How does this medication work? What will it do for me?

Ixekizumab belongs to the class of medications called immunomodulators. It is used to treat adults and children 6 years of age and older with moderate-to-severe plaque psoriasis. It is also used to treat adults with active psoriatic arthritis, active ankylosing spondylitis, and active non-radiographic axial spondyloarthritis, a type of arthritis in the spine, that have not responded to other medications, or when other medications are not appropriate or tolerated.

For people with psoriasis, ankylosing spondylitis, or spondyloarthritis, the body overproduces a protein called interleukin-17A (IL-17A). Increased levels of this protein can result in inflammation, itching, pain, stiffness, and scaling. Ixekizumab recognizes this protein and blocks its action, reducing the symptoms of these diseases.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each 1 mL of clear and colourless-to-slightly-yellow, sterile solution for subcutaneous injection contains 80 mg of ixekizumab. Nonmedicinal ingredients: polysorbate 80, sucrose and water for injection. Sodium hydroxide may be added to adjust pH.

This medication is supplied as a sterile solution in a single-use, prefilled autoinjector with a 27-gauge fixed ½ inch needle or a single-use, prefilled syringe with a 27-gauge fixed ½ inch needle.

How should I use this medication?

Plaque psoriasis: The recommended starting dose of ixekizumab for adults is 160 mg (given as 2 injections of 80 mg) injected subcutaneously (under the skin) once. After this starting dose, 80 mg is injected subcutaneously every 2 weeks for 12 weeks (6 doses). After the first 12 weeks, 80 mg is injected every 4 weeks.

The dose for children is based on body weight. Your doctor will determine the correct dose for your child. After the initial dose, injections are given every 4 weeks.

Psoriatic arthritis: The recommended starting dose of ixekizumab is 160 mg (given as two injections of 80 mg) injected subcutaneously (under the skin) once. After this starting dose, 80 mg is injected subcutaneously every 4 weeks.

Ankylosing spondylitis and non-radiographic axial spondyloarthritis: The recommended dosage of ixekizumab is 80 mg injected subcutaneously (under the skin) every 4 weeks.

Ixekizumab is administered by subcutaneous injection in the thigh, buttocks, or abdomen. It is important to rotate the site of injection in order to minimize the risk of fat wasting at the site of injection. If possible, avoid injecting into areas that are affected by psoriasis.

Do not shake this medication before using it. The solution for injection should be clear and colourless to slightly yellow. If it is brown or you can see particles in the solution, do not use it. Allow the medication to warm to room temperature for 30 minutes before you inject it.

If you are using this medication at home, your doctor will ensure that you understand exactly how to use it. Make sure you ask any and all questions necessary to ensure that you use it exactly as prescribed. Please refer to the appropriate package insert for details on proper injection procedures. It is important to visit your doctor regularly during therapy to ensure that the medication is working safely and effectively.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you are receiving this medication at your doctor's office and miss an appointment to receive ixekizumab, contact your doctor as soon as possible to reschedule your appointment.

Store this medication in the refrigerator, protect it from light and moisture, and keep it out of the reach of children. Do not allow this medication to freeze. If necessary, this medication may be left out of the refrigerator for up to 5 days, but should be discarded if not used within this 5-day period.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you are allergic to ixekizumab or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • cold-like symptoms (e.g., sore throat, runny nose)
  • eczema (e.g., dry, flaky skin; red, irritated patches of skin)
  • flu-like symptoms (e.g., sudden lack of energy, fever, cough, sore throat)
  • headache
  • diarrhea
  • injection site reactions (e.g., rash, pain, itching, swelling)
  • itching
  • stomach pain
  • nausea
  • runny nose

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • athlete's foot
  • eye infection or irritation (e.g., discharge with itching, redness, swelling, pain, or blurred vision)
  • hives
  • itchy rash
  • signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • symptoms of inflammatory bowel disease (e.g., stomach pain, diarrhea with or without blood, weight loss)
  • thrush (white patches in the mouth)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: As with other similar medications, it is possible to experience a severe allergic reaction with ixekizumab. Signs of an allergic reaction include a severe rash, hives, swollen face or throat, or difficulty breathing. If these occur, contact your doctor immediately.

Inflammatory bowel disease: If you have Crohn's disease or ulcerative colitis, this medication may make symptoms of your condition worse. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infections: This medication can increase the risk of developing an infection, including serious infections such as tuberculosis. Before starting ixekizumab treatment, your doctor may test to see if you have tuberculosis. If you notice signs of an infection such as fever, chills, pain, swelling, or coughing, contact your doctor as soon as possible. This medication should also not be started while you have an active infection.

Tell your doctor if you have a history of infections that keep coming back, or other conditions that might increase your risk of infections such as diabetes. While you are taking ixekizumab, your doctor will monitor you for signs of infection.

Vaccines: Before starting this medication, all your immunizations should be up to date. Live vaccines (e.g., BCG, yellow fever) are not recommended for people taking this medication. Talk to your doctor if you need any vaccinations while taking this medication.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known whether ixekizumab passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under the age of 6 years for the treatment of plaque psoriasis.  The safety and effectiveness of using this medication have not been established for children under the age of 18 years for the treatment of psoriatic arthritis, ankylosing spondylitis, or spondyloarthritis.

What other drugs could interact with this medication?

There may be an interaction between ixekizumab and any of the following:

  • medications that suppress the immune system:
    • corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
    • medications used to treat conditions such as cancer, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, or medications used after a transplant
  • vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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