Skyrizi (risankizumab-rzaa)

Skyrizi is a brand-name prescription medication that’s approved for use in adults with the following conditions.

• Moderate to severe plaque psoriasis. With plaque psoriasis, you have patches of thickened skin with scales. Doctors prescribe this drug for people who could use either systemic therapy (treatment that affects the entire body) or phototherapy (also called light therapy).
• Psoriatic arthritis (PsA). With PsA, you have skin changes due to psoriasis along with arthritis symptoms, such as joint pain. Doctors prescribe this drug for people with active PsA, which means the condition is causing symptoms.

To learn more about these conditions and how Skyrizi treats them, see the “Skyrizi: Uses” section below.

The following table provides key facts about Skyrizi.

* The reason “-rzaa” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Skyrizi contains the active drug risankizumab-rzaa.* It only comes as a brand-name medication. And it isn’t currently available as a biosimilar drug.

A biosimilar medication is a drug that’s similar to a brand-name biologic medication (the parent medication). Skyrizi is a biologic medication, which is also referred to as a biologic. 

Biologics are made from living cells. It’s not possible to make an exact copy of these drugs. A generic, on the other hand, refers to drugs made from chemicals. A generic is an exact copy of the active drug in a brand-name medication. 

Biosimilars are considered to be just as effective and safe as their parent drug. And like generics, biosimilars tend to cost less than brand-name medications.

* The reason “-rzaa” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.

As with most drugs, it’s possible to have side effects with Skyrizi. These can include some mild side effects, but also some serious ones.

To learn more about Skyrizi’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Skyrizi, you can do so through MedWatch.

Mild and serious side effects of Skyrizi are listed in the table below. This table does not include all of Skyrizi’s possible side effects.

* This is not a complete list of Skyrizi’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† For more information about this side effect, see “Skyrizi’s side effects explained” below.

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

Serious side effects from Skyrizi aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Below, you can find detailed information about some of Skyrizi’s side effects. To learn more about other side effects of this medication, talk with your doctor. 

Taking Skyrizi can increase your risk of infections. This is because Skyrizi works by weakening your immune system.

In clinical studies, most infections were mild, such as the common cold or a minor fungal infection. However, in rare cases, infections with Skyrizi were serious.

To learn more about how often infections occurred in clinical studies, see the drug’s prescribing information.

Symptoms of infection can vary, but they may include:

• abdominal pain
• a burning sensation during urination or frequent urination
• chills, fever, or sweating
• cough
• muscle aches
• sores that aren’t caused by psoriasis, which Skyrizi is used to treat
• unexplained weight loss

Before beginning treatment with Skyrizi, your doctor will check you for infection, including tuberculosis (TB). If your TB test is positive, or you have a different infection, they’ll likely treat the infection before prescribing Skyrizi.

During treatment with Skyrizi, your doctor will monitor you for infection. If you notice symptoms of an infection while taking this medication, tell your doctor. They can prescribe a treatment for the infection. They’ll also have you temporarily pause Skyrizi injections until the infection clears.

Headache is a possible mild side effect of Skyrizi. It was one of the more common side effects in Skyrizi’s clinical studies. However, most people taking the drug didn’t have this side effect.

To learn more about how often headache occurred in clinical studies, see the drug’s prescribing information.

Talk with your doctor if you’re having headaches with Skyrizi. They can recommend treatment for this side effect. This may include an over-the-counter pain reliever such as ibuprofen (Advil, Motrin). Be sure to check with your doctor about which medications you can safely take for a headache.

Having Skyrizi injections may cause injection site reactions. These reactions were among the more common side effects reported in Skyrizi’s clinical studies. However, most people who took the drug didn’t have this side effect. No one in these studies had to stop taking Skyrizi due to injection site reactions.

To learn more about how often injection site reactions occurred in clinical studies, see the drug’s prescribing information.

