Understanding SKYRIZI and Your Immune System
SKYRIZI (risankizumab-rzaa) is a prescription biologic medication used to treat several autoimmune conditions in adults, including moderate to severe plaque psoriasis, active psoriatic arthritis, moderately to severely active Crohn’s disease, and moderately to severely active ulcerative colitis [1.10.1]. It works by targeting and blocking interleukin-23 (IL-23), a protein in the immune system that causes inflammation [1.10.3, 1.10.5]. By reducing this inflammation, SKYRIZI helps improve symptoms [1.10.3]. However, because it modulates the immune system, there are important things to avoid to minimize risks and ensure safe treatment [1.2.2].
The Primary Avoidance: Live Vaccines
The most critical instruction for patients on SKYRIZI is to avoid all live vaccines [1.2.1, 1.3.1]. Live vaccines contain a weakened form of a virus or bacteria [1.2.2]. In a person with a healthy immune system, this safely triggers an immune response. However, since SKYRIZI suppresses parts of your immune system, receiving a live vaccine could potentially lead to developing the infection the vaccine is meant to prevent [1.3.3].
Examples of live vaccines to avoid include:
- Measles, mumps, and rubella (MMR) vaccine [1.3.2]
- Influenza nasal spray (FluMist) [1.3.3]
- Varicella (chickenpox) vaccine [1.3.2]
- Yellow fever vaccine [1.3.3]
- Rotavirus vaccine [1.4.1]
- Bacillus Calmette-Guérin (BCG) for tuberculosis [1.3.4]
Before starting SKYRIZI, your healthcare provider will want to ensure you are up-to-date on all age-appropriate vaccinations according to current guidelines [1.2.4]. Always tell your provider you are taking SKYRIZI before receiving any vaccine [1.2.1].
Other Medications and Supplements
Combining SKYRIZI with other substances that affect the immune system can increase your risk of side effects, particularly infections [1.2.2].
You should discuss the following with your doctor:
- Other Immunosuppressants: Taking SKYRIZI with other medicines that weaken the immune system can significantly raise your infection risk [1.4.2]. This includes other biologic medications, corticosteroids like prednisone, and drugs such as methotrexate or azathioprine [1.2.2]. It is not common to take more than one biologic at the same time [1.4.2].
- Supplements Affecting the Immune System: Some over-the-counter supplements can either weaken or boost the immune system. Those that weaken it (like glucosamine) add to the infection risk, while those that enhance it could potentially interfere with SKYRIZI's effectiveness and worsen your autoimmune condition [1.2.2]. Always disclose all supplements, including herbal products, to your doctor [1.6.3].
There are currently no known interactions between SKYRIZI and specific foods, antibiotics, vitamins, or alcohol [1.4.1, 1.5.3]. However, while alcohol does not directly interact with the drug, it can worsen the symptoms of psoriasis, Crohn's disease, and ulcerative colitis, so your doctor may recommend limiting or avoiding it [1.5.1, 1.5.2].
Important Health Conditions and Precautions
Before and during your treatment with SKYRIZI, your healthcare provider needs to be aware of your complete health history.
Key considerations include:
- Infections: Treatment should not be started if you have a clinically important active infection [1.7.4]. Your doctor will screen you for tuberculosis (TB) before starting SKYRIZI and monitor you for signs of infection during treatment [1.6.1, 1.6.2]. Tell your doctor right away if you develop symptoms like fever, cough, chills, or burning during urination [1.6.4].
- Liver Problems: For patients with Crohn's disease or ulcerative colitis, SKYRIZI can potentially cause liver problems. Your doctor will perform blood tests to check your liver function before and during the induction phase of treatment [1.9.2, 1.6.1]. Seek immediate medical attention if you experience symptoms like jaundice (yellowing of the skin and eyes), nausea, vomiting, or dark urine [1.9.2].
- Allergies: SKYRIZI is contraindicated in patients with a history of a serious hypersensitivity reaction to risankizumab-rzaa or any of its ingredients [1.7.3, 1.7.4]. Seek emergency medical help for symptoms of a serious allergic reaction, such as swelling of the face or throat, trouble breathing, or skin rash and hives [1.9.2].
- Pregnancy and Breastfeeding: It is not known if SKYRIZI is safe to use during pregnancy or if it passes into breast milk [1.8.1]. If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the risks and benefits with your doctor [1.8.2, 1.8.3]. There is a pregnancy registry to collect information on the health of mothers and babies exposed to SKYRIZI [1.8.1].
| Category | What to Avoid or Discuss with Your Doctor | Rationale |
|---|---|---|
| Vaccines | All live vaccines (e.g., MMR, FluMist nasal spray, chickenpox) [1.3.2, 1.3.3] | SKYRIZI suppresses the immune system, creating a risk of developing the infection the vaccine is meant to prevent [1.3.3]. |
| Medications | Other immunosuppressants (other biologics, corticosteroids, methotrexate) [1.2.2] | Combining these drugs significantly increases the risk of serious infections [1.4.2]. |
| Supplements | Supplements that either weaken or boost the immune system [1.2.2] | Can either increase infection risk or interfere with SKYRIZI's effectiveness [1.2.2]. |
| Alcohol | Recommended to limit or avoid [1.5.4] | While not a direct interaction, alcohol can worsen symptoms of the autoimmune conditions SKYRIZI treats [1.5.1, 1.5.2]. |
Conclusion
To ensure your safety while taking SKYRIZI, the most important step is to maintain open communication with your healthcare provider. The primary and most strict avoidance is live vaccines [1.2.1]. You must also inform your doctor about all other medications, supplements, and health conditions, especially any history of infections like TB or liver issues [1.6.1]. By following these guidelines, you can help minimize risks and allow SKYRIZI to work effectively in managing your condition.
For more detailed information, you can visit the official SKYRIZI website [1.2.1].
