What is Siliq?

Siliq is a brand-name prescription medication. It's used to treat moderate to severe plaque psoriasis in adults. Plaque psoriasis is one of many kinds of psoriasis.

Siliq is a systemic treatment, which means it works throughout your body. Before your doctor can prescribe the drug, you must have already tried some form of systemic treatment or phototherapy, a type of light treatment.

Siliq contains brodalumab, which is a type of biologic (a drug made from parts of living organisms). Siliq is part of a group of medications called monoclonal antibodies.

Siliq comes in a single-use prefilled syringe. The drug is given as an injection under your skin (subcutaneous injection). Your doctor will first give you the injection. Then they can teach you how to give yourself injections at home.

Effectiveness

Siliq has been shown to be effective in clinical trials. After 12 weeks of treatment, 83% of people who took Siliq to treat plaque psoriasis had 75% clearer skin.

By week 12 of the study, plaque psoriasis symptoms cleared up by 100% in about 40% of people who took Siliq. And only about 1% of people who took a placebo (no treatment) saw their symptoms clear up by 100%. Symptoms cleared up by 75% in about 80% of people who took Siliq. This is compared to about 5% of people who took a placebo.

Of the people whose symptoms cleared by 100% by week 12, about 70% were still symptom-free by week 52 of the study.

FDA approval

In February 2017, the Food and Drug Administration (FDA) approved Siliq to treat moderate to severe plaque psoriasis in adults.

Siliq generic or biosimilar

Siliq is available only as a brand-name medication. It contains the active drug brodalumab.

Siliq isn't available in a biosimilar form. A biosimilar is a medication that's similar to a brand-name drug. A generic medication, on the other hand, is an exact copy of a brand-name drug. Biosimilars are based on biologic medications, which are made from parts of living organisms. Generics are based on regular medications created from chemicals.

Both biosimilars and generics are as effective and safe as the brand-name drug they're trying to copy. Also, they tend to cost less than brand-name drugs.

Siliq side effects

Siliq can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Siliq. These lists do not include all possible side effects.

For more information on the possible side effects of Siliq, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

More common side effects

The more common side effects of Siliq can include:

  • joint pain
  • muscle pain
  • mouth or throat pain
  • headache
  • feeling tired
  • diarrhea
  • nausea
  • flu
  • injection site reactions (redness and soreness around the spot where you had the injection)
  • low white blood cell count
  • fungal infections on your skin, such as athlete's foot
  • bacterial or viral infections, such as the flu and bronchitis

Most of these side effects may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Siliq aren't common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Suicidal thoughts and behavior.* Symptoms can include:
    • new or worsening depression
    • thoughts of hurting yourself
    • changes in your mood
    • anxiety
  • Crohn's disease (a type of inflammatory bowel disease in which you have swelling in your digestive tract). Symptoms can include:
  • Tuberculosis (TB), which is a type of lung disease. Symptoms can include:
    • fever
    • fatigue (lack of energy) that you can't explain
    • night sweats
  • Severe infections, such as meningitis (swelling of the brain and spinal cord). Symptoms can include:
    • fever
    • stiff neck
    • headache
* Siliq has a boxed warning forsuicidal thoughts and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warning" at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it.Here's some detail on some of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Siliq. Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Siliq. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency. Allergic reactions didn't occur in clinical trials.

Infections

You may be at an increased risk for developing an infection while taking Siliq.

In a 12-week study, about 25% of people who took Siliq developed an infection. This is compared to about 23% of people who took a placebo (no treatment). Most commonly, these infections included:

Most of the infections that occurred in the studies weren't serious and didn't stop people from taking Siliq. However, 0.5% of people who took Siliq did develop a serious infection. This was compared to 0.2% of people who took a placebo.

If you take Siliq and develop a fever, a serious infection, or an infection that doesn't go away, see your doctor right away. (Refer to the "Serious side effects" section above for symptoms of serious infections.)

Crohn's disease

It's not likely that you'll develop Crohn's disease while taking Siliq. However, in clinical studies of Siliq, one person did develop Crohn's disease. (Crohn's disease is a type of inflammatory bowel disease in which you have swelling in your digestive tract.)

If you're concerned about developing Crohn's disease during your Siliq treatment, talk with your doctor.

And if you already have Crohn's disease, you shouldn't take Siliq because the drug can make the condition worse. (See the "Siliq precautions" section below to learn more.) Your doctor can recommend treatments other than Siliq to help ease your symptoms.

Suicide prevention

  • If you know someone at immediate risk of self-harm, suicide, or hurting another person:
  • Call 911 or the local emergency number.
  • Stay with the person until professional help arrives.
  • Remove any weapons, medications, or other potentially harmful objects.
  • Listen to the person without judgment.
  • If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Siliq for psoriasis

The Food and Drug Administration (FDA) approves prescription drugs such as Siliq to treat certain conditions. Siliq may also be used off-label for other conditions. Off-label use is when a drug that's approved to treat one condition is used to treat a different condition.

The FDA has approved Siliq to treat moderate to severe plaque psoriasis in adults. Plaque psoriasis is the most common form of psoriasis, a condition that mostly affects your skin. With plaque psoriasis, you may have raised, red patches on your scalp, knees, elbows, and back. The patches, which are also known as plaques, can be itchy and painful.

Your doctor will diagnose you with moderate to severe plaque psoriasis if the plaques cover more than 3% of your body surface. For reference, one of your hands (including your palm and all five fingers) makes up 1% of your body surface.

Your doctor may prescribe Siliq if they think your plaque psoriasis would benefit from:

  • Systemic treatment, which is medication that you take by mouth or as an injection. These medications work on your entire body, not just affected areas.
  • Phototherapy, a type of ultraviolet light treatment that works on areas of your body that are affected by psoriasis

Before trying systemic or phototherapy, you may have already used creams or topical treatments that didn't work for your symptoms.

And you must have already tried some form of systemic treatment before your doctor can prescribe Siliq.

In clinical trials that lasted 12 weeks, symptoms of plaque psoriasis cleared up by 75% in about 80% people who took Siliq. This was compared to about 5% of people taking placebos.

Siliq for other uses

In addition to the FDA-approved use listed above, Siliq may be used off-label to treat other conditions. Off-label use is when a drug that's approved to treat one condition is used to treat a different condition.

Siliq for psoriatic arthritis (off-label use)

Siliq is sometimes used off-label to help treat psoriatic arthritis. This is a type of arthritis (joint swelling) that can develop in people with psoriasis.

Siliq is being tested in clinical trials of people with psoriatic arthritis. These trials look at how safe a drug is and how well it works. If the trials are a success, the FDA may approve Siliq to treat psoriatic arthritis in the future.

Siliq cost

As with all medications, the cost of Siliq can vary. To find current prices for Siliq in your area, check out GoodRx.com:

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you'll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial assistance

If you need financial support to pay for Siliq, help is available. Bausch Health Companies Inc., the manufacturer of Siliq, offers a program called Siliq Solutions, which may help lower the cost of the drug. For more information and to find out if you're eligible for support, call 855-RX-SILIQ (855-797-4547) or visit the program website.

Siliq dosage

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Siliq comes in a single-use prefilled syringe. The drug is given as an injection under your skin (subcutaneous injection). Your doctor or healthcare provider will first give you the injection. Then they can teach you how to give yourself injections at home.

One syringe contains 210 mg of Siliq in 1.5 mL of solution (liquid).

Dosage for plaque psoriasis

The recommended dose of Siliq for plaque psoriasis is one 210-mg injection.

For the first three weeks of treatment, you'll receive one dose each week. After your third dose, you only need to get one dose every two weeks.

What if I miss a dose?

If you miss a dose of Siliq, take it as soon as you remember. But if it's near the time for your next dose, call your doctor or pharmacist for advice. Never take two doses of Siliq in the same day.

To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Siliq is meant to be used as a long-term treatment. If you and your doctor determine that Siliq is safe and effective for you, you'll likely take it long term.