Injection site reactions from Skyrizi can cause these symptoms at the site where you inject the drug:

• bleeding
• bruising
• infection
• itchiness
• pain
• redness or discoloration
• skin irritation
• swelling or warmth

The following tips can help you avoid injection site reactions with Skyrizi:

• Do not inject Skyrizi into skin that’s bruised, hard, sore, scarred, or affected by psoriasis plaques.
• Do not inject Skyrizi through clothing.
• Do not rub Skyrizi injection sites after injecting a dose of the drug.

Tell your doctor if you have injection site reactions with Skyrizi that don’t go away or bother you. Your doctor may suggest a different treatment for your condition.

Like other medications, prices for Skyrizi may vary. The injection’s price will depend on factors such as:

• the pharmacy you use
• your insurance coverage

Here’s a list of things to consider when looking into the cost of Skyrizi.

• Need for prior authorization. Before insurance coverage for Skyrizi is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Skyrizi. Then, the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Skyrizi, contact your insurance company.
• Possible cost assistance options. Financial assistance to help lower the cost of Skyrizi is available. AbbVie, Inc., the manufacturer of the drug, offers ways to save as well as help with understanding your insurance coverage. To learn more and see if you’re eligible for support, call 866-SKYRIZI (866-759-7494) or visit the manufacturer’s website. Also, check out this article to learn how to save on prescription drugs.
• Use of a specialty pharmacy. Your insurance may require you to get Skyrizi from a specialty pharmacy. These pharmacies are authorized to handle certain drugs considered specialty medications. These medications may be expensive or require help from healthcare professionals to be used safely and effectively. Ask your insurance company if they require you to get Skyrizi from a specialty pharmacy.
• Use of a mail-order pharmacy. Skyrizi may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
• Availability of a biosimilar form. Skyrizi doesn’t come in a biosimilar form. A biosimilar medication is a drug that’s similar to a brand-name biologic medication (the parent medication). Skyrizi is a biologic medication, which is also referred to as a biologic. Biosimilars tend to be cheaper than the brand-name parent medication.

Below, you’ll find dosages that are commonly recommended for Skyrizi. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

Skyrizi is available as follows.

• Form:
  • solution inside single-dose, prefilled syringes and pens that’s given by subcutaneous injection
• Strengths:
  • 150 milligrams per milliliter (mg/mL) in syringes and pens
  • 75 mg/0.83 mL in syringes

Recommended dosage for Skyrizi in adults is described below. The drug’s dosing for psoriasis and psoriatic arthritis is the same.

The recommended dosing schedule, including dosing frequency, for Skyrizi in adults is as follows.

• Starting dosage (also sometimes called a loading dosage): 150 mg given once at the start of treatment and again 4 weeks later
• Maintenance dosage: 150 mg given once every 12 weeks, beginning 12 weeks after  your last starting dose

Below are some things to consider about Skyrizi’s dosage.

• Missing a dose. If you miss a dose of Skyrizi, inject your dose as soon as possible. Then resume your normal dosing schedule. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Length of treatment. Doctors typically prescribe Skyrizi as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.

Prescription drugs, such as Skyrizi, are approved by the Food and Drug Administration (FDA) to treat certain conditions.

Skyrizi is prescribed to treat moderate or severe plaque psoriasis in adults. Doctors prescribe this drug for people who could use either:

• systemic therapy (treatment that affects the entire body), or
• phototherapy (also called light therapy)

Plaque psoriasis is a chronic (long-term) skin condition. (It’s also known simply as “psoriasis.”) The main symptom of psoriasis is patches of thickened, scaly skin. On lighter skin, psoriasis patches tend to be pink or red with white scales. On darker skin, psoriasis patches are typically dark brown or purple with gray scales.

Psoriasis most commonly affects skin on elbows, knees, lower back, scalp, and soles of the feet. However, it can also affect the armpits and areas near the genitals and breasts or behind the ears.

Psoriasis is caused by problems with your immune system. This leads to new skin cells being made faster than old skin cells are removed. With psoriasis, new skin cell growth happens in days, instead of taking weeks like usual.

