Cosentyx dosage and stomach issues

Hi there,

I’ve been on Cosentyx for maybe six months now, and it’s helped a lot with my PsA. I did the loading dose (300mg every week for 5 weeks), then transitioned to 300mg (which is 2 pens) once every 4 weeks. After doing that for a month or two, my rheumy told me to do a 150mg pen once every 2 weeks, to even it out. Does anyone have any opinions regarding that? I’m just wondering why the manufacturer says to do 300mg every 4 weeks rather than what my rheumy told me to do (I’m following his advice at the moment).

Also, anyone on Cosentyx having stomach issues? 5-6 weeks ago I started getting pain in my stomach coupled with acid reflux (and then mild shortness of breath and heartburn related to the acid reflux). I went to my GP but they just recommended a round of Prilosec. I’m 3 weeks into Prilosec with no noticeable improvement. I don’t have IBS or any other digestive diseases, and my BMs seem totally fine. I was thinking maybe an ulcer, as a lot of the symptoms seem to mirror an ulcer (including pain after eating certain foods or if I haven’t eaten for a while). I actually first experienced this as pain in my mid-back, and thought it was spinal. After a couple weeks it moved more to the front and it became apparent it was actually stomach pain radiating into my back. It could be entirely unrelated to Cosentyx (here’s hoping), but I saw Cosentyx mentions stomach pain could be a side effect.

I take no other medications regularly, but do take some supplements (vitamin D, probiotic, daily vitamin, glucosamine joint pill, fish oil, turmeric, and ginger). Very occasionally NSAIDs but even when I was having bad PsA pain I tried to stay away from them as much as I could. I drink beer more than I should, but I haven’t noticed that beer triggers any of my pain symptoms (nor does abstaining seem to offer relief). If I eat anything fatty or fried, or anything tomato-based, oooh boy. And this is different than the “pain” from eating dairy. I’m slightly dairy-intolerant and get an upset stomach from it sometimes. This new pain is different.

I have a regular appt with my rheumy coming up so I’ll ask him at that time. Just thought I’d also ping the forum and see if anyone else has run into similar issues.

Sorry for the long post… I didn’t find much in a forum search.


I’m afraid I haven’t been on Costenyx, so can’t offer too much there, I’ll just note that too much Celebrex and Steroids did put me in this situation too - mine was just the meds, which I could tell through cause and effect (stopped them and the reflux / pain stopped within 3-4 days). But certainly it could be consistent with a ulcer.

For me those meds were top-ups for when Humira wasn’t working as well as it should though. I probably would have gone to the GP to double-check for an ulcer before stopping the main DMARD I was on. If this is easy, and affordable enough for you, one option would be to do this before talking to your Rheumy so that is ruled out (or so you know if it’s the cause).

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Nothing in your list should cause problems but it sounds to me like gallbladder. I would really suggest you enroll in their support program. It has been a world of help for my granddaughter. From their website:

The COSENTYX Connect Personal Support Program can help take the hassle out of getting started. We help take care of the details, so you can focus on getting clear skin. Once enrolled, our ongoing tools and services can help take the stress out of taking another medication and simplify your monthly routine. Questions about insurance coverage? Getting your medication? We can help. Enroll in COSENTYX Connect now. Or call 1-844-COSENTYX (1-844-267-3689).

Had acid reflux, went recently on no gluten low carb (so no beer) no sugar no trans fats oils diet , and started taking apple cider vinegar , bio, diluted in my drinking water, and my digestive issues have abated, no more reflux, recommend it

Having suffered acis reflux for years and knowing that most autoimmune conditions radiate from the gut I went in search of a solution. I had been on lansaprozole for a long time and it was getting worse especially during the night. I stumbled across l glutamine powder and within a couple of weeks I came off the lansaprozole, I also did an aspartame detox which nearly killed me. I now drink it first thing in the morning and last at night. Its helped with muscle pains and what sometimes feels like a hernia. If you can get a nice flavoured one. This is something they have been trialling for the last few years in our main cancer hospital to ease the symptoms on the stomach from chemo with great success.

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Just an update: after being on Prilosec OTC for 4+ weeks my stomach issues are starting to get better. I was taking an injection every 2 weeks so it’s not something I can really just “go off” for a little bit to test it. But if the Prilosec is working I’ll run another 2-week course of it and see what happens when I finish that.


I’ve been on Cosentyx for over a year and I take the 300 mg dosage per month. I follow what my derm tells me & the manufacturer. Not sure why they have you take the smaller dose. I guess if that dose works well for you & your height and weight, then it sounds like your doctor is correct. But anyway, I’ve never had any stomach issues with this med yet. Glad to hear your are starting to feel better! Good luck on Cosentyx! I love it so far!

For psoriasis, the recommended dosage of Cosentyx is 300 mg by subcutaneous injection at Weeks 0, 1, 2, 3, and 4 followed by 300 mg every 4 weeks. Each 300 mg dosage is given as 2 subcutaneous injections of 150 mg and the 300 mg is used as loading doses. For some patients, a dosage of 150 mg may be acceptable every 2 weeks, and avoid some of the stomach issues by evening out the half lives.

I had very bad digestive side effects from Cosentyx until I started eating yogurt. I started eating two spoonfuls of whole milk probiotic yogurt whenever I ate any food. It only worked when I ate the yogurt with the meals, not if I ate the yogurt at other times. That seemed to get rid of almost all the digestive side effects.

My diet is also strictly healthy. No refined grains or added sugars at all. Only whole foods: whole grains, legumes, vegetables, fruit, and nuts, all cooked from scratch. Sugar, juice, and too much dried fruit would make the digestive problems worse. I was able to eat dried fruit again after the yogurt got rid of the worst side effects.