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Stelara

ustekinumab
Used for Plaque Psoriasis, Ulcerative Colitis, Psoriatic Arthritis, Crohn's Disease
Used for Plaque Psoriasis, Ulcerative Colitis, Psoriatic Arthritis, Crohn's Disease

Stelara (ustekinumab) is an injectable medication used to treat autoimmune conditions like plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis. As an interleukin antagonist, it works by blocking certain proteins that cause inflammation in your body, which helps reduce swelling and ease symptoms. You typically get it as an injection under your skin. Common side effects include common cold symptoms, headache, and feeling tired. This medication also has many biosimilars available.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Daisy Chau, PharmD
Last reviewed on June 11, 2025
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Stelara (ustekinumab)?

What is Stelara (ustekinumab) used for?

How Stelara (ustekinumab) works

Stelara (ustekinumab) is an interleukin antagonist. It works by blocking two proteins in your immune system — interleukin-12 (IL-12) and interleukin-23 (IL-23) — that play a major role in inflammation. By targeting these proteins, the medication helps to lower inflammation and relieve symptoms from autoimmune conditions.

Drug Facts

Common BrandsStelara
Drug ClassIL-12 and IL-23 antagonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Stelara (ustekinumab) essentials

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Skyrizi vs. Stelara for Psoriasis

Written by Nikki Javit, PharmD
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What are the side effects of Stelara (ustekinumab)?

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

Plaque psoriasis
  • Common cold symptoms (7-8%)
  • Upper respiratory tract infection (4-5%)
  • Headache (5%)
Psoriatic arthritis
  • Joint pain (3%)
  • Nausea (3%)
Crohn's disease
  • Common cold symptoms (11%)
  • Redness at the injection site (5%)
  • Yeast infection (5%)
  • Bronchitis (5%)
Ulcerative colitis:
  • Common cold symptoms (24%)
  • Headache (10%)
  • Stomach pain (7%)
  • Flu infection (6%)
  • Fever (5%)

Other Side Effects

  • Dizziness
  • Diarrhea
  • Back pain
  • Muscle pain
  • Depression
  • Sore throat
  • Itchiness
  • Vomiting

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious infection: fever, muscle aches, cough, trouble breathing, weight loss, sores on the body, diarrhea, stomach pain, problems with urination, tiredness
  • Severe allergic reaction: feeling faint, facial swelling, chest tightness, rash
  • Brain condition: headache, confusion, vision problems, seizures
  • Lung conditions: trouble breathing, cough

Source: DailyMed

More on Stelara (ustekinumab) side effects

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The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Body aches or pain

chills

cough

cough producing mucus

difficulty with breathing

ear congestion

fever

headache

hoarseness

itching of the vagina or genitals

loss of voice

lower back or side pain

painful or difficult urination

runny or stuffy nose

sneezing

sore throat

stomach pain

thick, white vaginal discharge with mild or no odor

tightness in the chest

unusual tiredness or weakness

Less common

Bladder pain

bloody or cloudy urine

burning feeling while urinating

diarrhea

depression

dizziness

frequent urge to urinate

itching skin

lower back or side pain

pain or tenderness around the eyes and cheekbones

vomiting

Rare

Blurred or loss of vision

clear or bloody discharge from the nipple

confusion

dimpling of the breast skin

disturbed color perception

double vision

halos around lights

inverted nipple

itching, pain, redness, swelling, tenderness, or warmth on the skin

lump in the breast or under the arm

night blindness

overbright appearance of lights

persistent crusting or scaling of the nipple

redness or swelling of the breast

seizures

sore on the skin of the breast that does not heal

tunnel vision

Incidence not known

Chest pain

difficulty with swallowing

dry cough

fast heartbeat

general feeling of tiredness or weakness

hives or welts, skin rash

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

rapid breathing

redness of the skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Muscle aches

Less common

Back pain

bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

difficulty with moving

joint pain or swelling

muscle cramps, pain, or stiffness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Stelara (ustekinumab)

thumbs-up

Pros

After the first few doses, only need a shot every 8 to 12 weeks

Available as a prefilled syringe or vial

Syringes can be stored at room temperature for up to 30 days

Approved for children as young as 6 years old

thumbs-down

Cons

Can weaken your immune system and raise your risk of infection

Potential to cause serious allergic reactions

For CD and UC, the first dose must be given as an IV infusion

Can't receive live vaccines while taking this medication

pharmacist-tips

Pharmacist tips for Stelara (ustekinumab)

pharmacist

  • Mark your injection dates on a calendar. You don’t use Stelara (ustekinumab) very often, so it can be easy to forget. Keeping track helps you stay on schedule.

