TYK2 (Tyrosine Kinase 2) Inhibitor Pregnancy: Available data from case reports in pregnancy are insufficient to evaluate a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; no effects on embryo-fetal development in rats and rabbits at doses at least 72 times the maximum recommended human dose of 6 mg once daily.

Deucravacitinib

Brand names: Sotyktu

Deucravacitinib is an oral selective tyrosine kinase 2 (TYK2) inhibitor licensed for moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy.

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: 6 mg

Route: Oral (tablets; do not crush, cut or chew)

Frequency: Once daily, with or without food

US prescribing information (SOTYKTU) — no UK SPC posology was retrieved, so verify against the UK SPC before use. Dermatology indication in the label: moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy (the label also covers active psoriatic arthritis). Before initiation, evaluate patients for active and latent tuberculosis — do not administer in active TB and start treatment for latent TB first; complete all immunisations according to current guidelines. HEPATIC IMPAIRMENT: not recommended in severe hepatic impairment (Child-Pugh C); no dosage adjustment for mild (Child-Pugh A) or moderate (Child-Pugh B) impairment. Safety and effectiveness in paediatric patients have not been established. In subjects aged 65 and over with plaque psoriasis there was a higher incidence of overall serious adverse reactions, including serious infections, and of discontinuations due to adverse reactions, than in younger adults.

Dose auto-extracted from 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

History of hypersensitivity reaction to deucravacitinib or to any of the excipients

Side effects

Upper respiratory infections (≥1%)
Blood creatine phosphokinase increased (≥1%)
Herpes simplex (≥1%)
Mouth ulcers (≥1%)
Folliculitis and acne (≥1%)
Serious: hypersensitivity reactions including angioedema, infections including tuberculosis, malignancies including lymphomas, rhabdomyolysis with markedly elevated CPK

Clinical monograph

How it works

It allosterically inhibits TYK2 by binding its regulatory domain, blocking signalling of interleukin-23, interleukin-12 and type I interferons that drive psoriatic inflammation.

Prescribing in practice

Screen for and treat latent tuberculosis and other active or chronic infections before starting, as TYK2 inhibition increases infection risk.
Live vaccines should be avoided during treatment, and immunisations brought up to date beforehand.
Although a selective TYK2 inhibitor, the recognised class warnings for Janus-kinase pathway agents (including malignancy and major cardiovascular and thrombotic events) should be considered in at-risk patients.

Monitoring

Monitor for signs of infection throughout treatment and consider liver function and lipid assessment in line with the current prescribing references.

Counselling the patient

Tell your team about any signs of infection such as fever, cough or persistent sores.
Avoid live vaccines and let healthcare staff know you take this medicine before any immunisation.
Take it as a whole tablet and do not crush or split it.

Evidence & guidelines

Efficacy over placebo and an active comparator in plaque psoriasis was shown in the POETYK PSO phase 3 trials, and NICE has appraised its use in moderate-to-severe disease.

Reference: POETYK PSO-1 trial (Armstrong et al. NEJM 2023); NICE TA929; MHRA SPC Sotyktu 2023; Strober et al. NEJM 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