If your symptoms don't ease after taking Siliq for 12 to 16 weeks, talk with your doctor. They may have you stop taking the drug and recommend another treatment. In clinical studies, if Siliq didn't help ease symptoms by 12 to 16 weeks, it was unlikely that the drug would work at all.

Siliq and alcohol

There's currently no known interaction between alcohol and Siliq. However, drinking alcohol can make psoriasis worse by increasing inflammation (swelling). Heavy drinking can also make certain medications work less well and may worsen psoriasis symptoms overall.

If you drink alcohol, talk with your doctor about how much is safe for you.

Siliq interactions

Siliq can interact with several other medications.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Siliq and other medications

Below is a list of medications that can interact with Siliq. This list doesn't contain all drugs that may interact with Siliq.

Before taking Siliq, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Siliq and certain CYP450 substrates

Cytochrome P450 (CYP450) is an enzyme that helps your body break down certain drugs. Taking Siliq with certain CYP450 substrates (medications that affect CYP450) may increase or decrease the level of these medications in your body. This can lead to serious side effects such as kidney problems and changes in blood pressure.

Examples of CYP450 substrates that Siliq may affect include:

  • cyclosporine (Gengraf, Neoral, Sandimmune)
  • warfarin (Coumadin, Jantoven)

If you're taking a CYP450 substrate and Siliq, your doctor may monitor the levels of the medication in your body. They may also change the dosage if needed.

Siliq and certain seizure medications

Siliq can increase the amount of certain seizure medications in your body. This can make side effects from these seizure drugs more severe.

Examples of seizure medications that Siliq may be affect include:

  • carbamazepine (Tegretol, Tegretol XR, Epitol)
  • ethosuximide (Zarontin)
  • fosphenytoin (Cerebyx)
  • phenytoin (Phenytek, Dilantin)

If you take seizure medication and Siliq, your doctor may give you extra tests and monitor you. This will help them decide whether your dose of seizure drugs needs to be changed.

Siliq and live vaccines

Getting a live vaccine while you're taking Siliq could lead to an infection.

Live vaccines contain a weakened form of a virus or bacteria. But they won't make you sick if you have a healthy immune system (your body's protection against disease).

Taking Siliq may weaken your immune system. So your body may not be able to fight the virus or bacteria in a live vaccine. As a result, you may develop an infection.

Examples of live vaccines include:

Before you take Siliq, ask your doctor if you need any live vaccines. They may want you to get the vaccines before you start your Siliq treatment.

Siliq and Olumiant

Taking Siliq with the rheumatoid arthritis drug baricitinib (Olumiant) may weaken your immune system. On their own, each drug may make your immune system weaker. So taking both medications together may make your body even less able to fight disease.

If you're taking Olumiant, talk with your doctor. They may be able to recommend a psoriasis treatment other than Siliq.

Siliq and aminophylline/theophylline

Taking Siliq with the drug aminophylline or theophylline may cause heart problems. Siliq can increase the amount of these two drugs your body, which may lead to an irregular heartbeat.

If you're taking aminophylline or theophylline, talk with your doctor. They may monitor your blood levels more often when you first start taking Siliq.

Siliq and tacrolimus

Taking Siliq with the medication tacrolimus may cause kidney problems. Siliq can increase levels of tacrolimus, and too much tacrolimus can harm your kidneys.

If you're taking tacrolimus and Siliq, it's very important that your doctor checks your tacrolimus levels during your Siliq treatment.

Siliq and herbs and supplements

There aren't any herbs or supplements that have been specifically reported to interact with Siliq. However, you should still check with your doctor or pharmacist before using any of these products while taking Siliq.

Alternatives to Siliq

Other drugs are available that can treat plaque psoriasis. Some may be better suited for you than others. If you're interested in finding an alternative to Siliq, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for plaque psoriasis

Examples of other drugs that can treat moderate to severe plaque psoriasis include:

  • adalimumab (Humira)
  • etanercept (Enbrel)
  • ustekinumab (Stelara)
  • secukinumab (Cosentyx)
  • guselkumab (Tremfya)
  • tilrakizumab (Ilumya)

Siliq vs. Humira

You may wonder how Siliq compares to other medications that are prescribed for similar uses. Here we look at how Siliq and Humira are alike and different.