    • Inject Stelara (ustekinumab) under the skin in your upper arms, thighs, buttocks, or stomach area. Pick a new spot each time to avoid skin irritation. Don’t inject into skin that’s red, bruised, sore, or hard.

      • Get medical help right away if you have signs of a serious allergic reaction after using Stelara (ustekinumab). These might include swelling of the face or throat, trouble breathing, or a rash.

        • Tell your prescriber if you have a latex allergy. The needle cover of the Stelara (ustekinumab) prefilled syringe contains latex which could cause a reaction if you're sensitive to it.

          • Stelara (ustekinumab) can weaken your immune system, making it harder to fight infections. Let your prescriber know if you have symptoms of an infection, such as a fever, cough, tiredness, muscle aches, or stomach pain.

            • Contact your care team right away if you notice symptoms like headache, confusion, vision problems, or seizures. These could be signs of a rare brain condition linked to Stelara (ustekinumab).

              • Stelara (ustekinumab) can affect how your body responds to vaccines. Avoid live vaccines during treatment. Talk to your prescriber before getting any type of vaccine.

                • Store Stelara (ustekinumab) in its original carton in the refrigerator. If you're using the prefilled syringes, you can keep them at room temperature (up to 30°C or 86°F) for up to 30 days, but don’t put them back once they've been out of the fridge. If you’re using a vial, it should stay refrigerated until it’s time for your dose.

                  How to inject Stelara (ustekinumab) from a prefilled syringe:

                  • Make sure you know how to inject Stelara (ustekinumab) the right way. Ask your prescriber or pharmacist if you have questions.

                    • Clean the spot on your skin with an alcohol wipe before you inject to help prevent infection.

                      • When you're ready to inject, take off the needle cover from the syringe. Hold the syringe with one hand and pinch the cleaned skin with the other.

                        • Insert the needle into the pinched skin at about a 45-degree angle and push the plunger down with your thumb until all the liquid is injected. Then take out the needle and let go of your skin.

                          • Put the syringe into a sharps container. Never throw used syringes into the regular trash since it could harm someone.

                            More on Stelara (ustekinumab) tips

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                            faqs

                            Frequently asked questions about Stelara (ustekinumab)

