Psoriasis Treatments- MPR

Psoriasis Treatments

PSORIASIS TREATMENTS
These medications are not recommended for children and should be used for adults ≥18yrs old, unless otherwise specified.
Generic	Brand	Strength	Form	Dose
TOPICAL
Corticosteroids
betamethasone dipropionate	Sernivo	0.05%	spray	Apply twice daily for up to max 4wks. Discontinue when control is achieved.
clobetasol propionate	—	0.05%	foam	Apply twice daily; max 50g/week or 21 capfuls/week and 2 consecutive weeks’ treatment per course. Discontinue when control is achieved.
clobetasol propionate	Impoyz	0.025%	crm	Apply twice daily; max 50g/week and 2 consecutive weeks’ treatment per course. Discontinue when control is achieved.
halobetasol propionate	Bryhali	0.01%	lotion	Apply once daily for up to 8wks; max 50g/week. Discontinue when control is achieved.
halobetasol propionate	Lexette	0.05%	foam	≥12yrs: apply twice daily for up to 2wks; max 50g/week. Discontinue when control is achieved. Treatment beyond 2 consecutive weeks: not recommended.
Others
calcipotriene	Dovonex	0.005%	crm	Apply twice daily; gently rub in completely.
calcipotriene	Sorilux	0.005%	foam	≥4yrs: apply twice daily; gently rub in completely. Apply to scalp when hair is dry.
calcipotriene + betamethasone dipropionate	Enstilar	0.005% + 0.064%	foam	≥12yrs: apply once daily for up to 4wks; max 60g every 4 days. Discontinue when control is achieved.
	Taclonex	0.005% + 0.064%	oint, topical susp	Apply once daily for up to 4wks (oint) or 8wks (susp). 12–17yrs: max 60g/week. ≥18yrs: max 100g/week. Discontinue when control is achieved. Oint: limit to max 30% body surface area.
	Wynzora	0.005% + 0.064%	crm	Apply once daily for up to 8wks; max 100g/week. Discontinue when control is achieved.
calcitriol	Vectical	3mcg/g	oint	≥2yrs: apply twice daily in AM & PM; max weekly dose (2–6yrs): 100g; (≥7yrs): 200g.
halobetasol propionate + tazarotene	Duobrii	0.01% + 0.045%	lotion	Apply once daily; max 50g/week. Discontinue when control is achieved.
roflumilast	Zoryve	0.3%	crm	≥6yrs: apply once daily; rub in completely.
tapinarof	Vtama	1%	crm	Apply thin layer once daily. Wash hands after application, unless treating the hands.
tazarotene	Tazorac	0.05%, 0.1%	gel, crm	Apply once daily in the PM. Gel: limit to max 20% body surface area. Initiate with 0.05% strength; may increase to 0.1% as tolerated and clinically indicated.
SYSTEMIC
Interleukin-12 and interleukin-23 antagonist¹
ustekinumab	Stelara	45mg/0.5mL, 90mg/mL	soln for SC inj	6–17yrs: give SC at Weeks 0 and 4, then every 12wks thereafter. (<60kg): 0.75mg/kg; (60–100kg): 45mg; (>100kg): 90mg. ≥18yrs (≤100kg): initially 45mg SC once, then 4wks later, and then once every 12wks; (>100kg): initially 90mg once, then 4wks later, and then once every 12wks.
Interleukin-17a antagonist¹
brodalumab	Siliq	210mg/1.5mL	soln for SC inj	210mg SC at Weeks 0, 1, and 2, then 210mg every 2wks.
ixekizumab	Taltz	80mg/mL	soln for SC inj	160mg (given as two 80mg SC injs) at Week 0, then 80mg at Weeks 2, 4, 6, 8, 10, and 12, then 80mg every 4wks.
secukinumab	Cosentyx	75mg/0.5mL, 150mg/mL, 300mg/2mL	soln for SC inj	≥6yrs: give SC at Weeks 0, 1, 2, 3, and 4, then every 4wks thereafter. (<50kg): 75mg; (≥50kg): 150mg. ≥18yrs: 300mg SC at Weeks 0, 1, 2, 3, and 4, then 300mg every 4wks. For some patients, 150mg dose may be acceptable.
Interleukin-23 antagonist¹
guselkumab	Tremfya	100mg/mL	soln for SC inj	100mg SC at Weeks 0 and 4, then every 8wks thereafter.
risankizumab-rzaa	Skyrizi	75mg/0.83mL, 150mg/mL	soln for SC inj	150mg at Weeks 0 and 4, then every 12wks thereafter.