Uses

The Food and Drug Administration (FDA) has approved both Siliq and Humira to treat moderate to severe plaque psoriasis in adults. Plaque psoriasis is one of many kinds of psoriasis.

Your doctor may prescribe either drug if they think systemic treatment or phototherapy would help you. Systemic treatment is medication that you take by mouth or as an injection, and it affects your entire body. Phototherapy is a type of light treatment. You must have already tried some form of systemic treatment.

Humira is also FDA-approved to treat:

If you have plaque psoriasis and another condition that Humira is approved for, Humira may be a better option for you. For example, Siliq isn't used to treat Crohn's disease. So if you have both plaque psoriasis and Crohn's disease, Humira may help treat both conditions.

Drug forms and administration

Siliq contains the drug brodalumab. Humira contains the drug adalimumab.

Siliq comes as a single-use prefilled syringe.* One syringe contains 210 mg of Siliq in 1.5 mL of solution (liquid).

Humira comes in three forms:

  • a single-use prefilled syringe (10 mg, 20 mg, 40 mg, or 80 mg)*
  • a single-use prefilled pen (40 mg or 80 mg)*
  • a single-use vial for injection by your healthcare provider (40 mg)

For the first three weeks of treatment with Siliq, you'll receive one dose each week. After your third dose, you only need to get one dose every two weeks.

For Humira, the first dose is 80 mg, followed by a dose of 40 mg one week later. After the first two doses, you'll take 40 mg of Humira every other week.

* The drug is given as an injection under your skin (subcutaneous injection). Your doctor or healthcare provider will first give you the injection. Then they can teach you how to give yourself injections at home.

Side effects and risks

Siliq and Humira are both in the same class of medications called monoclonal antibodies. However, Siliq and Humira have different main ingredients. Therefore, Siliq and Humira have some similar side effects and some different side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Siliq, with Humira, or with both drugs (when taken individually).

  • Can occur with Siliq:
    • mouth or throat pain
    • muscle pain
    • fungal infections on your skin, such as athlete's foot
    • low white blood cell count
    • feeling tired
  • Can occur with Humira:
  • Can occur with both Siliq and Humira:
    • headache
    • injection site reactions (redness and soreness around the spot where you had the injection)
    • minor allergic reactions
    • flu
    • joint pain
    • diarrhea
    • nausea

Serious side effects

These lists contain examples of serious side effects that can occur with Siliq, with Humira, or with both drugs (when taken individually).

  • Can occur with Siliq:
    • suicidal thoughts and behavior*
    • Crohn's disease, a type of inflammatory bowel disease in which you have swelling in your digestive tract
    • tuberculosis (TB), a type of lung disease
    • severe infections, such as meningitis (swelling of the brain and spinal cord)
  • Can occur with Humira:
    • certain types of cancer, such as lymphoma or skin cancer
    • new or worsening heart disorders, such as an irregular heartbeat or fast heartbeat
    • new or worsening blood disorders, such as increased red blood cells
    • new or worsening neurological disorders, such as tremors or confusion
    • new or worsening autoimmune disorders, such as lupus
    • serious infections, such as lung infections
  • Can occur with both Siliq and Humira:
    • severe allergic reactions
* Siliq has a boxed warning forsuicidal thoughts and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warning" at the beginning of this article.

Effectiveness

Siliq and Humira have different FDA-approved uses, but they're both used to treat moderate to severe plaque psoriasis.

These drugs haven't been directly compared in clinical studies, but studies have found both Siliq and Humira to be effective for treating moderate to severe plaque psoriasis.

Costs

Siliq and Humira are both brand-name drugs. Siliq isn't available in a biosimilar form. But Humira has three biosimilars: Amjevita, Cyltezo, and Hyrimoz. They may cost less than Humira and Siliq.

