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Cosentyx® (secukinumab): Dosing
Cosentyx is indicated for the treatment of moderate to severe plaque psoriasis (PsO) in adults, children and adolescents from the age of 6 years who are candidates for systemic therapy; active psoriatic arthritis (PsA) in adult patients (alone or in combination with methotrexate [MTX]) when the response to previous disease-modifying anti-rheumatic drug therapy has been inadequate; active ankylosing spondylitis (AS) in adults who have responded inadequately to conventional therapy; active non-radiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation as indicated by elevated C-reactive protein and/or magnetic resonance imaging evidence in adults who have responded inadequately to non-steroidal anti-inflammatory drugs; active moderate to severe hidradenitis suppurativa (HS; acne inversa) in adults with an inadequate response to conventional systemic HS therapy; active enthesitis-related arthritis (ERA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy; active juvenile psoriatic arthritis (JPsA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.1
Cosentyx is intended for use under the guidance and supervision of a physician experienced in the diagnosis and treatment of conditions for which Cosentyx is indicated.1
In Ireland Cosentyx is reimbursed for the following indications: adult plaque psoriasis (PsO); psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).
Convenience of a monthly injection with Cosentyx after initial loading doses*1
The ‘hand rule’ of Cosentyx dosing
Cosentyx is administered by subcutaneous injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing.1 After proper training in subcutaneous injection technique, patients may self-inject Cosentyx or be injected by a caregiver if a physician determines that this is appropriate. The physician should ensure appropriate follow-up of patients. Patients or caregivers should be instructed to inject the full amount of Cosentyx according to the instructions provided in the package leaflet.1
Depending on the patient dosing regimen, the dosing schedule may look something like this:
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Consideration should be given to discontinuing treatment in patients who have shown no response by 16 weeks of treatment. Some patients with an initial partial response may subsequently improve with continued treatment beyond 16 weeks.1
Dosing in PsA
Cosentyx dosing options available as per the SmPC for eligible patients.1
Following the appropriate loading regimen:
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PsA alone or in combination with MTX
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Depending on a patient’s diagnosis and clinical response, up-titration of Cosentyx may be prescribed at any point during the maintenance phase.1 After proper training in subcutaneous injection technique, eligible patients may self-inject Cosentyx or be injected by a caregiver if a physician determines that this is appropriate. The physician should ensure appropriate follow-up of patients. Patients or caregivers should be instructed to inject the full amount of Cosentyx according to the instructions provided in the package leaflet.1
Additional information for full posology in PsA
For patients with concomitant moderate to severe PsO, the recommended dose is 300 mg of Cosentyx by subcutaneous injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing. Based on clinical response, a maintenance dose of 300 mg every 2 weeks (Q2W) may provide additional benefit for patients with a body weight of 90 kg or higher.1
The Q2W dosing regimen is included in the SmPC but is currently not reimbursed under the HSE scheme in Ireland.
For patients who are anti-TNFα inadequate responders (IR), the recommended dose is 300 mg by subcutaneous injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing.1
Each 300 mg dose is given as one subcutaneous injection of 300 mg or as two subcutaneous injections of 150 mg.1
For other patients, the recommended dose is 150 mg by subcutaneous injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing. Based on clinical response, the dose can be increased to 300 mg.1
Special populations
Elderly patients (aged 65 years and over): No dose adjustment is required.1
Renal impairment/hepatic impairment: Cosentyx has not been studied in these patient populations. No dose recommendations can be made.1
Paediatric population: The safety and efficacy of Cosentyx in children with PsO and in the JIA categories of ERA and JPsA below the age of 6 years have not been established.
The safety and efficacy of Cosentyx in children below the age of 18 years in other indications have not yet been established. No data are available.1
For more information, please see the Cosentyx SmPC, here.
