Can't find or afford Sotyktu? Here are the best alternative medications for plaque psoriasis, including oral and biologic options.
Sotyktu (Deucravacitinib) has been a game-changer for many people living with moderate-to-severe plaque psoriasis. It's the only oral TYK2 inhibitor on the market, offering a once-daily pill that targets the immune pathways driving psoriasis without the boxed warnings associated with JAK inhibitors.
But what happens when you can't fill your prescription? Maybe your pharmacy doesn't carry it, your insurance won't cover it, or the cost is simply too high. Whatever the reason, it's important to know that there are effective alternatives available.
In this article, we'll explain how Sotyktu works, then walk through several alternative medications your dermatologist may consider.
Sotyktu is the brand name for Deucravacitinib, a selective TYK2 inhibitor. TYK2 is an enzyme in the immune system that helps transmit signals from inflammatory cytokines — specifically IL-23, IL-12, and Type I interferons. These cytokines play a major role in the development of psoriatic skin plaques.
By blocking TYK2 at its regulatory domain (not the active site), Sotyktu reduces inflammation in a highly targeted way. This selectivity is what sets it apart from broader JAK inhibitors and is why it doesn't carry a boxed warning for cardiovascular events or blood clots.
Sotyktu is taken as a 6 mg tablet once daily, with or without food. It was FDA-approved in September 2022 for adults with moderate-to-severe plaque psoriasis.
If Sotyktu isn't available to you, talk to your dermatologist about these alternatives. Each one targets the immune system in a different way, and the best choice depends on your medical history, insurance coverage, and personal preferences.
Drug class: IL-23 inhibitor (biologic)
How it's taken: Subcutaneous injection. Two loading doses at weeks 0 and 4, then one injection every 12 weeks.
Why it's a strong alternative: Skyrizi targets IL-23 — one of the same cytokines that Sotyktu blocks — making it one of the closest alternatives in terms of mechanism. Clinical trials have shown very high skin clearance rates (PASI 90 and PASI 100 responses). The every-12-week dosing is convenient for patients who don't mind injections.
Cost: Approximately $18,000–$22,000 per year before insurance. Manufacturer savings programs are available from AbbVie.
Drug class: IL-23 inhibitor (biologic)
How it's taken: Subcutaneous injection. Loading doses at weeks 0 and 4, then every 8 weeks.
Why it's a strong alternative: Like Skyrizi, Tremfya blocks IL-23 and delivers impressive psoriasis clearance. It's been on the market since 2017 and has a well-established safety record. The every-8-week injection schedule is slightly more frequent than Skyrizi but still very manageable.
Cost: Similar range to Skyrizi before insurance. Janssen offers a savings program for eligible patients.
Drug class: PDE4 inhibitor (oral)
How it's taken: Oral tablet, taken twice daily. Dose is gradually increased over the first 5 days.
Why it's a strong alternative: If you prefer an oral medication and want to avoid injections, Otezla is the most established oral option for psoriasis besides Sotyktu. It works by inhibiting phosphodiesterase 4 (PDE4), reducing inflammatory signaling. While generally considered less effective than Sotyktu or the IL-23 biologics for severe psoriasis, Otezla works well for many patients with mild-to-moderate disease.
Cost: Around $1,800–$2,200 per month without insurance. Amgen offers a patient savings card.
Drug class: JAK inhibitor (oral)
How it's taken: Oral tablet, once daily.
Why to consider it: Rinvoq is FDA-approved for psoriatic arthritis and atopic dermatitis, and it may be used off-label in certain psoriasis cases. However, it's important to note that Rinvoq carries a boxed warning for serious infections, malignancies, cardiovascular events, and blood clots — risks that Sotyktu does not share. Rinvoq is typically reserved for patients who haven't responded to other therapies.
Cost: Approximately $5,500–$6,500 per month without insurance. AbbVie offers savings programs.
Choosing an alternative to Sotyktu depends on several factors:
Not being able to fill your Sotyktu prescription is frustrating, but it doesn't mean you're out of options. Several highly effective alternatives exist, and your dermatologist can help you find the best fit for your situation.
Before switching medications, it's worth trying to locate Sotyktu through Medfinder or a specialty pharmacy — read our guide on how to find Sotyktu in stock near you. If cost is the barrier, our article on saving money on Sotyktu may help you keep your current treatment.
For a full overview of the medication, visit What is Sotyktu?
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