Risankizumab (Skyrizi)

Risankizumab is a biologic medication used to treat active psoriatic arthritis, moderate to severe plaque psoriasis. It is also approved to treat moderate to severe Crohn’s disease but at different doses and formulations. In all these conditions, the medication works by targeting IL-23A, a signaling protein involved with inflammation.

How To Take It

Risankizumab is given as a self-administered injection under the skin on the thigh or abdomen. The injection site should be changed at every injection so the same site is not used multiple times. Risankizumab comes as pre-filled syringes and pen injectors. The dose for adults is 150 mg in psoriasis and psoriatic arthritis, which can be given as one pre-filled 150 mg syringe or pen. The first two doses are taken 4 weeks apart, then every 12 weeks (about 3 months) starting with the third dose. Some patients will start to improve within a few weeks, but it may take up to 6 months to take full effect and see improvement.

Risankizumab may be taken alone or with methotrexate or other non-biologic drugs. Risankizumab should not be given in combination with another biologic drug.

Side Effects

Risankizumab can lower your immune system’s ability to fight infections. Testing for tuberculosis and hepatitis should also be done before starting risankizumab.

The most common side effects that may occur include injection site reactions, upper respiratory infections, headaches or fatigue. Serious allergic reactions are very rare.

Tell Your Rheumatology Provider

Before starting this medication talk with your physician about getting appropriate vaccinations to prevent infections. You should also tell your provider if you are pregnant, planning to get pregnant, or are breastfeeding. In general, patients who may become pregnant during treatment should use effective contraception while using biologic therapy. Risankizumab has not been studied in pregnancy and breastfeeding.

If you develop symptoms of an infection, hold this medication, and contact your rheumatologist. If you are planning to have surgery or get any live vaccinations, talk to your rheumatology provider first. These include, nasal spray flu vaccine, and others such as the measles, mumps, rubella, and yellow fever vaccines.

Updated June 2025 by Kiren Sahni, DO, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.