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Skyrizi (risankizumab) is a biologic medication used to treat plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis by targeting a specific part of the immune system.

If you’ve been prescribed Skyrizi or are considering it as a treatment option, understanding how the dosing schedule works is essential for managing your condition effectively.

This guide breaks down everything you need to know about Skyrizi dosing, from the initial loading doses to ongoing maintenance injections. You’ll also learn how Skyrizi is administered, how to stay on track with your schedule, and what to do if you miss a dose.

Key Takeaways

  • Skyrizi is available as both intravenous infusions and subcutaneous injections, with the form and dosage depending on the condition being treated.
  • Crohn’s disease and ulcerative colitis start with IV infusions before transitioning to subcutaneous injections, while plaque psoriasis and psoriatic arthritis are treated only with subcutaneous injections.
  • Skyrizi follows specific induction and maintenance phases, requiring careful adherence to the schedule for each condition to ensure effectiveness.
  • After the induction phase, many patients can transition to self-injections using prefilled syringes or an on-body injector, but proper guidance from a healthcare provider is necessary.
  • Patients need TB screening, liver function tests, and vaccination updates before starting Skyrizi to minimize risks associated with immunosuppression.

Dosage Strengths of Skyrizi

Skyrizi is available in multiple dosage strengths and forms, designed for either subcutaneous injection or intravenous (IV) infusion. Your doctor will determine the right option based on your treatment plan.

Subcutaneous Injection

For self-administration or administration by a healthcare provider, Skyrizi is available in the following subcutaneous formulations:

    • 150 mg/mL in a single-dose prefilled pen
    • 90 mg/mL in a single-dose prefilled syringe
    • 150 mg/mL in a single-dose prefilled syringe
    • 180 mg/1.2 mL (150 mg/mL) in a single-dose prefilled cartridge with a supplied on-body injector
    • 360 mg/2.4 mL (150 mg/mL) in a single-dose prefilled cartridge with a supplied on-body injector

These injection options are typically used for maintenance dosing after your initial IV treatment phase.

Intravenous Infusion

If you’re just starting treatment, your doctor may begin with an intravenous infusion before switching to subcutaneous injections. Skyrizi’s IV formulation is 600 mg/10 mL (60 mg/mL) in a single-dose vial. This form is given at a medical facility under the supervision of a healthcare provider.

Before You Start Skyrizi

Before your first Skyrizi dose, your doctor will need to:

    • Check your liver function by testing liver enzymes and bilirubin levels if you’re being treated for Crohn’s disease or ulcerative colitis. Liver problems, including drug-induced liver injury, have been reported with intravenous Skyrizi.
    • Screen for tuberculosis (TB) to make sure you don’t have an active or latent infection. Since Skyrizi weakens the immune system, a latent TB infection could become active.
    • Ensure your vaccinations are up to date. Certain live vaccines (e.g., measles, mumps, rubella, and yellow fever) are not recommended once you start Skyrizi, as they contain weakened viruses that require a healthy immune response to work safely.

Skyrizi Dosing Schedule

Below are the Skyrizi dosing instructions for each approved indication, along with essential administration guidelines to ensure safe and effective use.

For Plaque Psoriasis & Psoriatic Arthritis

The recommended dosage of Skyrizi is 150 mg, administered as a subcutaneous injection (prefilled pen or syringe). After the first dose, a second dose is given four weeks later. After that, the injection is scheduled once every 12 weeks for ongoing maintenance.

In psoriatic arthritis, Skyrizi can be used alone or in combination with non-biologic DMARDs (disease-modifying antirheumatic drugs) such as methotrexate.

Since Skyrizi is stored in the refrigerator, allow it to reach room temperature before injecting. This helps prevent discomfort and ensures proper medication absorption.

    • Prefilled Pen: wait for 30 to 90 minutes
    • Prefilled Syringe: wait for 15 to 30 minutes

Do not heat the medication artificially (e.g., microwaving or placing it in hot water), as this can degrade its effectiveness.

The best sites for injection are the thigh or abdomen. Avoid injecting into bruised, tender, or irritated skin to reduce discomfort and the risk of poor absorption.

For Crohn’s Disease

For Crohn’s disease, Skyrizi is administered according to the following schedule:

Phase Dosage Administration Method Timing Additional Notes
Induction Phase 600 mg per infusion IV infusion (into a vein)
  • Week 0 (first infusion)
  • Week 4 (second infusion)
  • Week 8 (third infusion)
 Each infusion lasts at least one hour and is given at a medical facility
Maintenance Phase 180 mg or 360 mg (based on response) Subcutaneous injection (under the skin), prefilled syringe or cartridge with supplied on-body injector
  • First maintenance dose at Week 12 (four weeks after the last induction infusion)
  • Then, every 8 weeks thereafter
 A healthcare professional will guide you through the first use. Once trained, you can self-inject at home.

For Ulcerative Colitis

For the treatment of ulcerative colitis, Skyrizi is administered with this schedule:

Phase Dosage Administration Method Timing Additional Notes
Induction Phase 1,200 mg per infusion IV infusion (into a vein)
  • Week 0 (first infusion)
  • Week 4 (second infusion)
  • Week 8 (third infusion)
 Each infusion lasts at least two hours and is given at a medical facility
Maintenance Phase 180 mg or 360 mg (based on response) Subcutaneous injection (under the skin), prefilled syringe or cartridge with supplied on-body injector
  • First maintenance dose at Week 12 (four weeks after the last induction infusion)
  • Then, every 8 weeks thereafter
 A healthcare professional will guide you through the first use. Once trained, you can self-inject at home.

