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Otezla

Generic name: apremilast [a-PRE-mi-last]
Dosage form: tablets (10 mg, 20mg, 30mg)
Drug class: Antirheumatics

Medically reviewed by Melisa Puckey, BPharm. Last updated on Jun 7, 2024.

What is Otezla?

Otezla (apremilast) is used to treat plaque psoriasis, psoriatic arthritis, and Behçet's disease in specific patients. Otezla tablets help improve plaque psoriasis for clearer skin and reduce inflammation and symptoms such as pain, redness, and swelling in psoriatic arthritis and Behcet's disease by blocking the phosphodiesterase type 4 (PDE4) enzyme. 

Otezla is from a class of medications called PDE4 inhibitors that work by increasing the level of cAMP (cyclic adenosine monophosphate), a messenger involved in cell signaling in our bodies. Otezla is not a biologic agent.

Otezla received FDA approval on March 21, 2014, for psoriatic arthritis. Since then, it has also been FDA-approved to treat types of plaque psoriasis and Behcet’s disease in specific patients. It is not available as a generic medicine.

What is Otezla used for?

Warnings

Depression: Some people have thoughts about suicide while taking this medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Carefully weigh the risks and benefits of treatment in patients with a history of depression and/or suicidal thoughts or behavior.

Hypersensitivity: Cases of swelling (angioedema) and anaphylaxis have been reported. Do not use this medicine in patients with known hypersensitivity to apremilast or any of the inactive ingredients: 

Otezla Weight loss: Otezla may cause weight loss. Monitor weight regularly. If clinically significant or unexpected weight loss occurs, evaluate the reason for weight loss and consider stopping this medicine.

Drug Interactions: Medications that are strong cytochrome P450 enzyme inducers (e.g., rifampin, phenobarbital, carbamazepine, phenytoin) are not recommended because loss of efficacy may occur. See the Interactions section below.

What is the cost of Otezla?

The cost of prescription drugs varies depending on your insurance plan and which pharmacy you use. Refer to our price guide page for more information about the cost of Otezla.

You may also be eligible for an Otezla copay card, savings card, or Otezla coupon. Ask your doctor or pharmacist if you qualify.

Before taking this medicine

You should not use Otezla if you are allergic to the active ingredient apremilast or any of the inactive ingredients.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

Pregnancy:

Otezla may harm an unborn baby. It is important to use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of apremilast on the baby.

Breastfeeding: 

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Otezla pregnancy and breastfeeding warnings (more detail)

Otezla side effects

Common Otezla side effects may include:

Serious Otezla side effects

Get emergency medical help if you have signs of an allergic reaction to this medicine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Otezla may cause other serious side effects. Call your doctor at once if you have:

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Otezla side effects (more detail)

How should I take Otezla?

The tablet should be swallowed whole;  do not crush, chew, or break the tablet.
This medicine can be taken with or without food.

The Otezla dose is usually slowly increased over the first week to reduce gastrointestinal symptoms that may occur when this medication is first started. 

Take this medicine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Dosing information

Usual Adult Otezla Dose for Psoriatic Arthritis, Plaque Psoriasis, and Behcet’s disease

Adults Starting dose:

Maintenance dose:

Usual Otezla Dose Pediatric Patients with Moderate to Severe Plaque Psoriasis who are 6 Years of Age and Older and Weighing at Least 20kg.

Pediatric Patients 20kg to less than 50 kg:

Maintenance dose:

Pediatric Patients 50 kg or more:

Maintenance dose:

General Dosing Comments

Keep track of your body weight while you are taking this medicine, and tell your doctor about any major weight loss.

Dosage adjustments are required in renal impairment.

Otezla usually begins at a low dose that is increased over 5 days to the maintenance dose, this is to reduce gastrointestinal symptoms that may happen when you first start taking this medicine. You may be given your medicine in a starter pack containing tablets that have different strengths; it is important to follow your doctor's instructions carefully.

Detailed Otezla dosage information

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What other drugs will affect Otezla?

Sometimes, it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

When you are taking Otezla it is important to tell your doctor about all your current medicines and any medicine you start or stop using. It is especially important that your healthcare professional knows if you are taking any of the medications in the list below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using Otezla with any of the following medicines may not be recommended but may be necessary in some cases. If both medicines are to be used together, your doctor may change the dose or how often you use one or both of the medicines.

