Skip to main content
An Rx auto-injector pen and a drawing of two Rx pills: Stelara (ustekinumab) alternatives
Drug Info

Stelara (ustekinumab) alternatives: What can I take instead of Stelara?

Used to treat autoimmune diseases, this brand-name monoclonal antibody doesn't work for everyone, but there are other options available
Marissa Walsh headshot
By | Jul. 3, 2024

Key takeaways

  • Stelara is a type of biologic medication indicated for autoimmune diseases like plaque psoriasis.

  • Biologics suppress the immune system and are associated with an increased risk of infection, among other serious potential side effects. However, biologics are highly efficacious in disease state management. Balancing safety and efficacy may take trial and error until the best regimen is found.

  • Alternative biologics may be considered due to differences in administration frequency, individual efficacy, side effects, cost, and other factors.

  • Non-biologic options are also available for individuals who cannot tolerate this class of prescription medications.

In this article:

Stelara (ustekinumab) is a monoclonal antibody that inhibits interleukin-12 and interleukin-23. It is a biologic drug approved by the Food and Drug Administration (FDA) to treat autoimmune diseases, including plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis. Alternatives to Stelara may also be sought due to its side effect profile, risks associated with its use, interacting medications, and patient preference. 

What can I take in place of Stelara?

Other treatment options are available to treat autoimmune disorders. Alternatives include biologic medications, like biosimilars, IL-23 inhibitors, IL-17A inhibitors, and Tumor Necrosis Factor (TNF) blockers. Overall, biologic products target proteins in the body that cause inflammation or other immune problems. They act as immunosuppressants and can cause a range of moderate to severe infections, including upper respiratory infections like bronchitis. Biologics are generally administered as subcutaneous injections, which may be something certain individuals do not like or are unable to self-administer. A biosimilar of Stelara is available under the name Wezlana, which the FDA approved in October 2023 as an interchangeable biosimilar. Biosimilars are biologic products highly similar to approved biologic products, known as reference products. Non-biologic oral medication alternatives, as well as topicals, are also available.

Compare Stelera (ustekinumab) alternatives
Drug name Uses Dosage Savings options
Stelara (ustekinumab) 
  • Crohn’s disease
  • Hidradenitis suppurativa
  • Plaque psoriasis
  • Psoriatic arthritis
  •  Ulcerative colitis
 Stelara coupons 
Humira (adalimumab) 
  • Ankylosing spondylitis Crohn’s disease
  • Hidradenitis suppurativa
  • plaque psoriasis
  • psoriatic arthritis
  • rheumatoid arthritis
  • ulcerative colitis
 Indication-specific:
  • 160 mg SubQ first dose, then 80 mg SubQ in 2 weeks, then 40 mg SubQ every 1-2 weeks  
  • 80 mg SubQ first dose, then 40 mg SubQ every 1-2 weeks
  • 40 mg to 80 mg SubQ every 2 weeks
 Humira coupons 
Cimzia (certolizumab) 
  • Ankylosing spondylitis 
  • Crohn’s disease
  • Plaque psoriasis
  • Psoriatic arthritis 
  • Rheumatoid arthritis
 Indication-specific:
  • 400 mg SubQ first dose, 400 mg SuQ at 2 and 4 weeks, then 200 mg SubQ every 2 weeks (or 400 mg SubQ every 4 weeks)
  • 400 mg SubQ every 2 weeks
 Cimzia coupons 
Skyrizi (risankizumab) 
  • Crohn’s disease
  • Plaque psoriasis
  • Psoriatic arthritis 
 Indication-specific:
  • 600 mg IV at weeks 0, 4, 8; then 180 to 360 mg SubQ at week 12, then every 8 weeks
  • 150 mg SubQ at weeks 0, 4, and then every 12 weeks
 Skyrizi coupons 
Cosentyx (secukinumab) 
  • Ankylosing spondylitis
  • Hidradenitis suppurativa plaque psoriasis
  • Psoriatic arthritis
 Indication-specific:
  • IV: weight-based
  • SubQ: 150 mg at weeks 0, 1, 2, 3, and 4, followed by 150 mg every 4 weeks (up to 300 mg every 4 weeks) OR
  • 150 to 300 mg every 4 weeks OR 
  • 300 mg at weeks 0, 1, 2, 3, and 4, followed by 150 to 300 mg every 4 weeks (up to 300 mg every 2 weeks)
 Cosentyx coupons 
Otezla (apremilast) 
  • Behcet’s disease
  • Psoriasis
  • Psoriatic arthritis
  • Day 1: 10 mg by mouth once daily, Day 2:10 mg by mouth twice daily Day 3: 10 mg in the morning and 20 mg in the evening
  • Day 4: 20 mg twice, Day 5: 20 mg in the morning, and 30 mg in the evening 
  • Day 6: 30 mg twice daily
 Otezla coupons 
Remicade (infliximab) 
  • Ankylosing spondylitis 
  • Plaque psoriasis
  • Psoriatic arthritis
  • Pustular psoriasis 
  • Rheumatoid arthritis 
  • Ulcerative colitis
  • Weight-based IV dosing
  • Indication-specific
 Check back for coupons
Enbrel (etanercept) 
  • Ankylosing spondylitis 
  • plaque psoriasis
  • psoriatic arthritis
  • rheumatoid arthritis
 Indication-specific:
  • 25 mg SubQ twice weekly to 50 mg SubQ weekly
 Enbrel coupons 
Siliq (brodalumab) 
  • Plaque psoriasis
  • 210 mg SubQ weeks 0, 1, and 2, followed by 210 mg SubQ every 2 weeks
 Siliq coupons 
Taltz (ixekizumab) 
  • Ankylosing spondylitis
  • Plaque psoriasis
  • Psoriatic arthritis 
 Indication-specific:
  • 160 mg SubQ once, then 80 mg SubQ every 4 weeks OR
  • 160 mg SubQ once, then 80 mg SubQ at weeks 2, 4, 6, 8, 10, and 12, then 80 mg SubQ every 4 weeks
 This drug is administered by your healthcare practitioner 
Ilumya (tildrakizumab) 
  • Plaque psoriasis
  • 100mg SubQ at weeks 0, 4, and then every 12 weeks
 This drug is administered by your healthcare practitioner 
Tremfya (guselkumab) 
  • Plaque psoriasis
  • Psoriatic psoriasis
  • 100 mg SubQ at weeks 0, 4, and then every 8 weeks
 Tremfya coupons 