                            How long can you stay on Stelara (ustekinumab)?
                            You can keep taking Stelara (ustekinumab) as long as it continues to help and doesn't cause serious side effects. Many people with long-term autoimmune conditions often stay on it for years. Your prescriber will check regularly to make sure it’s still safe and effective, and as long as it is, there’s usually no set time limit for how long you can stay on it.
                            Is Stelara (ustekinumab) a biologic?
                            Yes. Stelara (ustekinumab) is a biologic medication. Biologic medications are made from living sources, like cells or proteins.
                            Is Stelara (ustekinumab) an immunosuppressant?
                            Yes, Stelara (ustekinumab) is considered an immunosuppressant because it works by slowing down part of your immune system. By doing this, the medication helps reduce symptoms, but it might also make it slightly harder for your body to fight infections.
                            How long does Stelara (ustekinumab) stay in your system?
                            Stelara (ustekinumab) can stay in your system for months after your last dose. This is because it has a long half-life — between 15 and 45 days — meaning it takes that long for half the medication to leave your body. How long it stays can vary depending on your dose, how often you took it, and how your body processes medications.
                            How long does it take for Stelara (ustekinumab) to work?
                            It depends on the condition you're taking Stelara (ustekinumab) for. For example, studies show that some people saw improvement in their symptoms within 3 weeks for Crohn's disease and within 2 weeks for ulcerative colitis. But it can take a few months to feel the full effect, no matter the condition. Everyone responds differently, so be sure to follow up with your prescriber to talk about how the medication is working for you.
                            Does Stelara (ustekinumab) cause weight gain?
                            Weight gain isn’t a common side effect of Stelara (ustekinumab). But changes in weight can happen for other reasons, such as your medical condition, how your body responds to treatment, or other medications you might be taking. If you notice unexpected weight gain while taking this medication, talk to your prescriber.
                            Does Stelara (ustekinumab) cause hair loss?
                            Hair loss wasn't reported as a side effect by people using Stelara (ustekinumab) during clinical trials. If you notice hair loss while taking this medication, contact your prescriber — they can help you look into possible causes and recommend next steps.
                            How long can Stelara (ustekinumab) be out of the refrigerator?
                            Stelara (ustekinumab) prefilled syringes can be stored out of the refrigerator for up to 30 days as long as the temperature stays below 30°C (86°F). Once the syringe has been kept at room temperature, it shouldn't be returned to the refrigerator. Don’t use the medication if it has been left out for too long, exposed to heat or sunlight, or if you notice any changes in color or particles. Always follow the storage instructions from your pharmacist or the product label.
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                            What are the risks and warnings for Stelara (ustekinumab)?

                            Stelara (ustekinumab) 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.

                            risk-warning

                            Infections

                            • Risk factors: Active, chronic, or recurrent infection | People with certain genetic mutations | Taking other medications that weaken your immune system

                              Stelara (ustekinumab) can raise your risk of infections, including serious ones that might need hospital care. These can be caused by bacteria, viruses, or fungi. Tell your prescriber about your medical history before starting Stelara (ustekinumab), especially if you've ever had tuberculosis (TB). Let your care team know right away if you have signs of infection, such as fever, chills, cough, or tiredness — your treatment might need to be paused until you recover.

                              risk-warning

                              Cancers

                              • Risk factors: Older adults | Taking other medications that weaken your immune system | History of skin cancer

                                Stelara (ustekinumab) weakens your immune system and can raise your risk of certain cancers. Some people developed skin cancer while taking this medication, especially those with a higher risk. Your care team will check your skin regularly during treatment, particularly if you have a history of cancer or other risk factors. Let your prescriber know if you’ve had cancer before or if you notice any new or changing spots on your skin.

                                risk-warning

                                Severe allergic reaction

                                Serious allergic reactions, including anaphylaxis and angioedema, have been reported with Stelara (ustekinumab). If you have a severe reaction, your care team will stop the medication and treat you right away. Get medical help immediately if you have symptoms like trouble breathing, swelling of your face or throat, or a serious rash.

                                risk-warning

                                Brain condition

                                Rare cases of a brain condition called posterior reversible encephalopathy syndrome (PRES) have been reported in people taking Stelara (ustekinumab). Symptoms can include headache, seizures, confusion, or vision changes. These symptoms can appear anywhere from a few days to months after starting the medication, sometimes even after a year or more. If you have PRES, your care team will stop the medication and provide treatment. Let your prescriber know right away if you notice any of these signs.

                                risk-warning

                                Vaccines

                                Before starting Stelara (ustekinumab), you or your child should be up to date on all recommended vaccines. While you're being treated, avoid getting live vaccines. You should also avoid the BCG vaccine during treatment, as well as for one year before starting and one year after stopping the medication. Be careful if someone in your household gets a live vaccine since it can spread and pose a risk to you. Non-live vaccines are generally safe, but they might not work as well while you're taking Stelara (ustekinumab). Check with your care team before getting any vaccines during treatment.

                                risk-warning

                                Lung problems

                                Different types of pneumonia have been reported in people taking Stelara (ustekinumab), and in some cases, these conditions were serious. Symptoms can include cough and trouble breathing. Let your care team know right away if you have new or worsening breathing problems. You might have to stop taking the medication and receive the appropriate treatment.