Dosing in axSpA
AxSpA patients are initially assigned:1
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Axial spondyloarthritis (axSpA)1
Following the appropriate loading regimen:
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Depending on a patient’s diagnosis and clinical response, up-titration of Cosentyx may be prescribed at any point during the maintenance phase.1
After proper training in subcutaneous injection technique, patients may self-inject Cosentyx or be injected by a caregiver if a physician determines that this is appropriate. The physician should ensure appropriate follow-up of patients. Patients or caregivers should be instructed to inject the full amount of Cosentyx according to the instructions provided in the package leaflet.1
Additional information for full posology in axSpA
AS (radiographic axSpA): The recommended dose is 150 mg by subcutaneous injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing. Based on clinical response, the dose can be increased to 300 mg.1
Each 300 mg dose is given as one subcutaneous injection of 300 mg or as two subcutaneous injections of 150 mg.1
Non-radiographic axial spondyloarthritis (nr-axSpA): The recommended dose is 150 mg by subcutaneous injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing.1 The nr-axSpA indication is included in the SmPC but is currently not reimbursed under the HSE scheme in Ireland.
Special populations
Elderly patients (aged 65 years and over): No dose adjustment is required.1
Renal impairment/hepatic impairment: Cosentyx has not been studied in these patient populations. No dose recommendations can be made.1
Paediatric population: The safety and efficacy of Cosentyx in children with PsO and in the JIA categories of ERA and JPsA below the age of 6 years have not been established.
The safety and efficacy of Cosentyx in children below the age of 18 years in other indications have not yet been established. No data are available.1
For more information, please see the Cosentyx SmPC, here.
Cosentyx dosing with the UnoReady pen® and SensoReady® pen.1
SensoReady® 150 mg injection video
UnoReady® 300 mg injection video
Cosentyx dosing precautions and warnings
The efficacy of Cosentyx across its various indications has been established through clinical studies. Based on the available evidence, a clinical response is normally achieved within the first 16 weeks of treatment, however, if your patients don't demonstrate a response to the prescribed Cosentyx dose within this timeframe, consideration should be given to discontinuing the treatment. Some patients with an initial partial response may subsequently improve with continued treatment beyond 16 weeks.1
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Cosentyx dosing and special populations
No dose adjustments are required for elderly individuals aged 65 and over. The safety and efficacy of Cosentyx in children below the age of 6 years have not yet been established. Cosentyx has not been studied in patients with renal or hepatic impairment and therefore no dose recommendations can be made in these populations.1
There are no adequate data from the use of Cosentyx in pregnant women. As a precautionary measure, it is preferable to avoid the use of Cosentyx during pregnancy. Because of the potential for adverse reactions in nursing infants from Cosentyx, a decision on whether to discontinue breast-feeding during treatment and up to 20 weeks after treatment or to discontinue therapy with Cosentyx must be made taking into account the benefit of breast-feeding to the child and the benefit of therapy to the woman.1
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Cosentyx missed dose
Encourage your patient to promptly consult with you in the event that they miss a scheduled dose, so that you may determine when they should take the subsequent Cosentyx injection dose.2
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Cosentyx overdose
In the event of overdose, it is recommended that the patient be monitored for any signs or symptoms of adverse reactions and appropriate symptomatic treatment be instituted immediately.1
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Cosentyx special warnings and precautions
Contraindications
Cosentyx is contraindicated in:
Patients with hypersensitivity to the active substance or to any of the excipient1
Clinically important, active infection, e.g. active tuberculosis1
Infections
Cosentyx has the potential to increase the risk of infections. Serious infections have been observed in patients receiving Cosentyx in the post-marketing setting. Caution should be exercised when considering the use of Cosentyx in patients with a chronic infection or a history of recurrent infection. If a patient develops a serious infection, the patient should be closely monitored and Cosentyx should not be administered until infection resolves. Please see the SmPC for the full information.1
