How to inject Stelara?

Stelara (ustekinumab) is a monoclonal antibody used to reduce inflammation in conditions such as plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis. It is given as a subcutaneous injection and may be self‑administered if your healthcare provider approves. Always review the Instructions for Use and Medication Guide before administering Stelara.

Injection Instructions for a Stelara Prefilled Syringe

Preparing for Your Injection

Before injecting, check the expiration date on the carton and syringe. Do not use Stelara if:

  • The expiration date has passed
  • The syringe has been at room temperature (up to 86ºF / 30ºC) for more than 30 days
  • The syringe has been stored above 86ºF (30ºC)

Inspect the solution in the syringe. It should be clear, colorless or light yellow, with only a few white particles (normal). Do not use if it is frozen, cloudy, discolored, or contains large particles.

Remove the syringe from the refrigerator and let it warm to room temperature for 30 minutes. Gather the following supplies:

  • Antiseptic wipes
  • Gauze pads or cotton balls
  • Adhesive bandage
  • FDA‑approved sharps container

Injecting Stelara

  1. Wash your hands thoroughly with soap and warm water.
  2. Choose an injection site: abdomen (at least 2 inches away from the belly button), thighs, or buttocks. If a caregiver administers, the upper arms are also acceptable. Rotate sites and avoid injecting into red, tender, bruised, or hardened skin.
  3. Clean the site with an antiseptic wipe and let it dry without touching again.
  4. Hold the syringe straight up, remove the needle cover, and discard the cover. Do not touch the plunger. A small drop of medication on the needle tip is normal.
  5. Pinch the cleaned skin area and insert the needle at a 45° angle in one quick motion.
  6. Press the plunger all the way down until the syringe is empty, then remove the needle and release the skin.
  7. If minor bleeding occurs, apply a gauze pad or cotton ball—do not rub. Cover with a bandage if desired.
  8. If your dose requires two syringes (e.g., 90 mg dose using two 45 mg syringes), repeat steps 2–7 at a different site for the second injection.

Disposing of the Syringe

Immediately place the used syringe into an FDA‑approved sharps container. Do not discard in household trash.

If you do not have an approved container, use a heavy‑duty plastic container with:

  • A puncture‑resistant, leak‑resistant lid
  • A tight-fitting closure
  • A label indicating hazardous waste

When the container is nearly full, follow your community’s guidelines for disposal. For local disposal information, visit your municipality’s waste management website. For self‑injection support resources, including a video and guide, go to stelarainfo.com/stelara-injection-support.

Stelara FAQs

What is Stelara used for?

Stelara is an injectable biologic that calms the immune system to treat inflammatory conditions. FDA‑approved indications include:

  • Adults with moderate to severe plaque psoriasis eligible for systemic or phototherapy
  • Adults with active psoriatic arthritis, alone or with medications like methotrexate
  • Adults with moderate to severe active Crohn’s disease
  • Adults with moderate to severe active ulcerative colitis
  • Children (6 years and older) with moderate to severe plaque psoriasis
  • Children (6 years and older) with active psoriatic arthritis

How does Stelara work?

Stelara (ustekinumab) is a monoclonal antibody that inhibits interleukin‑12 (IL‑12) and interleukin‑23 (IL‑23), proteins that drive inflammation. Blocking these cytokines reduces immune response and relieves symptoms in treated conditions.

What drug interactions are there with Stelara?

Concomitant medications may alter efficacy or increase side effects. Inform your healthcare provider about all prescription drugs, OTC medications, vitamins, and supplements. Notable interactions include cyclosporine, warfarin, and live vaccines.

What are the side effects of Stelara?

Common side effects include:

  • Runny or stuffy nose, sore throat, upper respiratory infections, sinus infections, bronchitis
  • Injection site reactions
  • Headache, tiredness, itchiness, nausea, vomiting
  • Vaginal yeast infections, urinary tract infections

Possible additional side effects:

  • Dizziness, diarrhea, back pain, muscle pain, depression

Rare but serious reactions include severe allergies, increased infection risk (e.g., tuberculosis), certain cancers (including skin cancer), and neurological events such as posterior reversible encephalopathy syndrome (PRES). Seek immediate care for symptoms like facial swelling, breathing difficulty, confusion, vision changes, or seizures.

Report adverse effects to the FDA: 1-800-FDA-1088 or www.fda.gov/medwatch.

What should you avoid while on Stelara?

Avoid contact with people who are ill or recently received live vaccines. Do not receive live vaccines (e.g., MMR, yellow fever, chickenpox, shingles, nasal flu) or BCG vaccine for at least one year after your last dose.

What should you tell your healthcare provider before using Stelara?

Inform your provider if you have:

  • A latex allergy (the syringe needle cover contains latex)
  • New or changing skin lesions
  • Upcoming or recent vaccinations
  • Received phototherapy
  • Allergy shots (risk of reduced efficacy and allergic reactions)
  • Pregnancy or plans to become pregnant
  • Breastfeeding or plans to breastfeed

What if you forget a dose?

If you miss a Stelara dose, contact your healthcare provider for instructions.

Best injection sites

Administer Stelara subcutaneously in the front thighs, abdomen (except a 2‑inch area around the belly button), or buttocks. Caregivers may use the upper arm.

How long to warm Stelara

Remove the syringe from the refrigerator and let it sit at room temperature for 30 minutes before injecting to reduce discomfort.

Route of administration

Stelara is given via subcutaneous injection as described above. For Crohn’s disease, the initial dose is an IV infusion based on weight, followed by subcutaneous injections every eight weeks.

Related Medications

  • Humira (adalimumab)
  • Cosentyx (secukinumab)
  • Dupixent (dupilumab)
  • Fasenra (benralizumab)
  • Nucala (mepolizumab)

Sources