A biosimilar is a medication that's similar to a brand-name drug. A generic medication, on the other hand, is an exact copy of a brand-name drug. Biosimilars are based on biologic medications, which are made from parts of living organisms. Generics are based on regular medications created from chemicals. Both biosimilars and generics are as effective and safe as the brand-name drug they're trying to copy. Also, they tend to cost less than brand-name drugs.

According to estimates on GoodRx.com, Siliq generally costs more than Humira. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Siliq vs. Enbrel

Enbrel is another drug that has a use similar to that of Siliq. Here we look at how Siliq and Enbrel are alike and different.

Uses

The Food and Drug Administration (FDA) has approved both Siliq and Enbrel to treat moderate to severe plaque psoriasis. This is one of many kinds of psoriasis. Siliq should be used in adults only, while Enbrel can be used in people ages 4 years and older.

Your doctor may prescribe Siliq or Enbrel if they think systemic treatment or phototherapy would help you. Systemic treatment is medication that you take by mouth or as an injection, and it affects your entire body. Phototherapy is a type of light treatment. You must have already tried some form of systemic treatment.

Enbrel is also FDA-approved to treat:

If you have both plaque psoriasis and another condition that Enbrel is approved for, Enbrel may be a better option for you. For example, Siliq isn't approved to treat rheumatoid arthritis. So if you have both plaque psoriasis and rheumatoid arthritis, Enbrel may help treat both conditions.

Drug forms and administration

Siliq contains the drug brodalumab. Enbrel contains the drug etanercept.

Siliq comes as a single-use prefilled syringe. One syringe contains 210 mg of Siliq in 1.5 mL of solution (liquid).

Enbrel comes in three forms:

  • a single-dose prefilled syringe (25 mg or 50 mg)
  • a single-dose prefilled autoinjector (50 mg)
  • a single-use vial for injection by your healthcare provider (25 mg)

Both Siliq and Enbrel are given as an injection under your skin (subcutaneous injection). Your doctor or healthcare provider will first give you the injection. Then they can teach you how to give yourself injections at home.

You'll take a dose of Siliq every week for the first three weeks. After that, you'll take a dose every two weeks.

For Enbrel, you'll take a 50-mg dose twice a week for the first three months. After three months, you'll need only one 50-mg dose each week.

Doses for children vary and are usually based on weight.

Side effects and risks

Siliq and Enbrel have different active ingredients. Also, the two drugs don't work in the same way. Therefore, some of the side effects of Siliq and Enbrel are similar and some are different.

More common side effects

These lists contain examples of more common side effects that can occur with Siliq, with Enbrel, or with both drugs (when taken individually).

  • Can occur with Siliq:
    • joint pain
    • muscle pain
    • mouth or throat pain
    • headache
    • feeling tired
    • nausea
    • flu
    • low white blood cell count
  • Can occur with Enbrel:
    • rash
    • fever
    • itching
  • Can occur with both Siliq and Enbrel:
    • fungal infections on your skin such as athlete's foot
    • diarrhea
    • injection site reactions (redness and soreness around the spot where you had the injection)
    • minor allergic reactions

Serious side effects

These lists contain examples of serious side effects that can occur with Siliq, with Enbrel, or with both drugs (when taken individually).

  • Can occur with Siliq:
    • suicidal thoughts and behavior*
    • Crohn's disease, a type of inflammatory bowel disease in which you have swelling in your digestive tract
    • tuberculosis (TB), a type of lung disease
    • severe infections, such as meningitis (swelling of the brain and spinal cord)
  • Can occur with Enbrel:
    • neurologic reactions, such as seizure disorders
    • certain types of cancer, such as leukemia or lymphoma
    • weakened immune system
  • Can occur with both Siliq and Enbrel:
    • infections such as the flu (which can become serious)
    • severe allergic reactions
* Siliq has a boxed warning forsuicidal thoughts and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warning" at the beginning of this article.

Effectiveness

Siliq and Enbrel have different FDA-approved uses, but they're both used to treat moderate to severe plaque psoriasis.

