apremilast (Otezla)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Psoriasis Symptoms, Causes and Treatment

What is apremilast, and how does it work (mechanism of action)?

Apremilast is an oral medication used to treat adults with active psoriatic arthritis (a form of arthritis that affects some people with psoriasis). It is also used to treat moderate to severe plaque psoriasis in patients who are candidates for phototherapy or systemic therapy. Apremilast works by reducing production of an enzyme known as phosphodiesterase 4(PDE4). This may lead to a reduction in chemicals that cause inflammation in the body. However the exact mechanism in treating psoriatic arthritis and plaque psoriasis is not known. In clinical studies, patients with psoriatic arthritis had improvement in tender and swollen joints, as well as physical function. Patients with plaque psoriasis had reductions in redness, scaliness and thickness of the skin. The FDA approved apremilast in March 2014.

What brand names are available for apremilast?


Is apremilast available as a generic drug?


Do I need a prescription for apremilast?


What are the side effects of apremilast?

The most common side effects associated with apremilast are diarrhea, nausea, and headache. It also can cause upper respiratory tract infections. Depression, upper abdominal pain, and weight loss were also reported in clinical studies.

Quick GuidePsoriasis Types, Images, Treatments

Psoriasis Types, Images, Treatments

What is the dosage for apremilast?

Apremilast tablets should be swallowed whole and should not be broken, chewed or crushed before swallowing. Apremilast tablets can be taken with or without food.

Treatment is started with a 14-day starter pack. The starting dose is 10 mg taken on the first day. The dose is gradually increased for 5 days until the recommended dose of 30 mg twice a day is reached.

  • Day 1: 10 mg in the morning
  • Day 2: 10 mg in the morning and 10 mg in the evening
  • Day 3: 10 mg in the morning and 20 mg in the evening
  • Day 4: 20 mg in the morning and 20 mg in the evening
  • Day 5: 20 mg in the morning and 30 mg in the evening
  • Day 6 and thereafter: 30 mg twice a day

After the starter pack is complete, the rest of the tablets will be supplied by a specialty pharmacy. The recommended dose long term dose is 30 mg twice a day. Patients with renal failure should have only a maximum of 30 mg per day; pm doses should be skipped.

Which drugs or supplements interact with apremilast?

: Rifampin, St. John's Wort and carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol, Epitol, Teril) may reduce blood levels of apremilast by increasing its break down.

Is apremilast safe to take if I'm pregnant or breastfeeding?

It is not known whether apremilast is secreted into breast milk.

What else should I know about apremilast?

What preparations of apremilast are available?

Tablets: 10, 20, and 30 mg

How should I keep apremilast stored?

Apremilast tablets should be stored at room temperature below 30 C (86 F).

Medically reviewed by John Cunha, DO

REFERENCE: FDA Prescribing Information.

Last Editorial Review: 8/7/2017

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Reviewed on 8/7/2017
Medically reviewed by John Cunha, DO

REFERENCE: FDA Prescribing Information.

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