This list is not complete, and many other drugs can interact with Otezla. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you. Click the link below to check for interactions with this medication.

Otezla drug interactions (more detail)

Ingredients

Active ingredient: apremilast

Inactive ingredients:

10mg tablet: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, polyvinyl alcohol (unspecified), titanium dioxide, polyethylene glycol (unspecified), talc, ferric oxide red.

20mg tablet:  lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, polyvinyl alcohol (unspecified), titanium dioxide, polyethylene glycol (unspecified), talc, ferric oxide red, ferric oxide yellow.

30mg tablet: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, polyvinyl alcohol (unspecified), titanium dioxide, polyethylene glycol (unspecified), talc, ferric oxide red, ferric oxide yellow, ferrosoferric oxide.

Company

Manufactured for: Amgen Inc. Thousand Oaks, CA 91320-1799 U.S.A

Popular FAQ

Sotyktu and Otezla are both oral prescription medicines used to treat moderate-to-severe plaque psoriasis, but they work in different ways. Sotyktu blocks a protein called TYK2 (tyrosine kinase 2) to help lower inflammation and improve the severity and number of psoriasis lesions. Otezla works by blocking the phosphodiesterase type 4 (PDE4) enzyme to lower inflammation. Continue reading

Otezla may need to be taken long-term to manage symptoms caused by the chronic conditions it is approved to treat — psoriasis, psoriatic arthritis, and Behçet's disease. But exactly how long it should be taken can vary because it can depend on factors like response, personal preference, and condition severity. Continue reading

There is no evidence that it is unsafe to drink alcohol while taking Otezla. However, there are other reasons why it can be beneficial to limit alcohol consumption if you have psoriasis or psoriatic arthritis. Continue reading

The cash price of Otezla is around $5096 for a month’s supply of medication (60 tablets) using an online coupon. Your cost will be different based on your pharmacy location, insurance, or any discounts you may have. The manufacturer Amgen offers the Otezla $0 Co-pay Card Program for eligible patients. Continue reading

Otezla does not cause withdrawal symptoms when stopped, so it may be stopped suddenly, but there have been reports of people experiencing gastrointestinal complaints such as constipation, after they have stopped Otezla. This may be because Otezla tends to help bowels move much better, with some people reporting diarrhea or loose motions while on Otezla, and their stools become a lot harder once they have stopped Otezla. Other symptoms of their condition may also return. For this reason it may be better to reduce the dose of Otezla slowly over a week or two. Continue reading

Otezla is made by Amgen Inc, located in Thousand Oaks, California. Otezla is expensive because it is the original, brand name drug and Otezla's manufacturer sponsored the clinical development. The lower-cost generic option called apremilast was approved by the FDA in February 2021, but may not yet be on the market. Continue reading

No, Otezla does not cause weight gain, in fact, it is more likely to cause weight loss. In a pooled analysis of two large trials, ESTEEM 1 and ESTEEM 2, the average change in weight from the start of the trial to week 16 was -1.51 kg, or -3.33 lb for patients receiving Otezla 30mg twice daily. By week 52, approximately 19% of patients had lost more than 5% of their starting weight. Nobody described their weight loss as serious although two patients discontinued treatment because of weight loss. Continue reading

No, Otezla is not classified as a biologic agent. Otezla (apremilast) is a small molecule phosphodiesterase 4 (PDE4) inhibitor approved by the FDA for the treatment of plaque psoriasis, psoriatic arthritis, and oral ulcers associated with Behçet’s Disease. It is taken as an oral tablet. Continue reading

Rarely, Otezla may lower a person's mood, cause depression, and increase suicidal thoughts. Research has shown approximately 1% of people treated with Otezla for psoriatic arthritis reported depression or a depressed mood compared with 0.8% of those treated with an inactive treatment. The risk was slightly higher for those with psoriasis, with 1.3% reporting a lower mood compared with 0.8% treated with placebo. 0.3% of people with psoriatic arthritis and 0.1% of people with psoriasis discontinued treatment because of the depression. There was not any difference in the rates of depression for those treated with Otezla for Behçet’s disease. Continue reading

View more FAQ

References

  1. Otezla Package Insert FDA

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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