These drugs haven't been directly compared in clinical studies, but studies have found both Siliq and Enbrel to be effective for treating moderate to severe plaque psoriasis.

Costs

Siliq and Enbrel are both brand-name drugs. There are currently no biosimilar forms of either drug.

A biosimilar is a medication that's similar to a brand-name drug. A generic medication, on the other hand, is an exact copy of a brand-name drug. Biosimilars are based on biologic medications, which are made from parts of living organisms. Generics are based on regular medications created from chemicals. Both biosimilars and generics are as effective and safe as the brand-name drug they're trying to copy. Also, they tend to cost less than brand-name drugs.

According to estimates on GoodRx.com, Siliq generally costs more than Enbrel. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

How to take Siliq

Siliq comes in a single-use prefilled syringe. The drug is given as an injection under your skin (subcutaneous injection). Your doctor or healthcare provider will first give you the injection. Then they can teach you how to give yourself injections at home.

Take Siliq out of the refrigerator about 30 minutes before you plan to take your dose. The drug will need to come to room temperature. Don't warm Siliq with a heat source such as hot water, a microwave, or the sun.

You can inject Siliq into your upper arm, thigh, or stomach area, except for a 2-inch area around your belly button. You shouldn't inject the drug into any area that's tender, bruised, scarred, or red. And never reuse or recycle syringes. (See the "Disposal" section below for how to dispose of syringes properly.)

You can find instructions and pictures of how to use Siliq on the drug's website. You can also watch a video on how to give yourself injections properly. These tips and directions can be helpful if you'll be giving yourself Siliq injections at home.

When to take

For the first three weeks of treatment, you'll receive one dose each week. After your third dose, you only need to get one dose every two weeks.

Medication reminders can help make sure that you don't miss a dose.

How Siliq works

Psoriasis is a condition that's occurs when your immune system (your body's protection against disease) is overactive. Your skin cells grow too quickly, so they build up and form red, scaly, thick patches. The patches, known as plaques, can occur anywhere on your body. Plaques most commonly occur on your elbows, knees, scalp, and back.

According to the National Psoriasis Foundation, about 2% to 3% of people in the United States develop psoriasis. Although psoriasis is a lifelong condition, you can manage it with proper treatment.

Siliq is a monoclonal antibody, which is a type of protein that affects your immune system. Specifically, Siliq blocks another protein called the interleukin-17 (IL-17) receptor. IL-17 is known to increase inflammation (swelling). By blocking IL-17, Siliq helps reducing inflammation, which helps clear up psoriasis plaques.

How long does it take to work?

It may take a few weeks for Siliq to build up in your body and start easing symptoms. Clinical trials studied people with plaque psoriasis who took Siliq. After 12 weeks of treatment, 83% of people had 75% clearer skin. This is compared to a placebo group, where only 5% of people had 75% clearer skin.

In clinical trials, if Siliq didn't help ease symptoms by 12 to 16 weeks, it was unlikely that the drug would work at all.

If you've been taking Siliq for 16 weeks and your symptoms haven't started to clear up, talk with your doctor. They may have you stop taking the drug and recommend another treatment.

Siliq and pregnancy

There haven't been any studies on the use of Siliq in pregnant women. However, Siliq is a type of protein that can cross the placenta from a mother to the baby. (The placenta is an organ that grows in your uterus while you're pregnant.) Therefore, taking Siliq while you're pregnant may affect your baby.

In an animal study, Siliq didn't cause any harm to the pregnant mother. But animal studies don't always predict what happens in humans.

If you're pregnant or planning to become pregnant, talk with your doctor. They can help you decide whether Siliq is right for you.

Siliq and breastfeeding

There haven't been any studies on Siliq and breastfeeding. So it's not known whether Siliq passes into human breast milk or how the drug may affect a baby who's being breastfed.

However, in an animal study, Siliq did pass into breast milk. The effects of this breast milk on the baby animal are still being studied. Keep in mind that animal studies don't always predict what happens in humans.

