Stelara (ustekinumab) is a brand-name injectable drug prescribed for certain autoimmune conditions. Stelara has interactions with some other drugs and certain vaccines. Examples include abatacept (Orencia) and the vaccine for measles, mumps, and rubella.
Stelara is prescribed for the following autoimmune conditions in certain situations:
- ulcerative colitis in adults
- Crohn’s disease in adults
- psoriatic arthritis in adults and children ages 6 years and older
- plaque psoriasis in adults and children ages 6 years and older
An interaction occurs when one substance causes another substance to have a different effect than expected.
Stelara is a monoclonal antibody. It comes as a solution for subcutaneous injection or intravenous (IV) infusion. These forms have the same interactions.
To learn more about Stelara’s interactions, keep reading. For additional information about Stelara, including details about its uses, see this article.
Before you start treatment with Stelara, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Stelara interacts with supplements, herbs, or vitamins, see the “Stelara and other interactions” section below.)
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with Stelara. Keep in mind that this table doesn’t include all drugs that may interact with Stelara. Some of these interactions are described in detail just below in “Drug interactions in depth.”
Drug class or drug name | Drug examples | Interaction result with Stelara |
---|---|---|
other monoclonal antibodies | • canakinumab (Ilaris) • sarilumab (Kevzara) • tocilizumab (Actemra) | can increase the risk of infections with Stelara and the monoclonal antibody |
certain Janus kinase (JAK) inhibitors | • upadacitinib (Rinvoq) • tofacitinib (Xeljanz, Xeljanz XR) • baricitinib (Olumiant) | can increase the risk of infections with Stelara and the JAK inhibitor |
allergy immunotherapy | • Timothy grass pollen allergen extract (Grastek) • peanut allergen powder (Palforzia) • house dust mite allergen extract (Odactra) | can make allergy immunotherapy less effective |
abatacept (Orencia) | — | can increase the risk of infections with Stelara and abatacept |
cyclosporine (Gengraf, Neoral, others) | — | may alter the effect of cyclosporine |
warfarin (Jantoven) | — | may alter the effect of warfarin |
In some cases, factors or conditions could prevent your doctor from prescribing Stelara due to the risk of harm. These are known as contraindications. The contraindications of Stelara include:
Having had an allergic reaction to Stelara or any of its ingredients
If you have had an allergic reaction to Stelara or any of its ingredients, your doctor will likely not prescribe Stelara. Receiving the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
Note: Before you start treatment with Stelara, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Stelara.
There aren’t any known interactions between Stelara and alcohol.
However, alcohol may worsen symptoms of the condition you’re receiving Stelara to treat. For example, consuming alcohol may worsen symptoms of plaque psoriasis, ulcerative colitis, and Crohn’s disease.
For these reasons, your doctor may advise you to avoid or limit alcohol consumption while you’re receiving the drug.
If you have questions about drinking alcohol during Stelara treatment, talk with your doctor.
Here’s a closer look at certain drug interactions of Stelara.
Other monoclonal antibodies
As with Stelara, other monoclonal antibodies are prescribed for certain autoimmune conditions. Examples include rheumatoid arthritis and juvenile idiopathic arthritis.
Interaction result: Treatment with Stelara and other monoclonal antibodies can increase the risk of infection from either medication.
Interaction explained: Stelara and other monoclonal antibodies can weaken your immune system and increase the risk of infection when used individually. Treatment with these medications together further increases this risk.
Examples of monoclonal antibody drugs: Here are some monoclonal antibodies that may interact with Stelara:
Steps you or your doctor may take: Doctors won’t typically prescribe Stelara with other monoclonal antibodies.
Before starting Stelara, tell your doctor if you already take a monoclonal antibody. They can recommend which drug may be a better treatment option for you.
To learn more about Stelara and other monoclonal antibodies, talk with your doctor or pharmacist. For details about Stelara’s side effects, see this article.
Allergy immunotherapy
Allergy immunotherapy is used to help prevent allergic reactions to various substances, such as house dust mites and peanuts.
Interaction result: Receiving allergy immunotherapy during treatment with Stelara could make allergy immunotherapy less effective.
Interaction explained: Allergy immunotherapy contains small amounts of a substance that can trigger an allergic reaction in some people. The therapy is given gradually over time to help the immune system build up a tolerance to the substance. This helps reduce the severity of (or possibly prevent) an allergic reaction if you come in contact with the substance later.
