What Supplements Should I Avoid While Taking Skyrizi?

October 10, 2025 •

4 min read

As an immunosuppressant medication, Skyrizi (risankizumab-rzaa) increases the risk of infection by lowering the activity of the immune system. Therefore, understanding what supplements should I avoid while taking Skyrizi is crucial, as certain over-the-counter products can interfere with the treatment's effectiveness or further increase health risks. Always consult your healthcare provider before adding any new supplement to your regimen to ensure safety.

Quick Summary

Taking Skyrizi, a biologic medication, necessitates caution with supplements that affect the immune system. Patients should avoid immune-boosting herbs like Echinacea and Elderberry, as they can counteract Skyrizi's immunosuppressant effects. Probiotics containing live bacteria may also pose an infection risk and should be discussed with a doctor. General vitamins and herbs typically have no reported interactions but require medical consultation.

Key Points

Avoid Immune-Boosting Supplements: Supplements that boost the immune system, such as Echinacea, Ginseng, and Elderberry, should be avoided while taking Skyrizi as they can interfere with its immunosuppressive action.
Steer Clear of Live Probiotics: Live probiotics contain bacteria or yeast that can cause infections in an immunocompromised state. Avoid them unless specifically approved by your doctor.
Limit Supplements Affecting Immunity: Supplements like glucosamine, known to affect the immune system, should be avoided due to the increased risk of infection when combined with Skyrizi.
Consult Your Doctor on All Supplements: Always consult your healthcare provider or pharmacist before taking any new supplement, including multivitamins or Vitamin D, as potential interactions may exist.
Prioritize Third-Party Certified Supplements: If taking a doctor-approved supplement, look for third-party certification (e.g., USP) for assurance of quality and purity, though this does not replace medical advice.
Inform Your Healthcare Team: Keep your doctor and pharmacist updated on all medications, herbs, and supplements you use to prevent harmful interactions.

Understanding Skyrizi and Its Mechanism

Skyrizi, an injectable biologic medication, is prescribed to treat certain autoimmune disorders, including plaque psoriasis, psoriatic arthritis, and Crohn's disease. It functions by blocking interleukin-23 (IL-23), a protein that plays a key role in the inflammatory response associated with these conditions. By reducing IL-23 activity, Skyrizi effectively calms an overactive immune system and reduces symptoms. However, this immunosuppressive effect also means that your body's ability to fight infections is reduced. This is the primary reason why certain supplements that either stimulate or further suppress the immune system must be avoided.

Immune-Modulating Supplements to Avoid

One of the most critical categories of supplements to avoid while on Skyrizi are those that affect the immune system. Taking supplements that boost immune function can counteract the therapeutic effects of Skyrizi, potentially worsening the symptoms of your autoimmune condition. Conversely, supplements that further weaken the immune system can put you at a greater risk of developing serious infections.

Immune-Boosting Herbal Supplements

Certain herbs are widely marketed for their immune-boosting properties. These should be strictly avoided with Skyrizi:

Echinacea: A popular herbal remedy, Echinacea is known for its ability to stimulate the immune system. This directly conflicts with the intended immunosuppressive action of Skyrizi and could worsen your condition.
Ginseng: Often used to enhance immunity and energy, ginseng can also ramp up immune activity, potentially interfering with Skyrizi's effectiveness.
Elderberry: Touted for its antiviral and immune-stimulating properties, elderberry should be avoided. The goal of Skyrizi is to dampen the immune response, not heighten it.
Spirulina: This blue-green algae is a common supplement that may stimulate the immune system. It should be avoided to prevent compromising your treatment.

Other Immune-Affecting Supplements

In addition to the herbal remedies, other common supplements also pose a risk:

Melatonin: While commonly used for sleep, melatonin can have effects on the immune system and should be avoided unless explicitly approved by your doctor.
Probiotics with Live Cultures: High doses of probiotics containing live bacteria or yeast, such as Lactobacillus acidophilus, can potentially introduce an infection in an immunosuppressed individual. While beneficial for those with a healthy immune system, the risk of developing a rare infection means they should be avoided unless your doctor specifically recommends them.
Glucosamine: This supplement, commonly taken for joint pain, is another example of an over-the-counter product that can affect the immune system. Taking it with Skyrizi may increase your risk of infections.

Supplements that Require Medical Consultation

For many common vitamins and minerals, there are no specific reports of interactions with Skyrizi. However, this does not mean they are entirely safe, as future reports may reveal new interactions. Given the seriousness of compromising your treatment, it is essential to discuss all supplements with your healthcare team before starting them. This includes standard multivitamins, Vitamin D, and fish oil. A healthcare provider can assess your individual risk and determine if a supplement is safe for your specific situation.