If you'd like to breastfeed your child while taking Siliq, talk with your doctor. Together, you create can a plan and decide if you should keep using the drug.

Common questions about Siliq

Here are answers to some frequently asked questions about Siliq.

What vaccines should I avoid if I'm taking Siliq?

Avoid getting any live vaccines while you take Siliq. Live vaccines contain a weakened form of a virus or bacteria. But they won't make you sick if you have a healthy immune system (your body's protection against disease). Taking Siliq may weaken your immune system. So if you get a live vaccine, your body may not be able to fight the virus or bacteria in the vaccine. As a result, you may develop an infection.

Examples of live vaccines include:

Before you take Siliq, ask your doctor if you need any live vaccines. They may want you to get the vaccines before you start your Siliq treatment.

Will I need any tests before I start using Siliq?

Yes. Before you start to take Siliq, your doctor will test you for tuberculosis (TB). Siliq may cause changes in your immune system (your body's protection against disease). So if you have a TB infection that's inactive (doesn't cause symptoms), Siliq can make it active (causes symptoms). A TB infection that's active can make you very sick.

If you've had TB in the past, your doctor may give you more tests. And if you currently have TB, your doctor will treat the TB before you can start taking Siliq.

Why can't I get Siliq at my regular pharmacy?

Some people who've taken Siliq have had suicidal thoughts and behavior,* and even died by suicide. Due to this risk, you can get Siliq only through certain specialty pharmacies. These pharmacies typically handle drugs that have special requirements. For Siliq, the specialty pharmacy needs to be registered with the Siliq REMS (Risk Evaluation and Mitigation Strategy) program.

The program helps make sure that you know about possible side effects of Siliq. The program also helps explain what to do in case you have any suicidal thoughts or behaviors. To use Siliq, both you and your doctor must be registered with the Siliq REMS program.

If you take Siliq, your doctor should give you a Siliq patient wallet card to carry with you. This card tells you about important symptoms and when you should get help right away. If you have questions about Siliq REMS program, talk with your doctor.

* Siliq has a boxed warning forsuicidal thoughts and behavior. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warning" at the beginning of this article.

Will I have to keep using topical creams for psoriasis during my Siliq treatment?

Maybe. Siliq is a systemic treatment. This means that it works on your immune system (your body's protection against disease) and reduces plaques on your entire body. Plaques are raised, red patches on your skin. Siliq helps prevent plaques from forming. The drug also helps clear up plaques by reducing the inflammation (swelling) in your body.

Like Siliq, topical creams help reduce plaques on your skin. But these creams don't keep plaques from forming.

If you develop plaques while taking Siliq, talk with your doctor about possibly using a topical cream as well.

Will Siliq cure my psoriasis?

No. Siliq isn't a cure for psoriasis, but the drug may help ease your symptoms. Psoriasis doesn't have a cure yet.

The goals of treating psoriasis are to:

  • ease inflammation (swelling)
  • help prevent skin cells from growing quickly
  • clear up plaques (raised, red patches on your skin)

If you have psoriasis, talk with your doctor. They can discuss the best treatment options with you.

Siliq precautions

This drug comes with several precautions.

FDA warning: Suicidal thoughts and behavior

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Some people who've taken Siliq have had suicidal thoughts and behavior, and even died by suicide. If you have such thoughts while taking the drug, tell your doctor right away. Also tell them if you have new or worsening depression, changes in mood, or anxiety.

Due to these risks, you can only get Siliq through the Siliq REMS (Risk Evaluation and Mitigation Strategy) program. The program helps make sure that you know about possible side effects of the drug. The Siliq REMS program also teaches you what to do if you have suicidal thoughts or behavior. If you have questions about this program, talk with your doctor.

Other precautions

Before taking Siliq, talk with your doctor about your health history. Siliq may not be right for you if you have certain medical conditions. These include:

Current infections

You shouldn't take Siliq if you have an infection. The drug can lower your body's ability to fight disease. So if you already have an infection, taking Siliq can make it worse. If you develop an infection while taking Siliq, talk with your doctor. They can help treat the infection and monitor you. Your doctor may also have you stop taking Siliq until the infection goes away.

