Tildrakizumab

Overview

Tildrakizumab is a prescription-only biologic medicine. It is given by injection under the skin. It is a humanised monoclonal antibody: a laboratory-made protein that recognises one target in the body. That target is interleukin-23, a messenger protein that is part of the inflammatory process in psoriasis. Tildrakizumab attaches to the p19 part of interleukin-23 and stops it from reaching its receptor. This interrupts the inflammatory signal, and this can reduce the psoriasis plaques.

After the first two doses, tildrakizumab is given once every 12 weeks. You can read more about the condition on our psoriasis page.

Global Name

• Generic Name: Tildrakizumab (tildrakizumab-asmn in the United States)
• Brand Names: Ilumetri in Hong Kong, Mainland China and Europe; Ilumya in the United States and Australia.

Usage

What is tildrakizumab used for?

Tildrakizumab is used to treat moderate to severe plaque psoriasis in adults who are suitable for systemic treatment or phototherapy. Usually, these are adults whose psoriasis covers a large area or has a large effect on daily life, and who did not improve enough with creams and light therapy. A dermatologist decides if a biologic medicine is suitable.

Tildrakizumab is not licensed for other forms of psoriasis, for psoriatic arthritis, or for other skin conditions. It is not approved for children.

Other treatments for plaque psoriasis

Tildrakizumab is one of many treatments for plaque psoriasis. The correct treatment depends on how severe the psoriasis is, where it is on the body, and your general health. Other treatments include:

• Creams and ointments, such as corticosteroids, vitamin D analogues and coal tar.
• Phototherapy (light therapy), such as narrowband UVB.
• Tablets that act on the whole body, such as methotrexate, ciclosporin, acitretin and apremilast.
• Other biologic injections, which block TNF, interleukin-17, interleukin-23 or interleukin-12/23.

Your dermatologist can tell you which treatments are suitable for you.

How is tildrakizumab given?

In Hong Kong, tildrakizumab is supplied as a pre-filled syringe that contains 100 mg in 1 mL. Each syringe is for one use only.

The medicine is injected under the skin of the thigh, the abdomen or the upper arm. The usual schedule is:

• 100 mg at week 0, as the first dose.
• 100 mg at week 4.
• 100 mg once every 12 weeks after that.

A nurse or doctor usually gives the first injections. After training, many patients inject themselves at home. Use a different injection site each time. Do not inject into skin that has psoriasis, or into skin that is sore, bruised, red, hard or scaly. Do not shake the syringe.

Tildrakizumab is a long-term treatment. Your doctor examines the response, usually at about week 28, and then decides if you should continue.

Do not use tildrakizumab if you:

• Had an allergic reaction to tildrakizumab or to any other ingredient in the injection.
• Have an active, clinically important infection, including active tuberculosis.
• Are less than 18 years old, because its safety and effect in this group are not known.

If you are pregnant, plan to become pregnant or are breastfeeding, speak to your doctor. There is little data on tildrakizumab in pregnancy, and doctors usually do not advise it’s use it in pregnancy.

Interactions and Contraindications of Tildrakizumab

Before the first dose, your doctor will do a test for tuberculosis (TB). If the test finds latent tuberculosis, you will get treatment for it first. Bring your vaccination record to that appointment, because it is better to complete any vaccinations before treatment starts. Do not have live vaccines while you use tildrakizumab. Inactivated vaccines, including the usual influenza vaccine, are permitted. Tell your doctor about all other medicines that affect the immune system, because a combination can increase the risk of infection.

Side Effects

The most frequent side effects are mild. They include upper respiratory tract infections such as colds and sore throats, headache, diarrhoea, back pain, and reactions at the injection site, such as redness, pain or swelling. Injection site reactions usually stop within one or two days.

Tildrakizumab attenuates part of the immune system response. Thus, infections can occur more easily or can last longer. Speak to your doctor if you have a fever, chills, a cough that does not stop, burning when you pass urine, or a wound that does not heal. Serious allergic reactions are rare. Stop treatment and get medical help immediately if you have a rash on a large area of the body, swelling of the face, lips or tongue, or difficulty when you breathe. Tell your doctor if your psoriasis becomes worse after several doses.

