Stelara (ustekinumab) is a prescription drug that’s used to treat certain autoimmune conditions. This drug can interact with some other medications and certain vaccines. For example, Stelara can interact with warfarin (Jantoven) and the nasal spray flu vaccine.
Stelara is used in adults to treat:
Stelara is used in certain children to treat:
- plaque psoriasis
- psoriatic arthritis
Stelara contains the active ingredient ustekinumab. (An active ingredient is what makes a drug work.) The medication comes as a liquid solution inside prefilled syringes and vials. It’s usually taken by injection under your skin. But in some cases, a healthcare professional may administer the medication by intravenous infusion (an injection into a vein that’s given over a period of time.)
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Stelara’s possible interactions. And for more information about Stelara, including details about its uses, see this article.
Before you start taking Stelara, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Stelara interacts with herbs or vitamins and supplements, see the “Are there other interactions with Stelara?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Stelara. Keep in mind that this table does not include all drugs that may interact with Stelara. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| warfarin (Jantoven) | – | may affect the level of warfarin in your body |
| cyclosporine (Neoral, others) | – | may affect the level of cyclosporine in your body |
| allergy shots | – | can make allergy shots less effective |
| Janus kinase (JAK) inhibitors | • baricitinib (Olumiant) • tofacitinib (Xeljanz) • upadacitinib (Rinvoq) | may increase the risk of side effects from Stelara and JAK inhibitors |
| other biologic immunomodulators | • abatacept (Orencia) • sarilumab (Kevzara) •tocilizumab (Actemra) | may increase the risk of side effects from Stelara and other biologic immunomodulators |
Certain health conditions or other factors could raise your risk of harm if you take Stelara. In such cases, your doctor may not prescribe Stelara for you. These are known as contraindications. Allergic reaction is the only contraindication of Stelara.
If you’ve had an allergic reaction to Stelara or any of its ingredients, your doctor likely won’t prescribe Stelara for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Stelara is not known to interact with alcohol. But Stelara and alcohol can cause some similar side effects, such as headache, nausea, and vomiting. So you may be more likely to experience these side effects if you drink alcohol during your Stelara treatment.
If you have questions about consuming alcohol during Stelara treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Stelara.
Interaction with warfarin
Stelara can interact with warfarin (Jantoven), which is used to treat and help prevent blood clots.
What could happen
Taking Stelara with warfarin may affect the level of warfarin in your body. If the level of warfarin gets too high, this can increase your risk of warfarin side effects, such as bleeding. If the level of warfarin gets too low, this can make warfarin less effective at treating and preventing blood clots.
What you can do
If you take Stelara with warfarin, your doctor will likely monitor your warfarin treatment more closely. They may order more frequent blood tests to check your INR or international normalized ratio, which measures how long your blood takes to clot.
Depending on the results of these blood tests, your doctor may adjust your dosage of warfarin.
If you have questions about taking Stelara with warfarin, talk with your doctor or pharmacist.
Interaction with cyclosporine
Stelara can interact with cyclosporine (Neoral, Sandimmune, Gengraf), which is used to treat rheumatoid arthritis and psoriasis. It also helps prevent the rejection of organ transplants.
What could happen
Taking Stelara with cyclosporine may affect the level of cyclosporine in your body. If the level of cyclosporine gets too high, this can increase your risk of cyclosporine side effects, such as kidney failure. If the level of cyclosporine gets too low, this can make cyclosporine less effective.
What you can do
If you take Stelara with cyclosporine, your doctor will likely monitor your cyclosporine treatment more closely. They may order more frequent blood tests to check the level of cyclosporine in your blood.
Depending on the results of these blood tests, your doctor may adjust your dosage of cyclosporine.
If you have questions about taking Stelara with cyclosporine, talk with your doctor or pharmacist.
Interaction with allergy shots
Stelara can interact with allergen immunotherapy (allergy shots), which are injections used to treat severe allergies. They help desensitize your body to a particular allergen (something that causes allergic reactions), such as grass, pollen, dust mites, or bee stings.
