Standard Administration for Plaque Psoriasis
Stelara (ustekinumab) is administered by subcutaneous injection for plaque psoriasis in adults and children 6 years and older weighing at least 33 kg. The regimen starts with two initial doses 4 weeks apart, followed by maintenance injections every 12 weeks.[1]
Initial Dosing Schedule
- Week 0: First subcutaneous injection.
- Week 4: Second subcutaneous injection.
- Week 12 onward: Maintenance dose every 12 weeks.
Doses are weight-based:
| Patient Weight | Adult Dose (≥18 years) | Pediatric Dose (6-17 years) |
|----------------|------------------------|-----------------------------|
| ≤55 kg | 45 mg | 0.75 mg/kg |
| 56-85 kg | 45 mg (≤100 kg) or 90 mg (>100 kg) | 45 mg |
| >85 kg | 90 mg | 90 mg |
Self-injection is possible after training using prefilled syringes or autoinjectors.[1][2]
How Patients Inject It
Injections go into the thigh, abdomen (avoiding 2 inches around the navel), or upper arm (with assistance). Rotate sites to prevent irritation. Use alcohol swabs for cleaning, inject at 45-90 degree angle, and hold for 5-10 seconds post-injection. Store in refrigerator; allow to reach room temperature before use (up to 45 minutes).[1][3]
What If Weight Changes?
Recheck weight before each dose. Adjust if it crosses categories (e.g., from 45 mg to 90 mg). No dose adjustment for mild kidney/liver issues, but consult a doctor.[1]
Common Injection Site Reactions
Redness, itching, swelling, or pain at the site affects about 10-20% of patients, usually mild and short-lived. Bruising or bleeding can occur; apply pressure if needed.[1][4]
Differences from Other Psoriasis Treatments
Unlike topical creams or oral methotrexate, Stelara targets IL-12/IL-23 cytokines via injection, reducing frequency compared to weekly biologics like Humira. It's not IV like Remicade infusions.[1][5]
[1]: [Stelara Prescribing Information (Janssen)](https://www.stelara.com/sites/www Stelara/files/stelara-pi.pdf)
[2]: FDA Label for Ustekinumab
[3]: Stelara Patient Instructions for Use
[4]: Clinical Pharmacology Review - Stelara
[5]: American Academy of Dermatology - Biologics for Psoriasis