tildrakizumab-asmn	Ilumya	100mg/mL	soln for SC inj	100mg SC at Weeks 0 and 4, then every 12wks thereafter.
Interleukin-36 antagonist
spesolimab-sbzo	Spevigo⁴	450mg/7.5mL	soln for IV infusion	900mg as a single dose infused over 90mins. May give additional 900mg dose after 1 week if flare symptoms persist.
Tumor necrosis factor (TNF) blockers¹
adalimumab	Humira	10mg/0.1mL, 10mg/0.2mL, 20mg/0.2mL, 20mg/0.4mL, 40mg/0.4mL, 40mg/0.8mL, 80mg/0.8mL	soln for SC inj	Initially 80mg SC, followed by 40mg every other week 1wk after initial dose. Use beyond 1yr has not been evaluated.
	Abrilada	10mg/0.2mL, 20mg/0.4mL, 40mg/0.8mL
	Amjevita	10mg/0.2mL, 20mg/0.2mL, 20mg/0.4mL, 40mg/0.4mL, 40mg/0.8mL, 80mg/0.8mL
	Cyltezo	10mg/0.2mL, 20mg/0.4mL, 40mg/0.8mL
	Hadlima	40mg/0.4mL (citrate-free), 40mg/0.8mL
	Hulio	20mg/0.4mL, 40mg/0.8mL
	Hyrimoz	10mg/0.1mL, 10mg/0.2mL, 20mg/0.2mL, 20mg/0.4mL, 40mg/0.4mL, 40mg/0.8mL, 80mg/0.8mL
	Idacio	40mg/0.8mL (citrate-free)
	Yuflyma	20mg/0.2mL, 40mg/0.4mL, 80mg/0.8mL (all citrate-free)
	Yusimry	40mg/0.8mL
certolizumab pegol	Cimzia	200mg/mL	soln or pwd for SC inj	400mg (two 200mg inj at separate sites) SC every other week. ≤90kg: may consider 400mg on Day 1, then at Weeks 2 and 4, followed by 200mg every other week.
etanercept	Enbrel	25mg/0.5mL, 50mg/mL, 25mg/vial	soln or pwd for SC inj; soln for autoinjector	Give by SC inj. ≥4yrs: (<63kg): 0.8mg/kg (max 50mg) weekly; (≥63kg): 50mg weekly. ≥18yrs: initially 50mg SC twice weekly for 3mos (initial doses of 25mg or 50mg per week were shown to be efficacious). Maintenance: 50mg once weekly.
infliximab	Remicade	100mg/vial	lyophilized pwd for IV infusion	5mg/kg IV over ≥2hrs at Weeks 0, 2, 6, then once every 8wks.
	Renflexis
	Avsola
	Inflectra
Tyrosine kinase inhibitor
deucravacitinib	Sotyktu	6mg	tabs	6mg once daily
Others
acitretin	—	10mg, 17.5mg, 25mg	caps	25–50mg once daily with main meal; may discontinue when lesions resolve. May repeat if relapse occurs.
apremilast	Otezla	10mg, 20mg, 30mg	tabs	Starting on Day 1: 10mg in the AM. Day 2: 10mg in AM and 10mg in PM. Day 3: 10mg in AM and 20mg in PM. Day 4: 20mg in AM and 20mg in PM. Day 5: 20mg in AM and 30mg in PM. Following on Day 6 and thereafter: 30mg twice daily (AM & PM).
cyclosporine	Gengraf³	25mg, 100mg, 100mg/mL	caps, oral soln	1.25mg/kg twice daily; may increase after 4wks by 0.5mg/kg/day, then adjust at 2-week intervals; max 4mg/kg/day.
cyclosporine	Neoral³	25mg, 100mg, 100mg/mL	caps, oral soln
methotrexate	Otrexup	10mg/0.4mL, 15mg/0.6mL, 17.5mg/0.7mL, 20mg/0.8mL, 22.5mg/0.9mL, 25mg/mL	soln for SC inj	10–25mg once weekly using an oral, IM, SC, or IV form; max 30mg/wk. Use alternative MTX form in patients requiring oral, IM, IV, intra-arterial, or intrathecal dosing, doses <7.5mg/wk or >30mg/wk, high-dose regimens, or dose adjustments <2.5mg increments.
methotrexate	Rasuvo	7.5mg/0.15mL, 10mg/0.20mL, 12.5mg/0.25mL, 15mg/0.30mL, 17.5mg/0.35mL, 20mg/0.40mL, 22.5mg/0.45mL, 25mg/0.50mL, 30mg/0.60mL	soln for SC inj
NOTES
¹ These medications should only be used under the guidance and supervision of a physician. ² Intended to be administered only in conjunction with a schedule of controlled doses of long wave UV radiation. See full labeling for UVA exposure schedule. ³ Not bioequivalent to all other forms of cyclosporine; do not interchange without physician supervision. ⁴ Indicated for generalized pustular psoriasis (GPP) flares. Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 12/2023)

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