Tuberculosis
Tuberculosis (active and/or latent reactivation) has been reported in patients treated with Cosentyx. Patients should be evaluated for tuberculosis infection prior to initiating treatment with Cosentyx. Cosentyx should not be given to patients with active tuberculosis. In patients with latent tuberculosis, anti-tuberculosis therapy should be considered prior to initiation of Cosentyx as per clinical guidelines. Patients receiving Cosentyx should be monitored for signs and symptoms of active tuberculosis.1
Inflammatory bowel disease IBD, (including Crohn's disease and ulcerative colitis)
Cases of new or exacerbations of inflammatory bowel disease have been reported with Cosentyx. Cosentyx is not recommended in patients with IBD. If a patient develops signs or symptoms of IBD or experiences an exacerbation of pre-existing IBD, Cosentyx should be discontinued and appropriate medical management should be initiated.1
Hypersensitivity reactions
Rare cases of anaphylactic reactions and angioedema have been observed in patients receiving Cosentyx. If an anaphylactic reaction, angioedema or other serious allergic reaction occurs, administration of Cosentyx should be discontinued immediately and appropriate therapy initiated.1
Vaccinations
Live vaccinations should not be given concurrently with Cosentyx. Prior to initiating therapy with Cosentyx, it is recommended that paediatric patients receive all age-appropriate immunisations as per current immunisation guidelines. Please see the SmPC for full information regarding vaccinations.1
Latex-sensitive individuals - Cosentyx 150 mg solution for injection in pre-filled syringe and 150 mg solution for injection in pre-filled pen only
The removable needle cap of Cosentyx 150 mg in the pre-filled syringe and 150 mg pre-filled pen contains a derivative of natural rubber (latex). Use in latex-sensitive individuals has not been studied and there is therefore a potential risk of hypersensitivity reactions, which cannot be completely ruled out.1
Concomitant immunosuppressive therapy
In psoriasis studies, the safety and efficacy of Cosentyx in combination with immunosuppressants, including biologics, or phototherapy, have not been evaluated. Cosentyx was administered concomitantly with MTX, sulfasalazine and/or corticosteroids in arthritis studies (including in patients with PsA and AS). Caution should be exercised when considering concomitant use of other immunosuppressants and Cosentyx.1
Hepatitis B reactivation
Hepatitis B virus (HBV) reactivation can occur in patients treated with Cosentyx. In accordance with clinical guidelines for immunosuppressants, testing patients for HBV infection is to be considered before initiating treatment with Cosentyx. Patients with evidence of positive HBV serology should be monitored for clinical and laboratory signs of HBV reactivation during Cosentyx treatment. If reactivation of HBV occurs while on Cosentyx, discontinuation of the treatment should be considered, and patients should be treated according to clinical guidelines.1
Cosentyx is intended tor use under the guidance and supervision or a physician experienced in the diagnosis and treatment of conditions for which Cosentyx is indicated.
This is not an exhaustive list of warnings and precautions. Please refer to the Cosentyx SmPC for full information.
The most frequently reported adverse reactions are upper respiratory tract infections (17.1%) (most frequently nasopharyngitis, rhinitis).1
Adverse events associated with Cosentyx:1
Very common
Upper respiratory tract infections
Common
Oral herpes
Headache
Rhinorrhoea
Diarrhoea
Nausea
Eczema
Fatigue
Please refer to the Cosentyx SmPC for the full safety profile.
Cosentyx is intended for use under the guidance and supervision of a physician experienced in the diagnosis and treatment of conditions for which Cosentyx is indicated. Please refer to the Cosentyx SmPC for full product information and administration, including dosing in special populations, before prescribing.1
AS, ankylosing spondylitis; axSpA, axial spondyloarthritis; ERA, enthesitis-related arthritis; HBV, Hepatitis B virus; HS, hidradenitis suppurativa; HSE, Health Service Executive; IBD, Inflammatory bowel disease; JIA, juvenile idiopathic arthritis; JPsA, juvenile psoriatic arthritis; MTX, methotrexate; nr-axSpA, non-radiographic axial spondyloarthritis; PsA, psoriatic arthritis; PsO, plaque psoriasis; SmPC, summary of product characteristics; TNFα, tumour necrosis factor alpha.
References
Cosentyx® (secukinumab) Summary of Product Characteristics. Available at: www.medicines.ie.
Cosentyx 300 mg solution for injection pre-filled pen. Patient Information Leaflet.
IE11481264 | March 2026
