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Generic Name:

apremilast, Oral tablet

All Brands

  • Otezla
SECTION 1 of 5

Highlights for apremilast

Oral tablet
1

Apremilast is an oral medication used to treat psoriasis and psoriatic arthritis.

2

The recommended dose is 30 mg taken twice per day. You’ll slowly work up to taking a full dose over the course of 6 days to lower your risk of gastrointestinal side effects.

3

You should take apremilast with a full glass of water. You can take apremilast with or without food. Take it with food if it upsets your stomach.

4

Common side effects include diarrhea, headache, nausea, and vomiting.

5

Tell your doctor if you have a history of depression or suicidal thoughts. Apremilast can make your symptoms of depression worse and cause suicidal thoughts or other mood changes.

IMPORTANT INFORMATION

Risk of depression

Tell your doctor if you have a history of depression or suicidal thoughts or behavior. This drug can make your symptoms of depression worse or cause suicidal thoughts or other mood changes. Contact your doctor right away if you feel:

  • anxious
  • agitated
  • hostile
  • irritable
  • aggressive
  • unable to sleep 

Weight loss warning

Monitor your weight regularly. Tell your doctor if you have any unexplained weight loss. If you lose a significant amount of weight, your doctor may stop your treatment with apremilast. 

What is apremilast?

Apremilast is a prescription drug. It’s available as an oral tablet.

This drug may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

Apremilast is used to treat moderate to severe plaque psoriasis and active psoriatic arthritis in adults.

How it works

Apremilast belongs to a class of drugs called phosphodiesterase 4 (PDE4) inhibitors.

More Details

How It Works

Apremilast belongs to a class of drugs called phosphodiesterase 4 (PDE4) inhibitors. It isn’t fully understood how apremilast works to treat psoriasis and psoriatic arthritis. It’s thought to work by decreasing your body’s response to inflammation.

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apremilast Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with apremilast include:

  • diarrhea

  • headache

  • nausea

  • vomiting

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • depressed mood

  • thoughts of hurting yourself or others

  • weight loss

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Apremilast does not cause drowsiness.

Mild side effects may disappear within a few days or a couple of weeks. Talk to your doctor or pharmacist if they’re more severe or don’t go away.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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apremilast May Interact with Other Medications

Oral tablet

Apremilast can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Antibiotic
  • rifampin

Taking this drug with apremilast can lower the amount of apremilast in your body. This may reduce its effectiveness.

Barbiturates

These drugs may be used as anticonvulsants, sedatives, and more. Taking these drugs with apremilast can lower the amount of apremilast in your body, which may reduce its effectiveness.

Prostate cancer drug
  • enzalutamide

Taking this drug with apremilast can lower the amount of apremilast in your body. This may reduce its effectiveness.

Herb
  • St. John’s wort

Taking this drug with apremilast can lower the amount of apremilast in your body. This may reduce its effectiveness.

Seizure medications

These include:

  • phenytoin
  • fosphenytoin
  • phenobarbital
  • carbamazepine

Taking these drugs with apremilast can lower the amount of apremilast in your body, which may reduce its effectiveness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Apremilast warnings
depression
People with depression

If you’re currently depressed or have a history of depression, use this medication with caution. It has increased depression in some people. If you’re taking this medication and have any changes in mood or thoughts of harming yourself or others, contact your doctor right away. You may need to stop taking this medication if you experience these symptoms.

kidney problems
People with kidney problems
If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects. If you have severe kidney disease, your doctor will lower your dose of this medication.
pregnant woman
Pregnant women

Apremilast is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Apremilast should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

It isn’t known if apremilast passes through breast milk. If it does, it could cause side effects in a breastfeeding child.

