IL-17A and IL-17F Inhibitor Pregnancy: Limited data in pregnant women; as a precautionary measure it is preferable to avoid use during pregnancy. Women of childbearing potential should use effective contraception during treatment and for at least 17 weeks after treatment (UK SPC §4.6)

Bimekizumab

Brand names: Bimzelx

Bimekizumab is a humanised monoclonal antibody and a systemic biologic for moderate-to-severe plaque psoriasis, also used in psoriatic arthritis and axial spondyloarthritis, given by subcutaneous injection.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 320 mg (given as 2 subcutaneous injections of 160 mg, or 1 subcutaneous injection of 320 mg)

Route: Subcutaneous injection

Frequency: At weeks 0, 4, 8, 12 and 16, then every 8 weeks thereafter (plaque psoriasis)

UK SPC (Bimzelx 160 mg solution for injection). Dose above is the plaque psoriasis regimen. Other indications: psoriatic arthritis 160 mg every 4 weeks (for PsA with coexistent moderate to severe plaque psoriasis use the plaque psoriasis regimen; after 16 weeks, if joint response cannot be maintained, a switch to 160 mg every 4 weeks can be considered). Axial spondyloarthritis (nr-axSpA and AS): 160 mg every 4 weeks. Hidradenitis suppurativa: 320 mg every 2 weeks up to week 16, then every 4 weeks thereafter. Overweight patients with plaque psoriasis (including PsA with coexistent moderate to severe psoriasis) weighing 120 kg or more who have not achieved complete skin clearance at week 16 may further improve on 320 mg every 4 weeks after week 16. Consider discontinuing treatment in patients showing no improvement by 16 weeks. Elderly (65 years and over): no dose adjustment required. Renal or hepatic impairment: not studied; dose adjustment not considered necessary based on pharmacokinetics. Paediatric: safety and efficacy in children and adolescents below 18 years have not yet been established, no data available - no paediatric dose is stated. Administer into thigh, abdomen or upper arm, rotating sites and avoiding psoriasis plaques or tender, bruised, erythematous or indurated skin; administration in the upper arm only by a healthcare professional or caregiver. Evaluate for tuberculosis infection before initiating.

Dose adjustments

Renal

Not studied in renal impairment; dose adjustments not considered necessary based on pharmacokinetics (UK SPC §4.2)

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Clinically important active infections (e.g. active tuberculosis)

Side effects

Upper respiratory tract infections (very common)
Oral candidiasis; also tinea infections, ear infections, herpes simplex infections, oropharyngeal candidiasis, gastroenteritis, folliculitis, vulvovaginal mycotic infection (common)
Headache (common)
Rash, dermatitis and eczema, acne (common)
Injection site reactions and fatigue (common)
Inflammatory bowel disease and neutropenia (uncommon)

Interactions

Live vaccines should not be given to patients treated with bimekizumab; inactivated or non-live vaccinations may be given (UK SPC §4.4)
US labelling: CYP450 substrates - on initiation or discontinuation of bimekizumab in patients receiving CYP450 substrates with a narrow therapeutic index, consider monitoring effect (e.g. warfarin) or drug concentration (e.g. ciclosporin) and consider dose modification
US labelling: clearance not impacted by concomitant conventional DMARDs including methotrexate, or by prior biologic exposure

Clinical monograph

How it works

It selectively binds and neutralises both interleukin-17A and interleukin-17F, two pro-inflammatory cytokines central to the keratinocyte activation and inflammation that drive psoriatic plaques.

Prescribing in practice

Dual IL-17 inhibition carries a notable risk of mucocutaneous candidiasis (especially oral candidiasis), and the patient should be screened and treated if infection occurs.
Screen for active and latent tuberculosis and exclude active infection before starting, and avoid live vaccines during treatment.
Use with caution in patients with a history of inflammatory bowel disease, as IL-17 inhibition has been associated with new or worsening IBD.

Monitoring

Monitor for signs of infection, candidiasis and new or worsening inflammatory bowel symptoms throughout treatment and review response against psoriasis severity scores.

Counselling the patient

Report sore mouth, white patches, or other signs of thrush, as well as any signs of infection.
Tell the team about any new or worsening bowel symptoms such as diarrhoea or abdominal pain.
Avoid live vaccines while on treatment and discuss vaccination needs in advance.

Evidence & guidelines

NICE has recommended bimekizumab for moderate-to-severe plaque psoriasis, supported by the BE VIVID and BE RADIANT phase 3 trials.

Reference: BE VIVID trial (Reich et al. NEJM 2021); NICE TA878; MHRA SPC Bimzelx 2023; BE RADIANT trial (McInnes et al. Lancet 2023); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways