Cosentyx, the brand name for the generic secukinumab, is a protein-based medication made from living materials (blood, protein, viruses) known as a biologic. It targets interleukin-17 (IL-17), a proinflammatory protein. As with any medication, Cosentyx comes with a number of potential side effects. In this article, we'll take a look at these side effects and how you might address them with diet. Understanding Cosentyx side effects and how they can be reduced will help you make an informed decision about treating your condition with the drug.
What Does Cosentyx Treat?
Cosentyx is injected under the skin, and is prescribed to improve the symptoms of:
Cosentyx can lower your body’s ability to fight infection, and actually increase the likelihood of getting infections. Therefore, before starting Cosentyx, you should tell your health care provider if you:
are being treated for an infection, especially if that infection keeps coming back
have symptoms of an infection, including a fever, sweats, chills, muscle aches, cough, weight loss, shortness of breath, stomach pain, sores on your body, burning when you urinate, or diarrhea
are pregnant or plan to become pregnant, or arebreastfeeding or planning to breastfeed. Cosentyx hasn't been evaluated extensively in pregnant or breastfeeding people.
have a latex allergy
have recently received, or are planning to receive, a live vaccine that contains a weakened (attenuated) virus. (Flu and COVID-19 vaccines are not live vaccines.)
have had a positive tuberculosis test or a history of latent tuberculosis infection
have any other medical conditions
have surgeryscheduled or require surgery while you're taking Cosentyx, since you may be at a greater risk of postoperative infection
Cosentyx can worsen Crohn’s disease and ulcerative colitis, and may even lead to new onset of these inflammatory bowel diseases. If you're taking Cosentyx and you develop symptoms of Crohn's or ulcerative colitis, contact your provider immediately. Symptoms include:
diarrhea
blood in the stool
fatigue
unexpected and unintended weight loss
abdominal pain
reduced appetite
Your provider should take a complete medical history before you start Cosentyx, including any intestinal symptoms you may have had. Cosentyx can expose the symptoms of Crohn’s disease, so it’s important to know if there's ever been any suspicion that you have Crohn’s, or if anyone in your family has it. It’s possible that Cosentyx isn’t right for you, and if that's the case, there are alternative drugs to be considered. (Source, Source, Source)
Tuberculosis
Because Cosentyx works by dampening your immune response, there is concern it might increase your risk of contracting tuberculosis, or activate a latent (nonsymptomatic) tuberculosis infection if you have one. However, independent studies on the possible effects of secukinumab on tuberculosis infection have not found this to be likely.
Nevertheless, your health care provider should screen you for tuberculosis before starting you on Cosentyx, and continue to monitor you while you are taking it. Be sure to let your provider know if you develop any of the following symptoms:
There are certain medications that are incompatible with Cosentyx, including drugs that treat other autoimmune conditions. Taking these medications together can increase the likelihood of infections, or render the drugs less effective. Let your health care provider know if you'’e taking any of these:
Since Cosentyx can have some gastrointestinal side effects, let’s take a look at the ways these might be managed with changes to diet.
Hives
Hives are a rare side effect of Cosentyx, and they can also be an indication of a serious allergic reaction.When you have an allergic reaction, your body releases histamine, which enables immune molecules to reach areas that are injured or under siege from foreign invaders, such as viruses. Excessive histamine production can result in inflammation, which may lead to the onset of autoimmune conditions. Many symptoms of a histamine intolerance resemble side effects of Cosentyx, such as:
runny or stuffy nose
sneezing
rashes
Those with histamine intolerance are more likely to have Crohn’s disease and ulcerative colitis, which, ironically, Cosentyx can actually worsen. You may consider a low histamine diet while you’re taking Cosentyx to see if it lessens certain side effects, which means limiting or avoiding foods such as:
fermented foods such as wine, beer, sauerkraut, soy sauce, and cheese that’s cured, semi-cured, or grated
foods known as "histamine liberators," which may provoke cells to release histamine, such as spinach, avocados, papaya, pineapple, chocolate, and nuts
drinking fluids, including water, broth, tea, and electrolyte drinks
soluble fiber, found in oats, apples, beans, citrus fruits, barley, peas, and carrots
a low fiber BRAT (bananas, rice, applesauce, and toast) diet. A BRAT diet can also include sweet potatoes, crackers, and creamy peanut butter
avoiding foodshigh in sugar, dairy, or caffeine, or that are fatty, fried, or spicy, since they can lead to diarrhea or make it worse
avoiding high FODMAP foods, which are poorly absorbed and implicated in symptoms of inflammatory bowel disease. Considerlow FODMAPfoods such as gluten free bread, quinoa, oatmeal, rice, nuts, seeds, salmon, canned tuna, non-dairy milk, broccoli, cabbage, butternut squash, pumpkin, sweet potato, ginger, pineapple, and blueberries.