Skyrizi is also prescribed to treat psoriatic arthritis (PsA) in adults. With PsA, you have psoriasis symptoms, which are described directly above, as well as:

• joint pain and stiffness
• trouble moving
• discoloration of skin over affected joints

Other symptoms of psoriatic arthritis can include:

• nail problems, such as the nail separating from the nail bed
• pain in muscles
• scaly skin patches that may get worse when joint pain flares up
• swelling in fingers or toes

Psoriasis is caused by problems with your immune system.

For treating psoriatic arthritis, Skyrizi may be used alone or together with certain other medications. These medications are called disease-modifying antirheumatic drugs (DMARDs).

Your doctor can tell you more about whether you’ll take Skyrizi with other medications.

Skyrizi isn’t approved for use in children. It’s only approved for use in adults.

If you need help finding a healthcare professional to recommend whether Skyrizi is right for you, search here.

To prepare for your visit, you can check out these appointment guides for the following conditions:

• psoriatic arthritis
• psoriasis

Doctors may prescribe drugs other than Skyrizi for your condition. Certain drugs may work better for you than others.

In addition to treating plaque psoriasis, Skyrizi is used to treat psoriatic arthritis. Here’s a summary of other drugs that doctors sometimes prescribe for psoriatic arthritis.

To learn more about some alternatives of Skyrizi, view the following articles:

• Skyrizi vs. Humira
• Skyrizi vs. Tremfya

Your doctor can tell you about other similar drugs, such as:

• ixekizumab (Taltz)
• ustekinumab (Stelara)
• secukinumab (Cosentyx)
• apremilast (Otezla)
• dupilumab (Dupixent)

To learn more about alternatives to Skyrizi, ask your doctor. They can tell you about other medications that could be prescribed for your condition.

Here are some common questions about Skyrizi and brief answers to them. If you’d like to know more about these topics, ask your doctor.

Skyrizi isn’t a steroid, but it is an immunosuppressant.

Immunosuppressants are drugs that weaken your immune system.

Skyrizi treats psoriasis and psoriatic arthritis, both of which are caused by an overactive immune system. With these conditions, the immune system mistakenly attacks the body’s own cells. Skyrizi works by weakening the immune system, helping to stop this process.

Both Skyrizi and steroids work by reducing immune system activity, but they do so in different ways.

Yes, Skyrizi is a biologic drug.

Biologics are medications made from living cells, while nonbiologic drugs are made from chemicals.

No, Skyrizi isn’t approved to treat atopic dermatitis or arthritis.

Atopic dermatitis, which is also called eczema, causes an itchy rash. Researchers recently completed a study evaluating whether Skyrizi is effective for treating atopic dermatitis.  However, the drug hasn’t been approved to treat this condition.

“Arthritis” typically refers to a condition called osteoarthritis. It’s generally caused by breakdown in joints over time and is often related to age. Skyrizi isn’t approved to treat osteoarthritis, but it is approved to treat psoriatic arthritis. This form of arthritis is caused by an overactive immune system. To learn more about psoriatic arthritis, see the “Skyrizi: Uses” section above.

If you have questions about treatment options for atopic dermatitis or arthritis, talk with your doctor.

No, hair loss isn’t a side effect that was reported in Skyrizi’s clinical studies.

Other treatments for psoriasis and psoriatic arthritis may cause hair loss as a side effect, though. This includes the drug methotrexate (Trexall, others). However, this side effect hasn’t been reported with Skyrizi.

If you have concerns about hair loss during Skyrizi treatment, talk with your doctor.

It’s unlikely. Neither weight gain nor weight loss were side effects reported in Skyrizi’s clinical studies.

However, weight loss may be a symptom of a serious infection, which is a possible side effect of Skyrizi. (To learn more, see “Skyrizi’s side effects explained” in the “Skyrizi: Side effects” section above.)

People with psoriatic arthritis can experience joint or muscle pain. (Keep in mind, this is one of the conditions that Skyrizi treats.) These symptoms can make it difficult to exercise and may result in weight gain for some people.

