should keep Stelara in the fridge at 36°F to 46°F in the original carton until you’re ready to use it. Pick a spot in your fridge where the temperature stays consistent (avoid the door). Vials should be stored in an upright position.

If Stelara freezes, you can no longer use it — even after it thaws. So avoid areas of the fridge near the cooling unit to prevent this.

The prefilled syringe can be left at room temperature for up to 30 days. But it can’t go back in the fridge once it’s been left out. So unless you’re traveling, it’s best to leave Stelara in the fridge until right before your dose.

Storage tips when traveling

Since you’ll only need to inject Stelara every 8 to 12 weeks, you may be able to plan trips around your dosing schedule so you won’t need to travel with your medication.

But if you do need to travel with Stelara, you have two options:

• If you use the prefilled syringe and will be traveling for less than 30 days, you can take it out of the fridge and travel with it at room temperature.

• If you use the vials or you’ll be traveling for more than 30 days, you’ll need to keep your Stelara cold. So it’s best to place it in an insulated cooler with ice packs. Be sure to keep your dose in the original carton and wrap it in something to prevent it from touching the ice directly, as this may lead to frozen medication you can’t use.

Be sure to keep your medication in your carry-on luggage. Don’t forget to pack injection supplies, and be sure to follow TSA guidelines for traveling with medication.

5. How can you save on the cost of Stelara?

There are ways to save on Stelara, which is only available as a brand-name (reference) medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $5 per dose for Stelara using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Stelara’s patient assistance program, which offers the medication free of cost.

• Save with biosimilars. Biosimilars are products with similar safety and efficacy as their reference biologic. And they’re often available at a lower cost. Wezlana (ustekinumab-auub) is a newly FDA-approved biosimilar that’s interchangeable with Stelara. It’s expected to be commercially available no later than January 2025.

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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:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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