                                dosage

                                Stelara (ustekinumab) dosage forms

                                Typical dosing for Stelara (ustekinumab)

                                Plaque psoriasis

                                • Adults:

                                  • Weight 220 lbs or less: The typical dose is 45 mg injected under the skin once, then another 45 mg four weeks later. After the second dose, 45 mg is injected every 12 weeks.

                                  • Weight more than 220 lbs: The typical dose is 90 mg injected under the skin once, then another 90 mg four weeks later. After the second dose, 90 mg is injected every 12 weeks.

                                • Children ages 6 and older:

                                  • Weight less than 132 lbs: The typical dose is 0.75 mg/kg of body weight injected under the skin once, then another 0.75 mg/kg four weeks later. After the second dose, 0.75 mg/kg is injected every 12 weeks.

                                  • Weight of 132 lbs to 220 lbs: The typical dose is 45 mg injected under the skin once, then another 45 mg four weeks later. After the second dose, 45 mg is injected every 12 weeks.

                                  • Weight more than 220 lbs: The typical dose is 90 mg injected under the skin once, then another 90 mg four weeks later. After the second dose, 90 mg is injected every 12 weeks.

                                Psoriatic arthritis

                                • Adults:

                                  • Psoriatic arthritis only: The typical dose is 45 mg injected under the skin once, then another 45 mg four weeks later. After the second dose, 45 mg is injected every 12 weeks.

                                  • Psoriatic arthritis with plaque psoriasis and weighing more than 220 lbs: The typical dose is 90 mg injected under the skin once, then another 90 mg four weeks later. After the second dose, 90 mg is injected every 12 weeks.

                                • Children ages 6 and older:

                                  • Weight less than 132 lbs: The typical dose is 0.75 mg/kg of body weight injected under the skin once, then another 0.75 mg/kg four weeks later. After the second dose, 0.75 mg/kg is injected every 12 weeks.

                                  • Weight of 132 lbs or more: The typical dose is 45 mg injected under the skin once, then another 45 mg four weeks later. After the second dose, 45 mg is injected every 12 weeks.

                                  • Psoriatic arthritis with plaque psoriasis and weighing more than 220 lbs: The typical dose is 90 mg injected under the skin once, then another 90 mg four weeks later. After the second dose, 90 mg is injected every 12 weeks.

                                Crohn's disease and ulcerative colitis:

                                • Adults:

                                  • Weight less than 121 lbs: The typical dose is 260 mg infusion into the veins once, then 90 mg injected under the skin every 8 weeks.

                                  • Weight of 121 lbs to 187 lbs: The typical dose is 390 mg infusion into the veins once, then 90 mg injected under the skin every 8 weeks.

                                  • Weight more than 187 lbs: The typical dose is 520 mg infusion into the veins once, then 90 mg injected under the skin every 8 weeks.

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                                interactions

                                Interactions between Stelara (ustekinumab) and other drugs

                                Stelara (ustekinumab) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Stelara (ustekinumab). Please note that only the generic name of each medication is listed below.

                                More on Stelara (ustekinumab) interactions

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                                Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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                                alternatives

                                What are alternatives to Stelara (ustekinumab)?

                                There are a number of medications that your doctor can prescribe in place of Stelara (ustekinumab). Compare a few possible alternatives below.
                                Stelara (ustekinumab)
                                Used for:
                                $29049.89 Lowest GoodRx priceView Prices
                                Humira (adalimumab)
                                Used for:

                                • Rheumatoid arthritis (RA) - adults only

                                • Juvenile idiopathic arthritis (JIA) - people age 2 and older

                                • Psoriatic arthritis (PsA) - adults only

                                • Ankylosing spondylitis (AS) - adults only

                                • Crohn's disease (CD) - people age 6 and older

                                • Ulcerative colitis (UC) - people age 5 and older

                                • Plaque psoriasis - adults only

                                • Hidradenitis suppurativa (HS) - people age 12 and older

                                • Uveitis - people age 2 and older

                                $1335.32 Lowest GoodRx priceView Prices
                                Skyrizi (risankizumab)
                                Used for:
                                $22301.22 Lowest GoodRx priceView Prices
                                latest news

                                What is the latest news about Stelara (ustekinumab)?

