Skip to Content

Tildrakizumab

Medically reviewed by Drugs.com. Last updated on Aug 29, 2020.

Pronunciation

(til dra KIZ ue mab)

Index Terms

  • MK-3222
  • Tildrakizumab-asmn

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Prefilled Syringe, Subcutaneous [preservative free]:

Ilumya: tildrakizumab-asmn 100 mg/mL (1 mL) [contains polysorbate 80]

Brand Names: U.S.

  • Ilumya

Pharmacologic Category

  • Antipsoriatic Agent
  • Interleukin-23 Inhibitor
  • Monoclonal Antibody

Pharmacology

Human IgG1/k monoclonal antibody which selectively binds to the p19 subunit of interleukin (IL)-23, thereby inhibiting its interaction with the IL-23 receptor, resulting in inhibition of the proinflammatory cytokines and chemokines associated the binding of naturally occurring IL-23.

Distribution

Vd: 10.8 L

Metabolism

Expected to be degraded into small peptides and amino acids via catabolic pathways in a similar manner as endogenous IgG.

Time to Peak

~6 days; steady state concentrations reached by week 16

Half-Life Elimination

~23 days

Special Populations Note

Body Weight: Tildrakizumab concentrations were lower in subjects with higher body weight.

Use: Labeled Indications

Plaque psoriasis: Treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

Contraindications

Serious hypersensitivity to tildrakizumab or any component of the formulation

Dosing: Adult

Plaque psoriasis: SubQ: 100 mg at weeks 0, 4, and then every 12 weeks thereafter.

Dosing: Geriatric

Refer to adult dosing.

Reconstitution

Allow prefilled syringe in original carton to sit and reach room temperature (30 minutes) before injecting. Solution should be colorless to light yellow; do not use if solution has visible particles or the syringe is damaged. Syringe may contain small air bubbles; there is no need to expel air bubbles prior to administration. After injection, discard used prefilled syringe and any unused portion.

Administration

SubQ: Administer SubQ into thighs, upper arm, or abdomen (except for 2 inches around navel); do not inject into areas where the skin is tender, bruised, erythematous, indurated, or affected by psoriasis, or where there are scars, blood vessels, or stretch marks.

Storage

Store refrigerated at 2°C to 8°C (36°F to 46°F) in the original carton. Protect from light; do not freeze. Do not shake. Can be kept at room temperature at 25°C (77°F) for up to 30 days in the original carton. Once stored at room temperature, do not place back in the refrigerator. Discard if not used within 30 days. Do not store above 25°C (77°F).

Drug Interactions

Belimumab: May enhance the immunosuppressive effect of Biologic Anti-Psoriasis Agents. Avoid combination

InFLIXimab: May enhance the immunosuppressive effect of Biologic Anti-Psoriasis Agents. Avoid combination

Vaccines (Live): Tildrakizumab may enhance the adverse/toxic effect of Vaccines (Live). The risk for contracting an infection from the vaccine may be increased. Tildrakizumab may diminish the therapeutic effect of Vaccines (Live). Avoid combination

Adverse Reactions

>10%:

Infection: Infection (23%)

Respiratory: Upper respiratory tract infection (14%)

1% to 10%:

Gastrointestinal: Diarrhea (2%)

Immunologic: Antibody development (7%; neutralizing: 3%)

Local: Injection site reaction (3%)

Frequency not defined:

Dermatologic: Urticaria

Hypersensitivity: Angioedema

Respiratory: Tuberculosis

<1%, postmarketing, and/or case reports: Dizziness, limb pain, severe infection

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity: Hypersensitivity, including anaphylaxis and angioedema, has been reported. Discontinue immediately with signs/symptoms of a serious hypersensitivity reaction and treat appropriately, as indicated.

• Infections: May increase the risk of infections; upper respiratory tract infections have occurred more frequently. Consider the risks versus benefits prior to treatment initiation in patients with a history of chronic or recurrent infection; treatment should not be initiated in patients with clinically important active infections until it is resolved or treated. Monitor for infections; patients should seek medical attention for signs/symptoms of a clinically important infection (acute or chronic). If a serious infection develops or is unresponsive to appropriate therapy for the infection, monitor closely and consider discontinuing use until the infection resolves.

Disease-related concerns:

• Tuberculosis: Patients should be evaluated for tuberculosis (TB) infection prior to initiating therapy. Do not administer to patients with an active TB infection. Treatment for latent TB should be administered prior to administering tildrakizumab. Consider anti-TB therapy prior to treatment initiation in patients with a history of latent or active TB in whom an adequate course of TB treatment cannot be confirmed. Monitor closely for signs/symptoms of active TB during and after treatment.

Concurrent drug therapy issues:

• Immunizations: Patients should be brought up to date with all immunizations before initiating therapy. Live vaccines should not be given concurrently; there are no data available concerning secondary transmission of infection by live vaccines in patients receiving therapy.

Monitoring Parameters

Latent tuberculosis screening (prior to initiating and periodically during therapy); signs and symptoms of infection, including active tuberculosis (during and after treatment).

Reproductive Considerations

Contraception was required of females of reproductive potential and males with female partners of reproductive potential during the initial studies of tildrakizumab (Haycraft 2020).

Pregnancy Considerations

Tildrakizumab is a humanized monoclonal antibody (IgG1). Placental transfer of human IgG is dependent upon the IgG subclass, maternal serum concentrations, birth weight, and gestational age, generally increasing as pregnancy progresses. The lowest exposure would be expected during the period of organogenesis (Palmeira 2012; Pentsuk 2009).

Outcome information following inadvertent exposure to tildrakizumab during pregnancy is limited. During the initial studies, tildrakizumab was discontinued in all cases (n=14) once pregnancy was confirmed (Haycraft 2020).

Patient Education

What is this drug used for?

• It is used to treat plaque psoriasis.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Common cold symptoms

• Injection site irritation

• Diarrhea

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Infection

• Coughing up blood

• Skin sores

• Sweating a lot

• Muscle pain

• Muscle weakness

• Shortness of breath

• Passing a lot of urine

• Abdominal pain

• Weight loss

• Severe dizziness

• Passing out

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Related questions