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Apremilast

Generic name: apremilast [ a-PRE-mi-last ]
Brand name: Otezla
Dosage form: oral tablet (10 mg-20 mg-30 mg; 30 mg)
Drug class: Antirheumatics

Medically reviewed by Philip Thornton, DipPharm. Last updated on Nov 6, 2023.

What is apremilast?

Apremilast is a phosphodiesterase 4 (PDE4) inhibitor that works to suppress the immune system, which reduces inflammation.

Apremilast is used to treat active psoriatic arthritis in adults.

Apremilast is also used to treat moderate to severe plaque psoriasis in adults who may also receive phototherapy or other treatments for psoriasis.

Apremilast is also used to treat mouth ulcers in adults with Behçet's disease (a disease causing inflammation in blood vessels).

Warnings

Some people have thoughts about suicide while taking apremilast. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

You should not use apremilast if you are allergic to it.

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

Some people have thoughts about suicide while taking apremilast. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Apremilast may harm an unborn baby. 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.

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

Apremilast is not approved for use by anyone younger than 18 years old.

How should I take apremilast?

Take apremilast 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.

You may take apremilast with or without food.

Swallow the tablet whole and do not crush, chew, or break it.

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

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Psoriatic Arthritis:

Initial dose:
-Day 1: 10 mg orally once a day (AM)
-Day 2: 10 mg orally twice a day (AM and PM)
-Day 3: 10 mg orally once a day (AM); 20 mg orally once a day (PM)
-Day 4: 20 mg orally twice a day (AM and PM)
-Day 5: 20 mg orally once a day (AM); 30 mg orally once a day (PM)

Maintenance dose: 30 mg orally twice a day (AM and PM)

Comments: This titration is intended to reduce the gastrointestinal symptoms associated with initial therapy.

Use: Treatment of adult patients with active psoriatic arthritis

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 should I avoid while taking apremilast?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Apremilast side effects

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

Call your doctor at once if you have:

Common apremilast side effects may include:

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 FDA at 1-800-FDA-1088.

What other drugs will affect apremilast?

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.

Other drugs may interact with apremilast, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

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 is made by Amgen Inc, located in Thousand Oaks, California. Otezla is expensive because it is a brand name drug. The lower-cost generic option called apremilast was approved by the FDA in February 2021, but it is not yet on the U.S. market, possibly due to ongoing patent protection. Continue reading

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use apremilast only for the indication prescribed.

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