How Do You Use Tremfya? 5 Expert Tips for Maximizing This Under-The-Skin Injection

Tremfya (guselkumab) is an injectable medication that treats psoriasis and psoriatic arthritis in adults. You’ll likely receive your first dose from a healthcare professional (HCP) as an injection under the skin. This supervision helps make sure you’re comfortable with the injection process. If everything is good to go after that, you can conveniently inject Tremfya yourself at home.

Even so, learning to administer the shot on your own may seem intimidating. But don't worry — we'll walk you through a few pharmacist-backed tips for mastering your Tremfya injections.

1. Where to inject Tremfya

You can inject Tremfya into your stomach or the front of your thighs. If you don't want to inject it yourself, someone else can inject it in the back of your upper arms. The site you choose depends on personal preference, but the front of the thigh is recommended in many cases.

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However, if you're injecting the medication into your stomach, make sure it's at least 2 inches away from your belly button. You'll also want to avoid injecting into patches of skin affected by psoriasis or appearing red or tender.

Good to know: It's best to change the location of your injection each time you inject Tremfya. This helps lessen the chance of injection site reactions and irritation. 

2. How to inject Tremfya (in 4 steps)

Tremfya is injected under the skin (subcutaneously). It comes in two forms: a patient-controlled injector (called the One-Press injector) and a prefilled syringe. Both forms contain a single dose and should only be used once.

Between the two, some people prefer to use the One-Press injector because the injection needle is hidden. Some believe it hurts less, too. This is because it allows you to determine the speed of the injection. Depending on what you’re comfortable with, you can inject it faster or slower. It doesn’t require fine motor skills to use, either.

Step 1: Getting started

Remove your Tremfya device from the refrigerator and let it come to room temperature (up to 86℉). This should take about 30 minutes and helps lessen injection pain.

Find a clean workplace and collect your injection supplies. This includes an alcohol swab, cotton ball or gauze pad, bandage, and a sharps container.

You'll then need to inspect your medication. First, check the expiration date on the Tremfya carton to make sure it hasn't passed. Then, check to make sure the seal on the carton isn't broken and look for any cracks in the device. You'll also want to make sure the liquid inside your device is clear or slightly yellow. Don't inject your dose if the device is broken or if the medication is expired, cloudy, or has large particles in it.

Finally, clean your hands with soap and water or hand sanitizer. Then, clean the injection site with an alcohol swab using a circular motion and allow it to air dry.

Step 2: Preparing your dose

The Tremfya injection process differs based on which device you're using. But removing the cap comes first for both formulations.

• One-Press injector: Pull off the clear cap on the end of the One-Press injector and throw it away. This will expose the gray needle guard.

• Prefilled syringe: Hold the middle of the syringe in one hand and pull the needle cover straight off with the other. You can throw this away. Don't worry if there's a drop of liquid at the tip of the needle — this is normal.

For either device, you have 5 minutes to inject your dose after removing the needle cover.

Step 3: Injecting your dose

After you’ve decided where to inject your dose, here are some general tips to follow to make sure that you inject it the correct way.

One-Press injector

Place the injector at a 90-degree angle (straight up and down) on the intended injection site. Then, firmly push the handle all the way down until you can't see the teal body of the injector. You may hear a click once the injection begins or feel resistance. This is normal. Once the injection is completed (you can’t push down anymore, and the teal body of the injector is no longer visible), you may hear another click. Remove the injector from your body.

Keep in mind: The medication is injected as you push. It’s a little different from auto-injectors that time the dose for you. Push at a speed that's comfortable for you. But make sure not to prematurely lift up after you start the injection process; you may not get the full dose.

Prefilled syringe

Pinch an area of cleaned skin with your free hand. Then, insert the needle at a 45-degree (slanted) angle using a quick, dart-like motion. After the needle is in, let go of the pinched skin and use your free hand to hold the middle of the syringe. Slowly press down on the plunger with your opposite hand until it stops.

Once the injection is completed, let go of the plunger. This will remove the needle from your skin, and the safety guard will cover the needle.

Step 4: Clean-up

Place the used injection device into your sharps container. Each device only contains one dose, so no need to save it for later.

A small amount of bleeding is normal, too. If this happens, apply pressure to the injection site with a cotton ball or gauze pad for 10 seconds. Don't rub the injection site. Apply a bandage if needed.

3. Storing Tremfya properly can help it work at its best

It’s important to store your unused Tremfya devices in their original container. This helps protect the medication against light and physical damage.

You should also keep Tremfya in the refrigerator (36℉ to 46℉) until about 30 minutes before your dose. Unlike other injectable medications, Tremfya can't be kept at room temperature for too long. Once you remove it from the refrigerator, you should inject it within 4 hours. You shouldn’t keep it at room temperature for longer than that.

To be cautious, it’s helpful to set an alarm for yourself when you remove Tremfya from the refrigerator so you don't accidentally leave it out longer than recommended. Also avoid storing it on the top shelf where it could freeze. If Tremfya freezes, you shouldn't use it — even after it thaws. Avoid storing it in the refrigerator door too; this location is more prone to temperature changes.

4. Set reminders for your injection days

You'll likely only inject Tremfya once every 2 months (8 weeks). Since this is relatively infrequent, it can be hard to remember when you administered your last dose. Calendar alerts and medication reminder apps can help you remember when your next dose is due.

If you miss your dose of Tremfya, inject it as soon as you remember and continue your regular dosing schedule. Check with your HCP if you're unsure about when you should inject your next dose.

5. Keep an eye out for these Tremfya side effects

Like all medications, Tremfya can cause side effects. Many common side effects can be managed at home and should go away once your body gets used to the medication. But other side effects can be more serious and should be discussed with your HCP without delay.

The most common Tremfya side effects include:

• Upper respiratory infections (sore throat or the common cold)

• Headache

• Mild injection site reactions (redness, swelling, or itching)

• Joint pain

Serious side effects

Although rare, some Tremfya side effects are more serious and should be reported to your HCP immediately. Stop using Tremfya and seek emergency medical care right away if you experience swelling of your face or mouth or have trouble breathing after an injection. These are symptoms of a potentially serious allergic reaction.

What’s more, because of its effects on the immune system, Tremfya increases the risk of severe infections, including tuberculosis. Before you start Tremfya, tell your HCP if you've been exposed to tuberculosis in the past or have any current symptoms of an infection.

How to save on Tremfya

There are ways to save on Tremfya, which is only available as a reference (brand-name) medication. GoodRx can help you navigate between copay savings cards and patient assistance programs 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 for Tremfya using a savings card from the manufacturer.

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

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Written by:

Nikki Javit, PharmD

Nikki Javit, PharmD, is a clinical pharmacist with certifications in international travel medicine, immunization delivery, and pharmacogenomics. She received her bachelor’s of science in biology from Indiana University Bloomington and her doctor of pharmacy degree from Butler University.

Edited 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.

Reviewed 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.

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