Cosentyx (secukinumab) is given once every 4 weeks for long-term maintenance, but you’ll start with a loading phase of weekly injections during the first month. This pattern applies across most of the conditions Cosentyx treats, though the dose amount and whether you get a loading phase can vary depending on your diagnosis.
The Loading Phase: Weekly for 5 Weeks
For most conditions, Cosentyx starts with a loading phase: one injection per week at weeks 0, 1, 2, 3, and 4. That means five injections over your first five weeks of treatment. The purpose of this front-loaded schedule is to build up enough of the medication in your system to start controlling inflammation quickly.
For plaque psoriasis in adults, the loading phase uses 300 mg at each of those five weekly appointments. For psoriatic arthritis and ankylosing spondylitis, the loading dose is typically 150 mg per injection. Your prescriber may skip the loading phase entirely for psoriatic arthritis or ankylosing spondylitis and go straight to the maintenance schedule, depending on your situation.
Maintenance: Once Every 4 Weeks
After the loading phase ends, Cosentyx shifts to once every 4 weeks. This is the long-term schedule you’ll follow indefinitely. For plaque psoriasis, the standard maintenance dose is 300 mg every 4 weeks. For psoriatic arthritis and ankylosing spondylitis, it’s usually 150 mg every 4 weeks, though the dose can be increased to 300 mg if you’re not responding well enough.
For hidradenitis suppurativa (HS), the schedule follows the same pattern: 300 mg weekly for the first five weeks, then 300 mg every 4 weeks. If that isn’t controlling symptoms adequately, the frequency can be increased to every 2 weeks rather than every 4.
Dosing for Children and Teens
Cosentyx is approved for children as young as 2 for some conditions, with doses based on body weight. The schedule mirrors the adult pattern: weekly injections at weeks 0 through 4, then every 4 weeks after that.
Children weighing under 50 kg (about 110 pounds) typically receive 75 mg per injection for plaque psoriasis and juvenile psoriatic arthritis. Those at or above 50 kg get 150 mg. For adolescents 12 and older with hidradenitis suppurativa, the cutoff is different: 150 mg for those under 90 kg, and 300 mg for those at 90 kg or above.
How the Injection Works
Cosentyx is a subcutaneous injection, meaning it goes just under the skin rather than into a vein. Most people self-inject at home using the Sensoready auto-injector pen. You press it against your skin (thigh, abdomen, or upper arm), and you’ll hear a click when the injection starts. A second click a few seconds later signals it’s nearly done. You hold the pen in place until a green indicator fills the window and stops moving.
Each 300 mg dose can be given as a single 300 mg injection or as two separate 150 mg injections. If you’re doing two injections, they go in different spots on your body but are given at the same time.
What to Do If You Miss a Dose
If you miss a scheduled injection, take it as soon as you remember. If your next dose is coming up soon, skip the missed one and resume your regular schedule. Don’t double up to make up for a missed dose.
When the Schedule Might Change
The every-4-weeks maintenance schedule is the starting point, but not necessarily the final one. For plaque psoriasis and hidradenitis suppurativa, patients who don’t achieve an adequate response can be moved to every 2 weeks. This escalation isn’t where most people start. The recommendation is to begin at every 4 weeks and step up only if needed.
For ankylosing spondylitis, the adjustment works differently. Rather than increasing frequency, the dose itself may be raised from 150 mg to 300 mg while staying on the every-4-weeks schedule. Your prescriber will typically give the initial regimen several months to work before making changes.