Tell your doctor right away if you have unintentional weight loss during Skyrizi treatment. They may check to see if you have an infection. Also, talk with your doctor if you notice weight gain while taking this drug.

No, liver damage isn’t a side effect that was reported in Skyrizi’s clinical studies.

However, other treatments for psoriasis and psoriatic arthritis may cause liver damage as a side effect. This includes the medication methotrexate (Trexall, others). But this side effect hasn’t been reported with Skyrizi.

If you have concerns about liver damage with Skyrizi, talk with your doctor.

Skyrizi treats psoriasis and psoriatic arthritis, both of which are caused by an overactive immune system. To learn more about these conditions, see the “Skyrizi: Uses” section above.

With these conditions, the immune system mistakenly attacks the body’s own cells. It’s not known why psoriasis and psoriatic arthritis occur or why they affect certain people.

Skyrizi’s mechanism of action (how the drug works) is by weakening the immune system. This stops your immune system from attacking your own body.

Specifically, Skyrizi works by blocking a protein called IL-23. This protein helps activate certain parts of the immune system.

In people with psoriasis or psoriatic arthritis, IL-23 can send signals that result in your immune system attacking your body’s own cells. It can also cause cells to grow too quickly. This results in the skin plaques that are part of plaque psoriasis.

Blocking IL-23 prevents these immune system signals from being sent. In turn, this reduces inflammation in your body, helping to relieve symptoms of psoriasis and psoriatic arthritis.

Skyrizi begins working as soon as you start taking it. However, it may take several weeks of treatment before your symptoms improve.

How long a drug stays in your system can be estimated using the drug’s half-life. (Half-life describes how long it takes for your body to get rid of half of a dose of the drug.)

Skyrizi’s half-life is about 28 days. In general, it takes about five half-lives before a drug is cleared from your system. This means that Skyrizi may remain in your body for around 140 days after your last dose.

Your doctor will advise how you should take Skyrizi. It’s important that you administer the drug exactly as your doctor instructs.

Skyrizi comes as a solution inside single-dose, prefilled syringes and pens. It’s given by subcutaneous injection.

Your first couple of Skyrizi doses will be given at your doctor’s office. You’ll be shown how to properly inject the drug. After that, you’ll be able to inject doses yourself.

You can inject Skyrizi into the following sites:

• front of your thighs
• abdomen, being careful to inject at least 2 inches away from your belly button

To view a video of step-by-step instructions for injecting Skyrizi, check out this website from the drug’s manufacturer.

Here’s a list of common questions related to taking Skyrizi.

• When should I take Skyrizi? After the first phase of treatment, Skyrizi doses are given once every 12 weeks. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Do I need to take Skyrizi with food? Skyrizi injections may be given with or without food.
• Is there a best time of day to take Skyrizi? You may inject a Skyrizi dose at any time of day.

There are no known interactions between Skyrizi and alcohol.

However, keep in mind that alcohol could worsen certain side effects of Skyrizi. These include headache and fatigue. Alcohol may also increase your risk for infection, another possible side effect of Skyrizi.

According to some studies, alcohol may also worsen symptoms of psoriasis, which Skyrizi is used to treat.

If you drink alcohol, talk with your doctor about how much is safe to drink while using Skyrizi.

Skyrizi may interact with certain vaccines.

This drug isn’t known to interact with other medications. However, it’s possible that drug interactions with Skyrizi could be discovered in the future. For this reason, it’s important to tell your doctor and pharmacist about all the medications you take. Your doctor and pharmacist can monitor for any new interactions that could affect you.

If any of the vaccine interactions listed below pertain to you, talk with your doctor. They can recommend what you should do to avoid the interaction.

