4 foods to avoid while on Stelara

In this article:

• How Stelara works
• Foods to avoid
• Diet tips
• The bottom line

In this article

• How Stelara works
• Foods to avoid
• Diet tips
• The bottom line

Stelara (ustekinumab) is an injectable drug approved by the Food and Drug Administration (FDA) for the treatment of autoimmune conditions, such as plaque psoriasis, active psoriatic arthritis, and inflammatory bowel diseases, including Crohn’s disease, and ulcerative colitis. There are no known food-drug interactions with Stelara. Still, it may cause digestive side effects, especially if you have an inflammatory bowel disease (IBD). You can limit unpleasant side effects and condition flare-ups by avoiding certain foods, including sugary foods, foods high in saturated and trans fat, alcohol, and processed foods.

How Stelara works

Stelara is a monoclonal antibody, which is a type of biologic drug called an interleukin antagonist. These prescription drugs are designed to block part of the inflammation pathway used by our immune system, which is why they are commonly used to treat medical conditions where an overactive immune system attacks healthy tissue.

“Stelara works by blocking certain proteins in your body responsible for causing inflammation in these conditions,” says Joanne Nguyen, Pharm.D., a clinical pharmacist based in Warner Robbins, Georgia. This medication can help get a current flare-up under control as well as prevent future symptoms from developing.

According to the medication guide, people taking Stelara for moderately to severely active Crohn’s disease or ulcerative colitis begin treatment with a one-time intravenous infusion in a healthcare setting, then continue with subcutaneous injections every eight weeks. People with psoriasis follow a dosing schedule with prefilled syringes.

How long it takes Stelara to work depends on the condition it’s being used to treat. In clinical trials, 56% of people with Crohn’s disease experienced symptom relief within six weeks of their first Stelara infusion. Seventy percent of people with plaque psoriasis reported at least 75% clearer skin after 12 weeks on Stelara.

Stelara is generally well tolerated, but side effects can occur. Common Stelara side effects include:

• Nasal congestion and runny nose
• Sore throat
• Upper respiratory infections
• Fever
• Headache
• Tiredness
• Itching
• Nausea and vomiting
• Diarrhea
• Stomach pain
• Joint pain
• Redness at the injection site
• Vaginal yeast infections
• Urinary tract infections
• Sinus infections

Rare but serious side effects and risks include:

• Increased risk of certain types of skin cancer
• Serious allergic reaction, including shortness of breath, facial swelling, and skin rash
• Posterior reversible encephalopathy syndrome (PRES), a rare condition affecting the brain
• Lung inflammation

Inform your healthcare provider before taking Stelara in the following scenarios:

• You have a history of PRES
• You have an active infection
• You have an allergy to latex (the needle cover contains latex)
• You are pregnant or breastfeeding, as the medication passes into breast milk
• You have had the Bacillus Calmette-Guérin vaccine (BCG vaccine) in the past year, a live vaccine for tuberculosis
• You have received or are receiving phototherapy for psoriasis
• You have received or are receiving allergy shots

4 foods to avoid with Stelara

People who use Stelara should avoid live vaccines due to the risk of serious infection, but there are no foods that interact with this biologic. Foods neither cause nor cure psoriasis or IBD, emphasizes Rickelle Tallent, RDN, LD, owner of Tallent Nutrition & Wellness in Las Vegas, Nevada. However, certain foods can increase inflammation in the body, triggering symptoms in people with plaque psoriasis, psoriatic arthritis, or IBD. Avoiding them may reduce flares. Certain foods may also worsen the side effects of Stelara.

For these reasons, you should avoid certain foods and beverages while on Stelara, including:

1. Foods high in added sugar
2. Foods high in saturated and trans fats
3. Alcohol
4. Processed foods

1. Sugary foods

Eating foods high in sugar is associated with increasing inflammation, says Tallent. So sweet treats like candy, cookies, and cake…those are best avoided if you’ve been prescribed Stelara. The same goes for sugary lattes and sodas. A three-year study of 1,133 adults with IBD found that those who drank seven or more sugar-sweetened beverages per week spent more time in the hospital and emergency room than those who drank two or fewer sugary beverages per week.

Research has shown a link between sugar consumption and psoriasis flare-ups, too. Ultimately, whether your condition is related to inflammation in your gut or on your skin, a diet high in sugary foods and drinks is likely to worsen symptoms.

2. Greasy, fatty foods

Eating fast food, fried food, and fatty meats won’t necessarily cancel out a dose of Stelara. Still, they can worsen gastrointestinal discomfort—bad news if you already have IBD or are experiencing diarrhea or stomach pain, two side effects of Stelara. Like sugar, saturated and trans fats are associated with increased systemic inflammation, according to Tallent.

Foods high in saturated fat include: 

• Red meats
• Pork
• Chicken skin
• Butter
• Full-fat cheese
• Ice cream

Foods high in trans fats may include:

• Fried foods
• Processed, prepackaged baked goods such as cookies and crackers
• Stick margarine

People on Stelara should consider avoiding foods that are high in these fats. The best way to gauge a food’s saturated or trans fat content is to look at the Nutrition Facts label.

3. Alcohol 

Alcohol will not directly interact with or cause an allergic reaction to Stelara. It’s technically safe to imbibe while on this medication. However, drinking alcohol may exacerbate possible side effects of Stelara or trigger an autoimmune flare-up.

“Alcohol consumption may cause side effects similar to Stelara, including nausea, fatigue, and headaches,” Nguyen says. “You may be more likely to experience these side effects if you consume alcohol while using Stelara.”

“Regular or excessive alcohol consumption can also contribute [to] increased levels of inflammation, and therefore is not recommended,” added Tallent.

4. Processed foods

The most common types of food associated with whole-body inflammation? “Ultra-processed foods,” says Tallent.

Highly processed foods are typically prepackaged snacks or meals high in unhealthy fats, sugar, and sodium. Often referred to as “junk food,” they are high in calories but low in nutrients. A diet high in processed foods has been linked to a higher risk of autoimmune disease.

Diet tips for people taking Stelara

Food doesn’t directly impact the absorption or efficacy of Stelara, but a balanced, nutrient-rich diet is important for anyone with an autoimmune disease. It may be especially important while on Stelara since biologic therapies can suppress your immune system.

Anyone experiencing a flare-up while taking Stelara should do their best to pinpoint and avoid food triggers while consuming nutrients such as essential vitamins and minerals. People experiencing diarrhea, a common Stelara side effect, should drink plenty of fluids such as water and no-sugar-added fruit juice, and stick to bland foods until symptoms subside. Abdominal pain and nausea—also possible Stelara side effects—may improve with smaller, more frequent meals and good hydration.

“When not experiencing a flare-up, a generally healthy diet rich in fruits, vegetables, whole grains, legumes, lean proteins, nuts and seeds, low-fat dairy or calcium-rich alternatives, and omega-3 fatty acids is recommended,” says Tallent.

The bottom line

There are no food-drug interactions with Stelara. Still, it’s essential to maintain a healthy diet during Stelara use. That’s because sugary foods, fatty foods, processed foods, and alcohol can all exacerbate symptoms of the conditions Stelara is designed to treat.

While on Stelara, it’s best to maintain a healthy, anti-inflammatory diet full of whole foods. It’s also a good idea to seek medical advice from a healthcare professional if you have any questions about diet, interactions with over-the-counter drugs or supplements, side effects, risk of infections, or the effectiveness of Stelara while on this medication.