Drug reference

Tildrakizumab

Anti-IL-23 (p19) monoclonal antibody (humanised IgG1) · Psoriasis Treatment

START

100 mg SC at weeks 0, 4, then every 12 weeks

TYPICAL MAX

200 mg SC every 12 weeks (selected ≥90 kg)

STOP IF

Serious infection or severe hypersensitivity

WATCH

Latent TB screen pre-start; infection signs; CBC if symptoms

CDSCO approvedSchedule HATC L04AC17

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 1d · SC absorption
PEAK: 6d · serum Cmax
t½: 3.3w · t½ ~23 d
DURATION: 12w · q12w

EXCRETION

Proteolytic catabolism; not excreted intact

route + CYP

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Limited data; transplacental passage in 3rd trimester (IgG1).

FDA category + note

Top interactionssee all 12 →

AdalimumabSevereDatabaseDDInter
BaricitinibSevereDatabaseDDInter
CertolizumabSevereDatabaseDDInter
CladribineSevereDatabaseDDInter

Mechanism

Selectively binds the p19 subunit of interleukin-23, inhibiting IL-23/Th17 axis activation involved in plaque psoriasis pathogenesis.

Indications

Moderate-to-severe plaque psoriasis (adults eligible for systemic therapy or phototherapy)

Dosing

Adult: 100 mg SC at weeks 0, 4, then every 12 weeks. 200 mg may be considered for higher body weight (≥90 kg) per individualised response.
Pediatric: Not established.
Renal adjustment: No dose adjustment.
Hepatic adjustment: No dose adjustment.
Geriatric: No specific adjustment.
Max dose: 200 mg SC every 12 weeks (selected, ≥90 kg)

Pharmacokinetics

Onset

PASI improvement over weeks

Peak effect

~6 days (serum Cmax)

Duration

~12-week dosing interval

Half-life

~23 days

Bioavailability

~73–80% (SC)

Protein binding

Not applicable (antibody)

Metabolism

Proteolytic catabolism

Excretion

Catabolised (not renally/hepatically excreted intact)

Contraindications

Active serious infection
Hypersensitivity to tildrakizumab
Caution: latent TB (screen before start)

Side effects

Common

Upper respiratory infectionsInjection-site reactionsHeadacheDiarrhoea

Serious

Serious infections
Reactivation of latent TB
Severe hypersensitivity
Inflammatory bowel disease (paradoxical, rare)

Pregnancy & lactation

Pregnancy

Limited data; transplacental passage in 3rd trimester (IgG1).

Lactation

Likely low milk transfer; weigh benefit/risk.