Top 5 Stelara alternatives

The following are some of the most common alternatives to Stelara.

1. Humira (adalimumab)

Humira (adalimumab) is a member of the TNF drug class. TNF is a naturally occurring cytokine and plays an important role in many inflammatory medical conditions. Excess TNF release is associated with inflammation and tissue damage. Humira has been available for a long time and has a strong use history and overall safety. This medication is administered by a subcutaneous injection, and after an induction dose, it can be self-administered every two weeks for the indication of plaque psoriasis. Humira does not hold an approved indication for managing plaque psoriasis in pediatric patients, whereas Stelara is FDA approved for children.

2. Cimzia (certolizumab)

Cimzia is another TNF-blocker biologic medication used for plaque psoriasis and other autoimmune diseases like Crohn’s disease and rheumatoid arthritis. Compared to other biologic TNF-blocker options, Cimzia provides a good balance between efficacy and side effects. TNF-blockers are considered first-line options for individuals with moderate to severe plaque psoriasis, which affects more than 5% of their body surface area. 

3. Cosentyx (secukinumab)

Cosentyx is an IL-17A blocker and is also recommended as a first-line option for individuals with moderate to severe plaque psoriasis affecting greater than 5% of their body surface area or those with resistant scalp psoriasis, palmoplantar psoriasis or nail psoriasis. As a class, IL-17A blockers are known to have a fast onset of action and are very efficacious. Cosentyx does require a subcutaneous injection every four weeks following induction and should be used cautiously in those with inflammatory bowel disease as this class of biologics can cause flare-ups. 

4. Skyrizi (risankizumab)

Skyrizi is an IL-23 blocker and is recommended as a first-line option for individuals with moderate to severe plaque psoriasis affecting greater than 5% of their body surface area or those with resistant scalp psoriasis or palmoplantar psoriasis. Like Stelara, it can be dosed every 12 weeks following induction, which many individuals may like. In comparison to TNF-blockers, Skyrizi poses a lower risk of serious infection. Skyrizi can also safely be used in patients with inflammatory bowel disease, unlike Cosentyx.

5. Otezla (apremilast)

Otezla is an oral option for moderate to severe psoriasis and is in the phosphodiesterase 4 (PDE4) inhibitor class. This option is recommended for individuals with significant skin or nail psoriasis and may be appealing to certain individuals since it is available orally, does not come with as many severe side effects as biologic medications and does not require laboratory monitoring. Otezla can, however, cause weight loss due to common side effects of nausea, diarrhea, and abdominal pain and cannot be combined with strong CYP3A4 inhibitors like carbamazepine. 

Natural alternatives to Stelara

Prescription medications have become standard for the management of moderate to severe plaque psoriasis, but alternatives like coal tar and phototherapy remain available. These two strategies, known as the Goeckerman protocol, may be combined as less expensive and non-prescription management modalities for mild to moderate plaque psoriasis. However, this may require assistance in its administration and under the supervision of a healthcare professional. 

Compared to Stelara and its biologic alternatives, more natural remedies for psoriasis are available, ranging from oatmeal baths to topical application of aloe vera to consumption of turmeric. 

How to switch to a Stelara alternative

Many alternatives to Stelara are available, and individuals can transition between them to improve symptoms and quality of life. Under a healthcare provider’s guidance, the timing of the transition varies depending on whether the switch is due to safety concerns and serious side effects or a lack of efficacy. For safety concerns, wait until the reaction has resolved before switching medications. If the therapy switch is being made due to lack of effectiveness, the new biologic can be switched as soon as the next scheduled administration is based on the shortest dosing interval recommended for the failed agent’s induction schedule.

Sources