Apremilast Disease Interactions

Apremilast therapy has been associated with adverse reactions of depression. Therapy with apremilast should be administered cautiously in patients with a history of depression and/or suicidal thoughts or behavior. Patients, their caregivers, and families should be advised of the potential for emergence or worsening of depression, suicidal thoughts or other mood changes. The need for continued treatment with apremilast should be carefully weighed against the risks.

Increased apremilast systemic exposure has been observed in patients with severe renal impairment (CrCl < 30 mL/min). Therapy with apremilast should be administered cautiously in these patients. Initial dosage titration and maintenance dosage should be reduced in accordance with the product package labeling.

Apremilast therapy has been associated with weight loss. During controlled clinical trials, weight reduction between 5% to 10% of body weight was reported in 10% of patients treated with apremilast compared to 3.3% of those receiving placebo. Weight change should be monitored during apremilast therapy, particularly in patients suffering from anorexia, malnutrition, or excessive weight loss. Physicians should evaluate patients for any unexplained or clinically significant weight loss, and discontinuation of apremilast should be considered if appropriate.