How to Self-Inject Skyrizi at Home (For Maintenance)

After completing the induction phase, you’ll transition to maintenance therapy, where Skyrizi is administered as a subcutaneous injection. You have two options for how to receive your injections:

1. Using the On-Body Injector with a Prefilled Cartridge

The On-Body Injector is a wearable device that delivers Skyrizi automatically. It contains a prefilled cartridge with either 180 mg (1.2 mL) or 360 mg (2.4 mL) of medication. Steps for proper use include:

    • Let it warm up: Take the carton out of the refrigerator and let it sit at room temperature for 45 to 90 minutes. Do not remove the cartridge or injector from the carton until you’re ready to use it.
    • Start the injection within 5 minutes: Once you insert the prefilled cartridge, begin the injection within 5 minutes to ensure proper delivery.

To prevent potential disruptions, it’s important to keep electronic devices, including cell phones, at least 12 inches (30 cm) away from the On-Body Injector during use. Electronic interference from nearby devices could impact its performance, possibly leading to a missed or incomplete dose.

The device should also never be exposed to an MRI (Magnetic Resonance Imaging) environment, as strong magnetic fields could cause it to malfunction. When using the injector near other electrical equipment, monitor its operation to ensure everything functions properly.

2. Using the Prefilled Syringe (90 mg/mL)

The prefilled syringe contains 90 mg of Skyrizi per mL and is injected under the skin. Since the full dose requires multiple syringes, you’ll need to inject more than once, depending on your prescribed dosage.

Here’s how to properly administer the Skyrizi prefilled syringe:

    • Let it warm up: Take the carton from the fridge and let it sit for 15 to 30 minutes before injecting. Keep the syringes inside the carton until you’re ready to use them.
    • For a 180 mg dose: You’ll need two 90 mg syringes. Inject one after the other in different locations (such as different areas of your thighs or abdomen).
    • For a 360 mg dose: You’ll need four 90 mg syringes, injecting each one in a separate spot.

Recommended injection sites for both the On-Body Injector and syringe include the thigh and abdomen. Avoid areas that are bruised, tender, or irritated to minimize discomfort and ensure proper absorption.

What to Do If You Miss a Dose of Skyrizi

Since Skyrizi is injected only a few times a year, it’s easy to forget a dose.

If you miss a dose of Skyrizi, take it as soon as possible. After administering the missed dose, resume your regular dosing schedule. Do not take two doses at once to make up for a missed injection.

If you miss a scheduled IV infusion during the induction phase, contact your healthcare provider immediately to reschedule. These infusions are critical for achieving full therapeutic benefits, and delaying them could impact treatment effectiveness.

Your doctor will determine the best way to adjust your schedule. Do not attempt to take a double dose or change the timing on your own.

What to Do If You Take Too Much Skyrizi

Although rare, if you accidentally take too much Skyrizi, contact your healthcare provider or call the Poison Help Line at 1-800-222-1222 immediately. If you experience severe side effects, such as signs of infection or immune system complications, seek emergency medical care at the nearest hospital.

To prevent accidental overdoses, store your medication in its original container and use it exactly as prescribed by your healthcare provider.

Takeaway

Skyrizi is available in different forms and dosages. For Crohn’s disease and ulcerative colitis, treatment begins with IV infusions before switching to subcutaneous injections for maintenance. For plaque psoriasis and psoriatic arthritis, only subcutaneous injections are used. Follow the proper preparation steps and choose the right injection sites for the best results.

Make sure to complete any required screenings before starting treatment and stick to your prescribed dosing schedule. Staying on track with your treatment plan helps ensure safe and effective results.

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Frequently Asked Questions

Improvement from Skyrizi can be noticed within four weeks, but significant results may take 16 weeks or longer. Individual responses vary, with some patients experiencing relief sooner. Clinical trials show that many achieve clearer skin by week 16.

Yes, Skyrizi should be stored in the refrigerator between 36°F and 46°F (2°C-8°C). It should not be frozen, and before injecting, it can be left at room temperature for up to 90 minutes.

Avoid live vaccines, as Skyrizi can weaken the immune system. It’s also best to limit exposure to infections and discuss any new medications with your doctor to prevent interactions.

Long-term studies suggest Skyrizi is generally safe, but continuous monitoring is necessary. Since it affects the immune system, there is a risk of infections or other potential complications over time. Regular check-ups help ensure ongoing safety.

Stopping Skyrizi should be discussed with a doctor, as discontinuing it may lead to symptom flare-ups. There are no specific guidelines on when to stop, but your doctor will assess your condition and risks before making a recommendation.

Signs of improvement include reduced redness, scaling, and skin plaques in psoriasis patients or decreased symptoms in Crohn’s disease. Visible changes are often noticeable by week 16, but symptom relief can begin as early as four weeks.

Sources

Learn more about SKYRIZI® (risankizumab?rzaa). (n.d.). https://www.skyrizi.com/

AbbVie Inc. (2024). HIGHLIGHTS OF PRESCRIBING INFORMATION OF SKYRIZI. https://www.rxabbvie.com/pdf/skyrizi_pi.pdf