Alternatives to Skyrizi (Risankizumab) If You Can't Fill Your Prescription

If you can't get your Skyrizi (risankizumab) prescription filled — whether due to insurance issues, prior authorization denials, or specialty pharmacy access problems — you're not without options. Several biologic and non-biologic alternatives can treat the same conditions that Skyrizi addresses: plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis.

Always discuss alternatives with your prescriber before switching medications. What works best depends on your specific condition, disease severity, insurance coverage, and medical history.

Other IL-23 Inhibitors (Most Similar to Skyrizi)

Skyrizi belongs to a class of biologics called IL-23 inhibitors, which specifically block the p19 or p40 subunit of interleukin-23. Other drugs in this class work by a similar mechanism and treat many of the same conditions.

Tremfya (Guselkumab)

Tremfya (guselkumab) is made by Johnson & Johnson (Janssen) and, like Skyrizi, selectively blocks the p19 subunit of IL-23. It is FDA-approved for moderate to severe plaque psoriasis, active psoriatic arthritis, and ulcerative colitis in adults. The dosing schedule is slightly different — 100 mg injected subcutaneously at weeks 0 and 4, then every 8 weeks for psoriasis — but the mechanism and efficacy profile are very similar to Skyrizi. For patients who cannot access Skyrizi due to insurance issues, Tremfya is one of the most comparable alternatives.

Stelara (Ustekinumab) — Now Available as Biosimilars

Stelara (ustekinumab), made by Janssen, is an older IL-12/23 inhibitor that blocks both IL-12 and IL-23 (versus Skyrizi's more targeted p19 blockade). It is FDA-approved for plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis — the same four indications as Skyrizi.

A major advantage of Stelara in 2026 is that FDA-approved biosimilars (such as Wezlana and Imuldosa) are now available, which can significantly lower the cost. If your insurer covers Stelara biosimilars under more favorable terms than Skyrizi, this can be an important consideration.

Omvoh (Mirikizumab)

Omvoh (mirikizumab-mrkz), made by Eli Lilly, is another selective IL-23p19 inhibitor FDA-approved for moderately to severely active ulcerative colitis in adults. If your primary diagnosis is UC and you can't access Skyrizi, Omvoh works by the same mechanism and may be more accessible through your specific insurance plan.

TNF Inhibitors: Broader Coverage, Often First-Line Under Step Therapy

Many insurance plans require patients to fail a TNF inhibitor before approving Skyrizi. This means TNF inhibitors are often the medications you'll be asked to try first. The most commonly used TNF inhibitors that overlap with Skyrizi's indications include:

Humira (adalimumab): FDA-approved for psoriasis, PsA, Crohn's disease, and UC. Many biosimilars (Hadlima, Hyrimoz, Cyltezo, etc.) are now available at lower costs.

Remicade (infliximab): IV infusion approved for psoriasis, PsA, Crohn's disease, and UC. Multiple biosimilars available.

Enbrel (etanercept): Approved for psoriasis and PsA. Note: not approved for Crohn's disease or UC.

IL-17 Inhibitors (Psoriasis and PsA Only)

For patients with plaque psoriasis or psoriatic arthritis (but not IBD), IL-17 inhibitors are another class of biologics to consider:

Cosentyx (secukinumab): Approved for psoriasis, PsA, and ankylosing spondylitis. Fast-acting, with high clearance rates in psoriasis.

Taltz (ixekizumab): Approved for psoriasis, PsA, and ankylosing spondylitis. Important note: IL-17 inhibitors can worsen inflammatory bowel disease and are not appropriate for patients with active IBD.

Non-Biologic Options

If biologics aren't accessible or appropriate, several non-biologic treatments are available depending on your condition:

Otezla (apremilast): An oral PDE4 inhibitor approved for psoriasis and PsA. Easier to access than injectable biologics and does not require refrigeration.

Rinvoq (upadacitinib) or Xeljanz (tofacitinib): Oral JAK inhibitors approved for psoriatic arthritis, Crohn's disease, or UC. Taken as a daily pill.

Methotrexate and cyclosporine: Traditional systemic options for psoriasis. Less effective than biologics for most patients but much lower cost.

What to Do While You Wait for Skyrizi Access

If you have a Skyrizi prescription but can't get it filled, don't stop treatment without your doctor's guidance. Contact your prescriber's office about bridging options. You can also use medfinder — a paid service that calls specialty pharmacies on your behalf to locate which ones can fill your Skyrizi prescription.

See also: How to Save Money on Skyrizi in 2026 for tips on using AbbVie's patient assistance programs.