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Healthy Living
May 26, 2023

Cosentyx Side Effects and How To Manage Them With Medicinal Food

Cosentyx side effects can affect the GI tract and actually provoke symptoms of IBD, but adjusting your diet can help reduce discomfort.
Medically Reviewed
Written by
Chanel Dubofsky
Medically Reviewed by
Dr. Anshul Gupta

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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:

  • psoriatic arthritis
  • psoriasis
  • ankylosing spondylitis, a type of arthritis that causes chronic inflammation of the spine

(Source, Source)

Side Effects of Cosentyx

cosentyx side effects

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
  • have Crohn's disease or ulcerative colitis
  • are pregnant or plan to become pregnant, or are breastfeeding 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 surgery scheduled or require surgery while you're taking Cosentyx, since you may be at a greater risk of postoperative infection

(Source, Source, Source)

a person itching their chest

Common Cosentyx Side Effects

The most commonly reported side effects of Cosentyx are:

  • diarrhea
  • runny or stuffy nose
  • sneezing
  • skin rash
  • sore throat
  • Itching

More Serious Cosentyx Side Effects

Some side effects of Cosentyx require medical attention, including:

Allergic Reactions

  • rash
  • hoarseness
  • hives
  • difficulty breathing or swallowing
  • feeling faint
  • tightness in your chest
  • swelling in your face, throat, eyes, lips, and throat


Inflammatory Bowel Disease

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)


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:

  • unexpected weight loss
  • fever
  • night sweats
  • coughing (especially coughing up blood)
  • chest pain

(Source, Source)

Cosentyx and Drug Interactions

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:

  • abatacept, baricitinib, sarilumab, tocilizumab, tofacitinib
  • upadacitinib, which treats immune disorders such as rheumatoid arthritis
  • canakinumab, used in the treatment of juvenile arthritis
  • macitentan, which treats hypertension
  • Cosentyx should not be taken with other biologics, such as Humira (adalimumab), Enbrel (etanercept), or Stelara (ustekinumab).

(Source, Source)

ginger and turmeric in fabric bags

Managing Cosentyx Side Effects With Diet

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 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

(Source, Source)


Diarrhea can be mitigated by:

  • 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 foods high 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. Consider low FODMAP foods 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.

(Source, Source, Source, Source, Source, Source)

two hands holding halves of a walnut

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)
  • aloe vera
  • rutabaga
  • garlic
  • lemons and limes


grapefruit, grapes, and pomegranate

Supporting Your Diagnoses Through Diet

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.


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:

  • lean protein
  • plant-based proteins (tofu, tempeh)
  • legumes
  • seeds

(Source, Source, Source, Source, Source)

Psoriatic Arthritis

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

(Source, Source, Source, Source)  

Ankylosing Spondylitis

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:

  • leafy greens
  • edamame
  • almonds
  • plant-based milks (if you need to avoid dairy)
  • winter squash

(Source, Source, Source, Source)

a person with their face under the covers in bed

The Bottom Line on Cosentyx Side Effects

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.

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Cosentyx Side Effects and How To Manage Them With Medicinal Food

Cosentyx side effects can affect the GI tract and actually provoke symptoms of IBD, but adjusting your diet can help reduce discomfort.
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Cosentyx side effects can affect the GI tract and actually provoke symptoms of IBD, but adjusting your diet can help reduce discomfort.
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