You and your doctor may need to decide if you’ll take apremilast or breastfeed.

children
For children

The safety and effectiveness of apremilast haven’t been established in people under the age of 18 years.

allergies
Allergies

Apremilast can cause a severe allergic reaction. Symptoms may include:

  • skin rash
  • trouble breathing
  • swelling of your throat or tongue
  • hives

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

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How to Take apremilast (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Psoriasis

Brand: Otezla

Form: Oral Tablet, Otezla tablet starter pack, Otezla tablet starter pack (28 day)
Strengths: 10 mg, 20 mg, and 30 mg
Adult Dosage (ages 18-64 years)
  • To reduce your chance of stomach problems, your doctor will start you on a low dose of apremilast and increase it each day over the first 5 days.
  • Your dose will be increased over the course of 6 days to 30 mg taken twice per day:
    • 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 after: 30 mg in the morning and 30 mg in the evening
Child Dosage (ages 0-17 years)

Dosage for people younger than 18 years hasn’t been established.

Senior Dosage (ages 65 years and older)

Your body may process this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic.

Special Considerations

Kidney disease: If you have severe kidney disease, your dose of apremilast will need to be lowered to 30 mg once daily. If you are just starting this drug, you’ll work up to taking 30 mg once per day:

  • Day 1: 10 mg in the morning
  • Day 2: 10 mg in the morning
  • Day 3: 10 mg in the morning
  • Day 4: 20 mg in the morning
  • Day 5: 20 mg in the morning
  • Day 6 and after: 30 mg once daily

Psoriatic arthritis

Brand: Otezla

Form: Oral Tablet, Otezla tablet starter pack, Otezla tablet starter pack (28 day)
Strengths: 10 mg, 20 mg, and 30 mg
Adult Dosage (ages 18-64 years)
  • To reduce your chance of stomach problems, your doctor will start you on a low dose of apremilast and increase it each day over the first 5 days.
  • Your dose will be increased over the course of 6 days to 30 mg taken twice per day:
    • 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 after: 30 mg in the morning and 30 mg in the evening
Child Dosage (ages 0-17 years)

Dosage for people younger than 18 years hasn’t been established.

Senior Dosage (ages 65 years and older)

Your body may process this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic.

Special Considerations

Kidney disease: If you have severe kidney disease, your dose of apremilast will need to be lowered to 30 mg once daily. If you are just starting this drug, you’ll work up to taking 30 mg once per day:

  • Day 1: 10 mg in the morning
  • Day 2: 10 mg in the morning
  • Day 3: 10 mg in the morning
  • Day 4: 20 mg in the morning
  • Day 5: 20 mg in the morning
  • Day 6 and after: 30 mg once daily

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Apremilast comes with risks if you don’t take it as prescribed.

If You Stop Taking It

Stopping the drug can cause the medication to stop working and cause your symptoms to return. Don’t stop taking apremilast unless your doctor advises you to stop.

What to Do If You Miss a Dose

If you miss a dose of apremilast, take it as soon as you remember. If it’s almost time for your next dose, only take a single dose.

Don’t take extra doses or double up on doses to make up for any missed doses.

How to Tell If the Drug Is Working

You may be able to tell apremilast is working for psoriasis if you have less irritation and fewer rashes.

You may be able to tell it’s working for psoriatic arthritis if you have less joint stiffness, pain, and swelling, and if you have better movement.

Apremilast is a long-term drug treatment.

Important Considerations for Taking Apremilast

You can take apremilast with or without food

Take it with food if it upsets your stomach. Take apremilast with a full glass of water.

Store in temperatures below 86°F (30°C)

Don’t freeze apremilast.

Keep it away from light and high temperature.

NOTE: Keep your medications away from areas where they could get wet, such as bathrooms. Store them away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled bottle with you when traveling.

Clinical Monitoring

Your doctor may check how well your kidneys are working before starting treatment. Your dose of apremilast will be lowered if you have severe kidney disease.

You and your doctor will also monitor your weight regularly while you take apremilast.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for apremilast.

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

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How Much Does apremilast Cost?

Oral tablet

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Lowest price for apremilast

Membership warehouse $2,583.77
Kroger Pharmacy $2,591.63
Target (CVS) $2,654.05
These prices represent the lowest priced national pharmacies for apremilast on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for apremilast on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on January 21, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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