The information provided here is meant to give you a general idea of what to expect from each of these medications. Only the most common side effects are included, so ask your healthcare provider if there are any cautions specific to your case. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.
A variety of medications are used to treat psoriasis. Generally you will start with medications that are mildest and have the fewest side effects, and then gradually move to the next level of medication, if needed.
The following prescription medications act systemically and are generally used in more severe forms of psoriasis.
Immunosuppressive agents Cyclosporine
Topical Medications CorticosteroidsCalcipotrieneAnthralinSalicylic Acid
Biologic Response Modifiers EtanerceptInfliximabAlefaceptUstekinumabGolimumab
This medication is taken on a weekly (NOT daily) basis, in either oral or injectable form. It is very helpful in reducing psoriasis symptoms. It works by interfering with certain types of skin cell growth, thus slowing the process of psoriasis cell reproduction.
Possible side effects include: Nausea and vomitingDiarrheaRashMild hair lossHeadacheMouth soresReduced immune function and increased risk of infection
More serious problems may include:
Blood problemsKidney problemsStomach or liver problemsCancerLung Inflammation
Methotrexate should not be taken:
By women who are pregnant or nursingBy men who want to get their partner pregnant (methotrexate gets into sperm)With alcoholWith non-steroidal anti-inflammatory (NSAID) pain medications
Cyclosporine works by suppressing certain immune functions.
Do not take this medication with grapefruit or grapefruit juice, as it will increase its effect.
Possible side effects may include: High blood pressureHeadachesJoint painBody hair growthBleeding, tender, or enlarged gumsReduced immune function and increased risk of infectionKidney damageGout
Common names include: Tazarotene
Retinoids are vitamin A related medications that may be prescribed as either topical treatments (such as gels) or oral medication. Oral retinoids are used for treating severe cases of psoriasis, while topical retinoids can be used in mild or moderate cases.
Tazarotene is used in psoriasis treatment to help reduce skin reddening and reduce the size and number of lesions. It may be prescribed alone or in conjunction with topical steroids. It is available as a gel or cream that is applied once a day and is used for skin, scalp, and nail psoriasis.
Possible side effects include: Skin irritation, especially when used by itselfBurning or stinging of the skin (severe)Changes in color of treated skinDryness, itching, peeling, or redness of the skin (severe)Pain or swelling of treated skin
Contraindications: Should not be used during pregnancyDo not expose skin to excessive sunlight after treatmentDo not use around eyes, lips, or near the inside of the nose
Acitretin is used to control and relieve moderate to severe psoriasis. It works by allowing normal growth and development of skin.
Possible side effects include: Elevation of triglyceridesLiver inflammationSevere skin dryness and occasional burning sensationMild bone or joint painHeadacheNausea or vomitingRarely stiff, painful muscles
Contraindications: Cannot be used by women who are pregnant or planning to have children in the next three yearsDo not drink alcohol during treatment and for two months after discontinuing usage. This may both exacerbate the liver side effects of soriatane and extensively prolong the storage of the drug in the body.Blood should not be donated during treatment, and 2-3 years after discontinuing usageAvoid skin products containing alcohol, spices or limes, which increase sun sensitivityAvoid acne products that contain peeling agentsDo not take vitamin A, since doses greater than the minimum daily requirement may increase your chance of developing side effects
Common names include: CorticosteroidsCalcipotrieneAnthralinSalicylic Acid
The following topical prescription medications are generally considered step one therapies and are used as first line treatment for mild to moderate psoriasis.
Corticosteroids are used for treating inflammation of mild to moderate psoriasis. Available in many forms (such as ointments, creams, sprays, gels, shampoos and foams) and strengths, they are a synthetic version of hormones that occur naturally in the body. The weaker, over-the-counter strengths are usually not effective in treating psoriasis. Unlike systemic steroids, withdrawal (stopping) of topical steroids does not flare psoriasis.
Calcipotriene is a synthetic form of vitamin D used for treating mild to moderate psoriasis. It is a prescription medication that is available as a cream, ointment, or scalp solution. It can be used in conjunction with other treatments, but should be used in limited amounts to avoid side effects such as local irritation, rash, or worsening of psoriasis. Calcipotriene has recently become available in combination with a topical steroid Betamethasone.
Anthralin can be very effective for treating mild to moderate psoriasis, particularly the tough-to-treat thick patches. It is often used in conjunction with ultraviolet light treatments. This treatment has no known long-term side effects, but may irritate skin and stain clothes. Anthralin is rarely used in modern psoriasis treatment regimens.
This medication is used to soften and remove scale from psoriasis plaques. When scales are removed, other medications may penetrate the skin and promote healing. Salicylic acid is available in many strengths and types of preparations. Milder strengths are available without prescription.
Common names include: EtanerceptInfliximabAlefaceptUstekinumabAdalimumabGolimumab
These medications are prescribed when conventional medications have failed. They are taken as an IV infusion or as an injection. They work by blocking the action of TNF, a pro-inflammatory cytokine implicated in the development of psoriasis, or by inhibiting inflammatory cell activation in the skin. All patients receiving these medications must first undergo a skin test for
complete blood count
, as well as blood tests for liver and kidney function. Certain blood tests will continue to be monitored throughout the course of treatment.
Possible side effects include: ChillsHeadacheFeverNauseaMuscular pain or tendernessInjection site reactions
Serious complications may include: Allergic reactionsSerious infectionsBlood-related cancersLow plateletsSevere, immune-mediated anemiaArthritis eventsPsoriasis worseningLupus-like reactionsMultiple sclerosis-like reactions
Increased risk for children and teens to develop
and other types of cancer
Contraindications: Known chronic infectionsAllergy to any of the medication componentsLow white blood cell counts
Contact your doctor if you have any adverse reactions to new or existing medication treatments, or if you feel that a new medication is not working.
Also, call anytime you have questions about using your medicine.