Tuberculosis (TB)

If you have tuberculosis (TB), you shouldn't take Siliq because the drug may make the disease worse. Your doctor will likely treat the TB before you start taking the drug. To find out whether you have TB, your doctor will test you before you begin your Siliq treatment.

Immunizations

Don't get any live vaccines while taking Siliq. Getting a live vaccine while you're taking the drug could lead to an infection.

Live vaccines contain a weakened form of a virus or bacteria. But they won't make you sick if you have a healthy immune system (your body's protection against disease).

Taking Siliq may weaken your immune system. So your body may not be able to fight the virus or bacteria in a live vaccine. As a result, you may develop an infection.

Before you take Siliq, ask your doctor if you need any live vaccines. They may want you to get the vaccines before you start your Siliq treatment.

Crohn's disease

If you have Crohn's disease, Siliq isn't recommended. (Crohn's disease is a type of inflammatory bowel disease in which you have swelling in your digestive tract.) Siliq may make Crohn's disease worse. Talk with your doctor about other possible treatment options.

Note: For more information about the potential negative effects of Siliq, see the "Siliq side effects" section above.

Pregnancy

If you're pregnant or planning to become pregnant, you shouldn't take Siliq. This drug may affect your pregnancy. See the "Siliq and pregnancy" section above for more information.

Siliq overdose

Avoid taking more than the dosage of Siliq that your doctor prescribes.

What to do in case of overdose

If you think you've taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Siliq expiration, storage, and disposal

When you get Siliq from the pharmacy, the pharmacist will add an expiration date to the label on the box of syringes. This date is typically one year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Store Siliq in your refrigerator between 36°F to 46°F (2°C to 8°C) in its original carton. By keeping Siliq in the original carton, you're helping protect the medication from damage and light.

If you need to, you can store Siliq at room temperature (up to 77°F or 25°C) for up to 14 days. Once you remove the medication from the refrigerator and it comes to room temperature, don't put it back in the refrigerator. If the medication cannot be used within 14 days, it should be thrown out. Do not freeze or shake the contents of Siliq.

Disposal

If you no longer need to take Siliq and have leftover medication, it's important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Be sure to dispose of used Siliq syringes in an FDA-approved sharps container. Don't put syringes in your regular trash or recycling. You can find more information about safe sharps disposal on the FDA's website.

Professional information for Siliq

The following information is provided for clinicians and other healthcare professionals.

Indications

Siliq is indicated for moderate to severe plaque psoriasis in adults who are candidates for phototherapy or systemic therapy. Siliq is indicated in patients who have failed or stopped responding to other systemic treatments for their plaque psoriasis.

Mechanism of action

Siliq is a monoclonal IgG2 antibody that binds to and blocks Interleukin-17 receptor A (IL-17RA). Blocking IL-17RA inhibits production of IL-17 cytokines including IL-17A, IL17F, IL-17C, IL17A/F and IL-25. Inhibiting these interleukins stops the release of proinflammatory cytokines, which contribute to plaque formation.

Pharmacokinetics and metabolism

Peak plasma concentration is reached three days post 210-mg subcutaneous dose. Steady state is achieved by week four after subcutaneous doses of 210 mg every two weeks. After subcutaneous injection, bioavailability is about 55%.

Siliq shows nonlinear pharmacokinetics, where increases in drug exposure are not linearly related to an increase in dose.

Elimination is believed to occur through a similar mechanism as endogenous IgG. Siliq is likely broken down into small peptides and amino acids.

Contraindications

Siliq is contraindicated in patients with Crohn's disease.

Storage

Siliq should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C) in its original carton. Siliq can be stored at room temperature (up to a maximum of 77°F or 25°C) if needed for up to 14 days. Once the carton has been removed from the refrigerator and allowed to come to room temperature, it should not be placed back in the refrigerator and should be used within a 14-day period. Do not freeze or shake Siliq.

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 other 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.