Importance of Third-Party Certified Supplements

The FDA does not regulate supplements for safety and effectiveness in the same way as prescription medications. Therefore, the labels on these products are not always accurate regarding ingredients and dosage. To mitigate some risk, always look for supplements with third-party certifications, such as a United States Pharmacopeia (USP) seal. This indicates that the product has been tested for quality and purity, though it still does not guarantee a lack of interaction with your prescription medication.

Comparison of Supplement Types and Associated Risks with Skyrizi


Supplement Type	Examples	Potential Risk	Doctor Consultation	Status	Citation
Immune-Boosting Herbs	Echinacea, Ginseng, Elderberry, Spirulina	Counteracts Skyrizi's immunosuppressant effect, potentially worsening autoimmune disease symptoms.	REQUIRED	AVOID
Live Probiotics	Lactobacillus acidophilus, Brewer's Yeast	Increased risk of infection due to the presence of live bacteria/yeast in an immunocompromised state.	REQUIRED	AVOID/DISCUSS
General Immunosuppressants	Glucosamine	Increases the risk of infections when combined with Skyrizi's immunosuppressive action.	REQUIRED	AVOID
Immune-Modulating Hormones	Melatonin	Potential impact on the immune system, which could interfere with treatment.	REQUIRED	AVOID/DISCUSS
Standard Vitamins/Minerals	Vitamin D, Multivitamins, Fish Oil	No specific interactions reported, but potential for unknown or future interactions.	HIGHLY RECOMMENDED	DISCUSS
Cannabis/CBD	Cannabis, CBD oil	No specific interactions reported, but requires discussion with a doctor due to federal status and potential effects on treatment adherence.	REQUIRED	DISCUSS

The Critical Importance of Professional Guidance

The most important takeaway is that no supplement should be taken while on Skyrizi without first consulting your doctor or pharmacist. Even if a supplement seems harmless, its ingredients could have unexpected effects on your immune system, especially given that Skyrizi is a powerful biologic medication. A medical professional is best equipped to evaluate the risk of potential interactions and to determine if any supplement is truly necessary or safe for you.

Furthermore, always inform your healthcare providers about all medications, vitamins, herbs, and supplements you are taking. This practice is crucial for managing your overall health and preventing potential complications. Your doctor or pharmacist can help you create and maintain an updated medication list, which is an invaluable tool for ensuring your safety while undergoing treatment with Skyrizi.

Conclusion

While on Skyrizi, a biologic medication that suppresses the immune system, it is vital to avoid certain supplements that affect immune function. Immune-boosting herbs like Echinacea, Ginseng, Elderberry, and Spirulina are contraindicated, as are high-dose live probiotics and supplements like glucosamine. For all other over-the-counter products, including standard vitamins, a mandatory discussion with your healthcare provider is the safest course of action. This proactive approach minimizes the risk of infection and preserves the effectiveness of your Skyrizi treatment. Never start a new supplement without professional medical guidance.

For more information, refer to the official prescribing information from RxAbbVie.

Frequently Asked Questions

No, you should not take Echinacea while on Skyrizi. Echinacea is known to boost the immune system, which directly counteracts the immunosuppressive effect of Skyrizi and could worsen your autoimmune condition.

You should avoid taking probiotics with live bacteria or yeast, such as those with Lactobacillus acidophilus, while on Skyrizi unless approved by your doctor. In an immunocompromised state, these can pose an increased risk of rare infections.

While there are no specific reports of interactions between Skyrizi and standard vitamins like Vitamin D, it is crucial to consult your healthcare provider or pharmacist before taking any vitamin supplement. They can assess your specific situation and ensure it is safe.

No, you should avoid herbal supplements like Ginseng and Elderberry. These are known to affect or stimulate the immune system and could interfere with your Skyrizi treatment.

Combining supplements with Skyrizi can pose two main risks: either the supplement boosts the immune system, rendering Skyrizi less effective, or it further suppresses the immune system, significantly increasing your risk of infections.

Yes, absolutely. It is important to disclose all prescription medications, over-the-counter drugs, vitamins, and herbal supplements you take to your healthcare team. This information helps them monitor for potential interactions and ensure your safety.

Because the FDA does not regulate supplements in the same way as prescription drugs, you should look for products with third-party certifications like the United States Pharmacopeia (USP) seal. This indicates the product has been tested for purity and quality.