What could happen
Stelara may affect the way your immune system responds to allergy shots. If you’re having allergy shots, taking Stelara could make the allergy shots less effective. This can raise your risk of having an allergic reaction. It can also raise your risk of having a serious allergic reaction (including anaphylaxis) to the allergy shots.
What you can do
If you’re having allergy shots or have done in the past, talk with your doctor about whether Stelara is right for you. If you have allergy shots during treatment with Stelara, your doctor will monitor you more closely in case you have a severe allergic reaction.
If you have questions about taking Stelara with allergy shots, talk with your doctor or pharmacist.
Stelara may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Stelara.
Does Stelara interact with supplements?
Before you start taking Stelara, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Stelara and herbs
There are currently no reports of Stelara interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Stelara.
Stelara and vitamins
There are currently no reports of Stelara interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Stelara.
Does Stelara interact with food?
There are currently no reports of Stelara interacting with food. If you have questions about eating certain foods during your treatment with Stelara, talk with your doctor.
Does Stelara interact with vaccines?
You should not receive live vaccines during your Stelara treatment. (Live vaccines contain weakened versions of the bacteria or virus that they’re meant to protect against.) This is because getting a live vaccine while you’re taking Stelara increases your risk of infection. Examples of live vaccines include:
- measles, mumps, rubella (MMR)
- rotavirus
- chickenpox
- bacillus Calmette-Guérin (BCG) vaccine
- nasal spray flu vaccine
You shouldn’t receive the BCG vaccine during Stelara treatment and for 1 year after stopping Stelara. The BCG vaccine is used to prevent tuberculosis (TB). If you received the BCG vaccine in the past year, you shouldn’t start Stelara until 1 year after you received the vaccine.
If you receive a non-live vaccine during Stelara treatment, the vaccine may be less effective than usual. Examples of non-live vaccines include tetanus, COVID-19 vaccine, and the injected flu vaccine.
Before starting Stelara treatment, talk with your doctor about any vaccines you may need. If you need to receive a vaccine during Stelara treatment, talk with your doctor first to make sure it’s safe.
Does Stelara interact with lab tests?
There are currently no reports of Stelara interacting with lab tests. If you have questions about having certain lab tests during your treatment with Stelara, talk with the healthcare professional ordering the test.
Does Stelara interact with cannabis or CBD?There are currently no reports of Stelara interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Stelara.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Stelara. Before taking Stelara, talk with your doctor about your health history. They’ll determine whether Stelara is right for you.
Health conditions or other factors that might interact with Stelara include:
Infections: Stelara can raise your risk of infections. Before starting Stelara, tell your doctor if you have any active infections or infections that keep coming back. Also tell your doctor if you’ve ever had tuberculosis (TB). Your doctor may test you for TB before prescribing Stelara. And they’ll likely prescribe medication to treat any infections you have before you start Stelara.
Cancer: Stelara can raise your risk of developing cancer, including nonmelanoma skin cancer. If you’ve ever had cancer, talk with your doctor about whether Stelara is right for you. Also, tell your doctor if you’ve ever had long-term treatment with immunosuppressants (medications that weaken your immune system) or PUVA treatment (a form of light treatment). These treatments can raise your risk of developing nonmelanoma skin cancer. So your doctor can monitor your skin for any changes while you’re taking Stelara.
Pregnancy: It’s not known whether Stelara is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Stelara.
Breastfeeding: It’s not known whether it’s safe to take Stelara while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Stelara or any of its ingredients, your doctor will likely not prescribe Stelara. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Stelara. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Stelara treatment.
It’s also important to understand Stelara’s
If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Taking Stelara exactly as prescribed can also help prevent interactions.
If you still have questions about Stelara and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Can I take Stelara with other treatments for my condition, and will that affect my risk of side effects?
- Can I take herbs or other supplements to support my immune system while using Stelara?
- Do I need to check with you before taking over-the-counter medications during my Stelara treatment?
To learn more about Stelara, see these articles:
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Disclaimer: Healthline 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 another 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.