Stelara may weaken your immune system and prevent your body from developing a tolerance to the allergen. This could also increase the risk of an allergic reaction to the substance in the immunotherapy.
Examples of allergy immunotherapies: Here are some allergy immunotherapies that may interact with Stelara:
- Timothy grass pollen allergen extract (Grastek)
- peanut allergen powder (Palforzia)
- house dust mite allergen extract (Odactra)
Steps you or your doctor may take: Before starting Stelara, tell your doctor about any allergy immunotherapy treatments you need. They’ll advise you on when it is safe to begin Stelara treatment or receive these treatments.
To learn more about Stelara and allergy immunotherapy, talk with your doctor or pharmacist.
Abatacept
Abatacept (Orencia) is prescribed for psoriatic arthritis and other autoimmune conditions.
Interaction result: Treatment with Stelara and abatacept can increase the risk of infection from either medication.
Interaction explained: When used individually, Stelara and abatacept may weaken your immune system and increase the risk of infection. Treatment with both medications together increases this risk even further.
Steps you or your doctor may take: Doctors won’t typically prescribe Stelara with abatacept.
Before starting treatment with Stelara, tell your doctor if you’ve been prescribed abatacept. They can help determine the treatment option that’s best for your condition.
To learn more about Stelara and abatacept, talk with your doctor or pharmacist. For details about Stelara’s side effects, see this article.
Stelara may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Stelara.
Stelara and supplements
It’s possible for drugs to interact with supplements such as vitamins and herbs.
Stelara and herbs
There are no specific reports of herbs interacting with Stelara. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Stelara treatment.
Stelara and vitamins
There are no specific reports of vitamins interacting with Stelara. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Stelara.
Stelara and food
There were no reports of food interactions with Stelara. If you’d like to learn more about eating certain foods during treatment with Stelara, talk with your doctor.
Stelara interactions with vaccines
Stelara is known to interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against.
When your immune system is healthy, live vaccines usually won’t cause infection. However, Stelara may weaken your immune system and prevent it from fighting the virus or bacterium in the vaccine. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to protect against.
Examples of live vaccines to avoid during Stelara treatment include:
- tuberculosis
- chickenpox
- measles, mumps, rubella (MMR)
- flu vaccine (nasal spray form)
Before starting Stelara, talk with your doctor or pharmacist about any vaccines you may need.
Stelara and lab tests
Stelara isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.
STELARA AND CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been reported to interact with Stelara. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Stelara. The impact of cannabis may affect how well you stick to your Stelara treatment plan.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with Stelara. Before you receive this drug, be sure to talk with your doctor about your health history. Stelara may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with Stelara include:
- Infection: Before starting Stelara treatment, tell your doctor if you have an infection. Also tell them about past infections you’ve had, including tuberculosis. Receiving Stelara may worsen infections or activate symptoms of certain infections you’ve had in the past. Your doctor may treat your infection and can recommend when it’s safe to start Stelara treatment.
- Cancer: Using Stelara may increase the risk of certain cancers, including skin cancer. It’s not known whether the drug is safe for people who’ve had cancer in the past. If you’ve ever had cancer, your doctor can advise whether Stelara is the right treatment option.
- Allergy to latex: If you have an allergy to latex, your doctor may not prescribe the form of Stelara that comes in a prefilled syringe. This is because the needle cover on these syringes contains latex. Your doctor can recommend other forms of Stelara to use instead.
- Allergic reaction: If you’ve had an allergic reaction to Stelara or any of its ingredients, your doctor will likely not prescribe Stelara. Receiving the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
- Breastfeeding: It’s not known whether it’s safe to use Stelara while breastfeeding. The drug passes into breast milk. However, there isn’t enough information to determine what effects Stelara may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before you start Stelara. They can talk with you about treatment options and ways to feed your child.
- Pregnancy: There haven’t been enough clinical trials to determine whether Stelara therapy is safe during pregnancy. If you’re pregnant or planning to become pregnant, tell your doctor before starting Stelara. They can advise you on the right treatment plan for you.
You can take certain steps to help prevent interactions with Stelara. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
- Let them know if you drink alcohol or use cannabis.
- Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
- Create a
medication list , which your doctor and pharmacist can help you fill out.
It’s also important to read the Stelara label and other
If Stelara doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
If you self-inject Stelara, you can help prevent interactions by using it exactly as your doctor prescribes. You can learn how Stelara is given in this article.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.