5 known interactions • 2 major • 3 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Live vaccines
Ustekinumab (IL-12/23 inhibitor) blunts immune responses; live vaccines may be ineffective or cause vaccine-strain infection.
Management: Administer all live vaccines ≥4 weeks before starting Stelara. Avoid live vaccines during treatment.
BCG (tuberculosis vaccine)
Live BCG vaccine should not be given to patients on ustekinumab.
Management: Screen for latent TB before starting Stelara. TB test recommended before treatment initiation.
CYP450 substrates with narrow therapeutic index (warfarin, cyclosporine, phenytoin)
Ustekinumab normalizes IL-12/23-mediated CYP450 suppression, potentially increasing enzyme activity and reducing drug levels.
Management: Monitor warfarin INR closely; check levels of narrow-index CYP substrates (phenytoin, cyclosporine) on initiation and dose change.
Other biologic immunomodulators (TNF inhibitors, IL-17 inhibitors)
No pharmacokinetic data on combinations; additive immunosuppression risk.
Management: Do not combine biologics. Ensure adequate washout period when switching.
Phototherapy (PUVA / UVB)
Combined use of immunosuppressive biologics and phototherapy may theoretically increase malignancy risk.
Management: Use with caution; monitor for skin malignancies at regular follow-up.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Stelara. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.