• Skyrizi and vaccines. It’s recommended that you don’t receive certain vaccines while taking Skyrizi. Specifically, you should avoid getting live vaccines while you’re receiving Skyrizi. (Live vaccines contain a live form of the germ they’re meant to protect you from.) Examples of live vaccines to avoid with Skyrizi include those for:
  • chickenpox
  • influenza (the flu), when the vaccine is given as a nasal spray (FluMist)
  • measles, mumps, rubella (MMR)
  • rotavirus
  • smallpox
  • typhoid
  • yellow fever

It’s not known whether it’s safe to take Skyrizi during pregnancy.

Animal studies did show some risk to offspring when Skyrizi was given to pregnant animals. However, animal studies don’t always predict what will happen in humans.

If you take Skyrizi while pregnant, consider enrolling in a pregnancy registry for the drug. Pregnancy registries collect information about the safety of a drug when it’s used during pregnancy. To learn more, call the Glow Pregnancy Registry at 877-302-2161 or talk with your doctor.

Talk with your doctor about your birth control needs with Skyrizi if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.

It’s not known whether Skyrizi passes into breast milk or whether it can cause side effects in a breastfed child.

If you’re considering Skyrizi treatment while breastfeeding, talk with your doctor about the benefits and risks. They can also provide more information on other feeding options.

Tell your doctor about your health history before starting treatment with Skyrizi. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

• Tuberculosis (TB) or an active infection. If you have TB or an active infection, your doctor will likely treat it before prescribing Skyrizi. (Active infections cause symptoms.) This includes active TB (TB with symptoms) and latent TB (TB without symptoms). Because Skyrizi works by weakening your immune system, the drug can make it harder for your body to fight off infections. Be sure to tell your doctor about any infections you have before you start Skyrizi treatment.
• Allergic reaction. Your doctor will likely not prescribe Skyrizi if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
• Pregnancy. If you’d like to learn more about taking Skyrizi while pregnant, view the “Skyrizi: Using while pregnant” section above.
• Breastfeeding. If you’d like more information about taking Skyrizi while breastfeeding, view the “Skyrizi: Using while breastfeeding” section above.

To learn more about effects of Skyrizi that could be harmful, see the “Skyrizi: Side effects” section above.

Serious effects can occur if you use more than the recommended dosage of Skyrizi. Do not use more Skyrizi than your doctor recommends.  

Call your doctor if you think you’ve taken too much of this drug. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. However, if your symptoms are severe, call 911 or your local emergency number. Or go to the nearest emergency room right away.

Here’s some information about Skyrizi’s expiration date, as well as how to store and dispose of the drug.

• Expiration. Your pharmacist will add an expiration date to the label on Skyrizi’s packaging. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time. The Food and Drug Administration (FDA) advises that you avoid using expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.
• Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. Skyrizi syringes or pens should be stored in the refrigerator at 36°F to 46° F (2°C to 8°C). Do not freeze Skyrizi. Avoid storing Skyrizi in areas where it could get damp or wet, such as bathrooms. The medication should be kept in the original container and away from light.
• Disposal. Dispose of any used syringes, needles, or autoinjectors right after using them. You can safely dispose of these items in an FDA-approved sharps container. Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps them avoid harm from needles. If you’re prescribed Skyrizi, you can get a free sharps container delivered to your home at no cost by signing up for Skyrizi Complete. If you’d like to buy a sharps container, you can find options online. Or ask your doctor, pharmacist, or health insurance company where you can purchase one. Your pharmacist can give you more information about disposing of Skyrizi. Also, check out this page for several tips on safe medication disposal.

If you have questions about Skyrizi, talk with your doctor. They can help advise you on whether Skyrizi could be a good treatment option.

Here’s a list of questions you may want to ask your doctor.

• How do Skyrizi’s side effects compare to those of alternative treatments?
• If I need to stop taking Skyrizi, will I have withdrawal symptoms?
• Will Skyrizi worsen any health conditions I have?
• Will I need to have lab work done while I’m taking Skyrizi?

Your doctor may also tell you about other treatment options for your condition. You may find this article helpful in learning about alternative drugs for psoriatic arthritis. And check out our selection of videos on psoriasis and psoriatic arthritis.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.