Psoriasis Treatments
PSORIASIS TREATMENTS

These medications are not recommended for children and should be used for adults ≥18yrs old, unless otherwise specified.

Generic Brand Form Adult Dose
TOPICAL
Corticosteroids
betamethasone dipropionate Sernivo spray Apply twice daily for up to max 4wks. Discontinue when control is achieved.
clobetasol propionate Impoyz crm Apply twice daily; max 50g/week and 2 consecutive weeks’ treatment per course. Discontinue when control is achieved.
Olux foam Apply twice daily; max 50g/week or 21 capfuls/week and 2 consecutive weeks’ treatment per course. Discontinue when control is achieved.
halobetasol propionate Bryhali lotion Apply once daily for up to 8wks; max 50g/week. Discontinue when control is achieved.
Lexette foam Apply twice daily for up to 2wks; max 50g/week. Discontinue when control is achieved.
Others
calcipotriene Dovonex crm Apply twice daily; gently rub in completely.
Sorilux foam ≥12yrs: apply twice daily; gently rub in completely. Apply to scalp when hair is dry.
calcipotriene + betamethasone dipropionate Enstilar foam ≥12yrs: apply once daily for up to 4wks; max 60g every 4 days. Discontinue when control is achieved.
Taclonex 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.
calcitriol Vectical oint Apply twice daily in AM & PM; max 200g/week.
halobetasol propionate + tazarotene Duobrii lotion Apply once daily; max 50g/week. Discontinue when control is achieved.
tazarotene Tazorac 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 soln for SC inj 12–17yrs: 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 soln for SC inj 210mg SC at Weeks 0, 1, and 2, then 210mg every 2wks.
ixekizumab Taltz 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 soln or lyophilized pwd for SC inj 300mg (given as two 150mg SC injs) 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 soln for SC inj 100mg SC at Weeks 0 and 4, then every 8wks thereafter.
risankizumab-rzaa Skyrizi soln for SC inj 150mg (two 75mg SC injs) at Weeks 0 and 4, then every 12wks thereafter.
tildrakizumab-asmn Ilumya soln for SC inj 100mg SC at Weeks 0 and 4, then every 12wks thereafter.
Psoralen1
methoxsalen2 8-MOP hard gel caps Take 8-MOP 2hrs before or Oxsoralen-Ultra 1.5–2hrs before UVA exposure with low fat food or milk. (<30kg): 10mg; (30–50kg): 20mg; (51–65kg): 30mg; (66–80kg): 40mg; (81–90kg): 50mg; (91–115kg): 60mg; (>115kg): 70mg.
Oxsoralen-Ultra soft gel caps
Tumor necrosis factor (TNF) blockers1
adalimumab Humira soln for SC inj Initially 80mg SC, followed by 40mg every other week 1wk after initial dose.
certolizumab pegol Cimzia 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 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

lyophilized pwd for IV infusion

5mg/kg IV over ≥2hrs at Weeks 0, 2, 6, then once every 8wks.

infliximab-abda Renflexis
infliximab-dyyb Inflectra
Others
acitretin Soriatane caps 25–50mg once daily with main meal; may discontinue when lesions resolve. May repeat if relapse occurs.
apremilast Otezla 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 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.
Neoral3
methotrexate Otrexup 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 <10mg/wk or >25mg/wk, high-dose regimens, or dose adjustments <5mg increments.
Rasuvo
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.

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. 9/2019)

This article originally appeared on MPR