Protecting Your Overall Gut Health While on Cosentyx
Increasing your intake of anti-inflammatory foods may also help alleviate gastrointestinal issues brought on by Cosentyx. Including antifungal foods in your diet may help prevent Candida overgrowth, a rare side effect of Cosentyx found in those taking it for psoriasis.
Anti-inflammatory foods include:
nuts
green, leafy vegetables such as kale and collards
fatty fish such as salmon, tuna, and sardines
fruits such as strawberries, blueberries, cherries
tomatoes
Antifungal foods include:
ginger
coconut oil
olive oil
kimchi (avoid this and other fermented foods if you're concerned about histamine)
The decision to go on any medication is one only you can make. It’s up to you, with the help of your health care provider, to evaluate the side effects and the pros and cons of that medication and how it might work (or not work) for your particular circumstances. Whether or not you ultimately choose to go on medication, nutrition can always help in supporting your overall health and managing symptoms.
So now that you know the side effects of Cosentyx, let’s take a look at how diet can impact the conditions it treats.
Psoriasis
The cause of psoriasis isn’t fully understood, but it’s believed to involve a combination of genetics and environment. Maintaining a healthy lifestyle with psoriasis is key, which includes avoiding smoking and alcohol, and eating a balanced diet that limits:
refined carbohydrate, such a white bread and pastries
saturated and trans fats found in fast foods and fried foods
foods high in sugar, such as soda and sweetened cereals
foods high in gluten, including beer, pretzels, and pasta
high fat dairy products
Adding foods that reduce inflammation (see our list above) can also help ease your psoriasis symptoms. That includes:
If you have psoriatic arthritis, you can benefit from eliminating foods that cause inflammation, as well as eating more of those that actively reduce it. It’s also important to include in your diet foods that help lower your risk of cardiovascular disease, a risk that is increased if you have psoriatic arthritis. These foods include:
foods with omega-3 acids, such as walnuts, flaxseed and fatty fish
potassium rich foods, such as low fat dairy, legumes, beet greens, dried fruits, and potatoes
foods high in vitamin D, such as eggs, mushrooms, orange juice, and sardines
Currently, there’s no conclusive evidence that diet has a relationship to ankylosing spondylitis, but reducing inflammation and losing weight (if necessary) can help improve how you feel. That may mean avoiding:
foods that cause inflammation
foods high in sugar
Osteoporosis is common in those with ankylosing spondylitis, so including foods high in calcium may help in preserving bone health. You may consider adding:
Cosentyx is an injectable medication that treats psoriasis, psoriatic arthritis, and ankylosing spondylitis, conditions associated with inflammation. While the common side effects are manageable, if you have a condition such as ulcerative colitis Cosentyx can actually aggravate it. Some side effects can be soothed by modifying your diet, especially by excluding foods known to increase inflammation in the body. Decreasing inflammation is also a vital part of managing symptoms of psoriasis, psoriatic arthritis, and ankylosing spondylosis.
Information is power, so now that you have it, you can make an informed decision about whether or not Cosentyx is right for you. And remember that WellTheory's Care Team, including our Nutritional Therapy Practitioners, are here to help you navigate changes and find community support.
Give yourself the time and space to find out what your ideal routine looks like to support your autoimmunity. Over 75 days, you’ll incorporate new routines focused on diet, sleep, movement, stress management, and lifestyle to make steady, sustainable progress towards reducing your symptoms.”
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