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                                Skyrizi vs. Stelara for Psoriasis: A Complete Guide to Effectiveness, Dosages, Side Effects, and More

                                Skyrizi or Stelara — which is right for you? Both are biologic medications that can treat conditions like plaque psoriasis. Compare efficacy, costs, and side effects here.
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                                How Do You Treat Psoriatic Arthritis?

                                There are many treatment options for psoriatic arthritis, including surgery. Patients typically take medications and perform self-care to help manage symptoms.
                                New treatments for psoriatic arthritis include biologics, JAK inhibitors, and more. Medications such as Sotyktu and sonelokimab are in advanced stages of development.

                                9 New Treatments for Psoriatic Arthritis in Development

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                                Whether you have moderate or severe psoriasis, there are many treatment options. Browse over-the-counter medications, biologics, and more psoriasis treatments.

                                What Is the Best Psoriasis Treatment for You?

                                Whether you have moderate or severe psoriasis, there are many treatment options. Browse over-the-counter medications, biologics, and more psoriasis treatments.
                                Learn more about medications for psoriasis, including the different types available, how they work, and their potential side effects.

                                What’s Next When Creams for Psoriasis Aren’t Working?

                                Learn more about medications for psoriasis, including the different types available, how they work, and their potential side effects.
                                What is scalp psoriasis? Here’s your guide to everything you need to know about scalp psoriasis causes, symptoms, treatment, and what it looks like.

                                What Is Scalp Psoriasis? Symptoms, Pictures, Causes, and Treatments

                                What is scalp psoriasis? Here’s your guide to everything you need to know about scalp psoriasis causes, symptoms, treatment, and what it looks like.
                                Biologics are a type of medication that can treat psoriasis, psoriatic arthritis (PsA), and other conditions. Here’s how biologics work for psoriasis and PsA and when they’re used.

                                Humira, Stelara, and More: 10 Biologics for Psoriasis and Psoriatic Arthritis

                                Biologics are a type of medication that can treat psoriasis, psoriatic arthritis (PsA), and other conditions. Here’s how biologics work for psoriasis and PsA and when they’re used.
                                Ulcerative colitis (UC) often responds to biologics like Remicade and Humira. Here’s a list of each biologic that treats UC, including side effects and how they work.

                                7 Biologics for Ulcerative Colitis: What to Know About Humira, Remicade, and More

                                Ulcerative colitis (UC) often responds to biologics like Remicade and Humira. Here’s a list of each biologic that treats UC, including side effects and how they work.
                                Original Medicare, Medicare Advantage plans, and Medicare Part D cover biologics that treat psoriasis and psoriatic arthritis. Learn which psoriasis treatments are covered.

                                What Psoriasis Treatments Does Medicare Cover? Biologics and More

                                Original Medicare, Medicare Advantage plans, and Medicare Part D cover biologics that treat psoriasis and psoriatic arthritis. Learn which psoriasis treatments are covered.
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                                References

                                Best studies we found

                                Aggeletopoulou, I., et al. (2018). Interleukin 12/interleukin 23 pathway: Biological basis and therapeutic effect in patients with Crohn's disease. World Journal of Gastroenterology.

                                American College of Allergy, Asthma & Immunology. (n.d.). Latex allergy.

                                Feagan, B. G., et al. (2016). Ustekinumab as induction and maintenance therapy for Crohn’s disease. The New England Journal of Medicine.

                                View All References (4)

                                Janssen Biotech, Inc. (2025). Stelara- ustekinumab injection, solution [package insert]. DailyMed.

                                Memon, R. J., et al. (2023). Angioedema. StatPearls.

                                Mishra, A., et al. (2018). Posterior Reversible Encephalopathy Syndrome following Ustekinumab Induction for Crohn's Disease. Case Reports in Gastroenterology.

                                Sands, B. E., et al. (2019). Ustekinumab as induction and maintenance therapy for ulcerative colitis. The New England Journal of Medicine.

                                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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