Pharmacist Tips and Storage

Keep the syringes in a refrigerator between 2°C and 8°C. Do not freeze them. Keep them in the original carton to protect the medicine from light. You can keep the medicine out of the refrigerator for one limited period only. Read the carton or ask your pharmacist for the correct time and temperature. Keep all syringes out of the reach and sight of children. Do not use a syringe after its expiry date.

Remove the syringe from the refrigerator approximately 30 minutes before the injection, and let it become room temperature. Do not make it warm in hot water, in a microwave or in direct sunlight. Do not shake it. Look at the liquid before the injection. It must be clear to slightly cloudy, and colourless to slightly yellow. Do not use it if it has a different colour or contains large particles. Put the used syringe into a sharps container immediately. Do not put it into household waste. Ask your clinic how to return a full container. When you travel, carry the medicine in a cool bag in your hand luggage, with a letter from your doctor.

Availability of Tildrakizumab

Where is tildrakizumab available in Hong Kong?

Tildrakizumab is a Prescription Only Medicine. It is registered in Hong Kong as Ilumetri Solution for Injection in Pre-filled Syringe 100 mg/1 mL, registration number HK-67428 (registered April 2022). It is classified as a Part 1, Schedule 1 and Schedule 3 poison. A pharmacist can supply it only against a prescription from a registered doctor.

A dermatologist starts and supervises the treatment. The dermatologist confirms the diagnosis, examines how severe the psoriasis is, and arranges the tuberculosis test before treatment. Hospital and specialist clinic pharmacies usually supply biologic medicines. Community pharmacies usually do not keep them. Biologic medicines are expensive. Speak to your insurer before treatment starts.

FAQs

How long does tildrakizumab take to work?

Many patients see an improvement in 12 to 16 weeks, and the skin can continue to improve after that. Your doctor usually examines the result at about week 28 and then decides if you should continue.

Can I inject tildrakizumab myself?

Yes, after a nurse or doctor trains you and your doctor agrees that it is suitable. Many patients inject at home after the first doses. If you are not confident, the clinic can continue to give the injections.

What should I do if I miss a dose?

Inject the dose when you remember. Then speak to your doctor or clinic about the date of your next dose. Do not inject two doses to make up for a missed dose.

Is tildrakizumab a steroid?

No. It is a biologic medicine that blocks one specific inflammatory signal, interleukin-23. It is not a steroid.

Do I need blood tests during treatment?

Before you start, you need a test for tuberculosis and often for hepatitis. Your doctor decides which other tests you need and how often.

Can I have vaccinations while I use tildrakizumab?

Do not have live vaccines during treatment. Inactivated vaccines, such as the usual influenza vaccine, are permitted. Tell any doctor or pharmacist who gives you a vaccine that you use a biologic medicine.

Does tildrakizumab cure psoriasis?

No. It controls the condition but does not cure it. Plaques usually return in the months after treatment stops. Thus, it is a long-term treatment.

OT&P last checked this page against the sources below on 19 October 2026.

Official drug information

• Hong Kong Drug Office, Department of Health Registered in Hong Kong as Ilumetri (HK-67428) since April 2022, as a prescription-only medicine. Check the register
• European Medicines Agency The assessment report and full product information for tildrakizumab (Ilumetri), covering dosing, warnings and pharmacology. Read the EMA page

Recent research

These studies look at the active ingredient, not at any one brand. All are peer-reviewed.

• Tildrakizumab versus placebo or etanercept for chronic plaque psoriasis (reSURFACE 1 and reSURFACE 2) The Lancet, 2017. Two randomised controlled phase 3 trials, 1,862 patients. View on PubMed
• Long-term efficacy and safety of tildrakizumab for moderate-to-severe psoriasis through 148 weeks British Journal of Dermatology, 2019. Pooled analysis of the two phase 3 trials. View on PubMed
• Tildrakizumab: a review in moderate to severe plaque psoriasis American Journal of Clinical Dermatology, 2019. Narrative review of efficacy and safety. View the paper