Medication	Screening and monitoring	Comorbid infectious disease considerations
Acitretin	Baseline: creatinine, lipid, and hCG levels; liver function tests Liver function tests and lipid levels monthly for 3 months, then every 3 months CBC and kidney function tests every 3 months; hCG levels monthly	HIV: may be used in those on antiretrovirals Not recommended in patients with active hepatitis B or C infection due to risk of hepatotoxicity
Apremilast (Otezla)	Baseline: creatinine level Repeat testing for creatinine level at least annually Monitor for signs of depression throughout treatment	HIV: may be used in those on antiretrovirals Active hepatitis B and C infection: consultation with a specialist is recommended; no known hepatotoxic effects
Cyclosporine	Baseline: blood pressure; CBC; hCG, bone morphogenetic protein, uric acid, magnesium, and lipid levels; liver function tests; urinalysis; and latent TB Blood pressure; CBC; and bone morphogenetic protein, uric acid, magnesium, and lipid levels every 2 weeks for 3 months, then monthly if on a stable dose	Potent immunosuppressant; not recommended with immunodeficiency disorders or chronic infections
Deucravacitinib (Sotyktu)	Liver function tests, creatinine and triglyceride levels, and screen for development of infections and latent TB	May increase the risk of infections and viral reactivation; consultation with specialist is recommended if patient has any chronic or recurrent infection
Interleukin- 12/23 inhibitors	Baseline: CBC, comprehensive metabolic panel, and purified protein derivative or QuantiFERON-TB Gold+ testing; HBsAg, anti-HBs, anti-abc, and hepatitis C antibody tests; and HIV screening For those taking secukinumab (Cosentyx), screen regularly for nonmelanoma skin cancer	HIV: may be used in those on antiretrovirals; do not use if patient has had a recent opportunistic infection Active hepatitis B or C infection: can be considered with specialist consultation
Interleukin-17 inhibitors	Baseline: CBC, comprehensive metabolic panel, and purified protein derivative or QuantiFERON-TB Gold+ testing; HBsAg, anti-HBs, anti-abc, and hepatitis C antibody tests; and HIV screening	HIV: use with caution Active hepatitis B infection: can use, consider use of antiviral with specialist consultation Active hepatitis C infection: can use
Methotrexate	Before initiation: hepatitis B and C screening and purified protein derivative or QuantiFERON-TB Gold+ testing Baseline: CBC; hCG, BUN, and creatinine levels; liver function tests; and chest radiography CBC monthly; BUN and creatinine levels and liver function tests every 4 to 8 weeks, or earlier if there is a dose change	HIV: use with caution as a second-line alternative Treatment may increase the risk of reactivating latent TB, hepatitis B and C infection, and Epstein-Barr virus–associated lymphoma Not recommended in patients with active hepatitis B and C infections due to hepatotoxicity
Tumor necrosis factor-alpha inhibitors	Baseline: CBC, comprehensive metabolic panel, and purified protein derivative or QuantiFERON-TB Gold+ testing; HBsAg, anti-HBs, anti-abc, and hepatitis C antibody tests; and HIV screening If taking infliximab and adalimumab, liver function tests every 3 months, then every 6 to 12 months, if normal Regular screening for skin cancer	HIV: can use if on antiretroviral therapy (with normal CD4 counts and no detectable viral load) Active hepatitis B infection: can use; consider use of antiviral with specialist consultation Active hepatitis C infection: may receive tumor necrosis factor-alpha inhibitor