Otezla (apremilast) is a prescription drug used to treat certain autoimmune conditions, such as psoriasis. The drug comes as a tablet. It’s usually taken once or twice daily, according to a dosage schedule.
Otezla is prescribed to treat:
- plaque psoriasis in adults and certain children
- psoriatic arthritis in adults
- mouth sores in adults with Behçet’s disease
The active ingredient in Otezla is apremilast. (An active ingredient is what makes a drug work.) Otezla belongs to a group of drugs called phosphodiesterase 4 inhibitors.
Otezla comes as a tablet that you swallow.
This article describes the dosages of Otezla, as well as its strengths and how to take it. To learn more about Otezla, see this in-depth article.
The sections below provide details about the typical form, strengths, and dosing of Otezla. Be sure to read on for more information.
What is Otezla’s form?
Otezla comes as a tablet that you swallow.
What strengths does Otezla come in?
Otezla comes in the following strengths:
- 10 milligrams (mg)
- 20 mg
- 30 mg
What are the usual dosages of Otezla in adults?
The information below describes dosages that are commonly used or recommended. But be sure to follow your doctor’s dosing instructions. They’ll determine the best dosage to fit your needs.
To decrease the risk of digestive side effects (nausea, vomiting, diarrhea), your doctor will likely recommend that you follow a special dosing schedule during the first 6 days of Otezla. The table below sets out these dosing instructions.
| Day of treatment | Morning dose | Evening dose |
|---|---|---|
| Day 1 | 10 mg | –– |
| Day 2 | 10 mg | 10 mg |
| Day 3 | 10 mg | 20 mg |
| Day 4 | 20 mg | 20 mg |
| Day 5 | 20 mg | 30 mg |
| Day 6 and beyond | 30 mg | 30 mg |
By the 6th day, you’ll be taking your maintenance dose.
Maintenance dosage for plaque psoriasis
Starting on day 6, the recommended maintenance dosage for plaque psoriasis is 30 mg, taken twice per day.
Maintenance dosage for psoriatic arthritis
Starting on day 6, the recommended maintenance dosage for psoriatic arthritis is 30 mg, taken twice per day.
Maintenance dosage for mouth sores from Behcet’s disease
Starting on day 6, the recommended maintenance dosage for mouth sores from Behçet’s disease is 30 mg, taken twice per day.
What are the dosages of Otezla for children?
Otezla is prescribed for certain children to treat plaque psoriasis that’s moderate to severe. The drug is approved for this condition in children ages 6 years and older who weigh at least 20 kilograms (kg) or about 44 pounds (lb).
The dosage for children with plaque psoriasis is determined by their weight. To decrease the risk of digestive side effects (nausea, vomiting, diarrhea), your child’s doctor will likely recommend a special dosing schedule during the first 6 days of Otezla. The table below sets out these dosing instructions.
| Day of treatment | Dosage for children weighing 20 to less than 50 kg | Dosage for children weighing 50 kg or more |
|---|---|---|
| Day 1 | • Morning dose: 10 mg • Evening dose: none | • Morning dose: 10 mg • Evening dose: none |
| Day 2 | • Morning dose: 10 mg • Evening dose: 10 mg | • Morning dose: 10 mg • Evening dose: 10 mg |
| Day 3 | • Morning dose: 10 mg • Evening dose: 20 mg | • Morning dose: 10 mg • Evening dose: 20 mg |
| Day 4 | • Morning dose: 20 mg • Evening dose: 20 mg | • Morning dose: 20 mg • Evening dose: 20 mg |
| Day 5 | • Morning dose: 20 mg • Evening dose: 20 mg | • Morning dose: 20 mg • Evening dose: 30 mg |
| Day 6 and beyond | • Morning dose: 20 mg • Evening dose: 20 mg | • Morning dose: 30 mg • Evening dose: 30 mg |
By the 6th day, your child will be taking their maintenance dose.
For children who weigh 20 kg to less than 50 kg, the recommended maintenance dosage is 20 mg, taken twice per day. For children who weigh 50 kg or more, the recommended maintenance dosage is 30 mg, taken twice per day.
For more information about Otezla’s dosage for children, talk with your child’s doctor or a pharmacist.
Is Otezla used long term?
Yes, Otezla is usually used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
Dosage adjustments
If you have severe kidney disease or kidney failure, your doctor will likely prescribe a dosage of 30 mg of Otezla that you take once per day. Taking the drug only once per day gives your kidneys more time to remove Otezla from your body between doses. You’ll only take the morning doses mentioned in the dosing schedule above for the first 6 days of treatment.
If you have side effects from Otezla, such as severe nausea, vomiting, or diarrhea, your doctor may adjust your dosage. If these side effects continue, they may recommend a different treatment for you.
Below are answers to some commonly asked questions about Otezla’s dosage.
What does Otezla cost?
The price you’ll pay for Otezla can vary. Your cost may depend on your treatment plan, your insurance coverage (if any), and the pharmacy you use. To save money on your Otezla prescription, explore these savings options.
Discover more about Otezla
What are the dosing instructions for the Otezla starter pack?
To make it easier to follow the dosing instructions during your first 6 days of Otezla, the drug is available in 14-day and 28-day starter packs.
Both packs contain the correct number of tablets for each strength as recommended in the dosing schedule for the first 6 days:
- four tablets of the 10-mg strength
- four tablets of the 20-mg strength
- three tablets of the 30-mg strength
The 14-day pack contains an additional 16 tablets of the 30-mg strength. And the 28-day pack contains 44 additional tablets of the 30-mg strength.
For detailed dosing instructions, see the table in the “What is Otezla’s dosage?” section above.
Is there a 60-mg daily dosage of Otezla?
Yes. Otezla’s daily dosage is usually 60 mg per day. This dosage is divided into two 30-mg doses. You take one tablet in the morning and one in the evening.
Adults with plaque psoriasis, psoriatic arthritis, and mouth sores from Behçet’s disease will likely take the same dosage. For children taking Otezla for plaque psoriasis, their doctor will prescribe a dosage based on the child’s body weight.
If you have questions about your daily dosage of Otezla, talk with your doctor or pharmacist.
The dosage of Otezla your doctor prescribes may depend on several factors. These include:
- your kidney health
- whether you experience side effects
- body weight, for children
To learn more about these two factors, see the “Dosage adjustments” section above.
Otezla comes as a tablet that you swallow. You can take Otezla with or without food.
Do not chew, crush, or split the tablets. If you have difficulty swallowing tablets, see this article for tips on how to take tablets.
For information on the expiration, storage, and disposal of Otezla, see this article.
Accessible drug containers and labels
Some pharmacies provide medication labels that:
- have large print or use braille
- feature a code you can scan with a smartphone to change the text to audio
Otezla is only available from specialty pharmacies. Your doctor may be able to recommend specialty pharmacies that offer these accessibility features.
If you have difficulty opening medication bottles, let your pharmacist know. They may be able to supply Otezla in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.
If you miss taking an Otezla dose, take it as soon as you remember. But if it’s almost time to take your next dose, skip the missed dose and take your next dose at its regularly scheduled time. You should not take two doses of Otezla at once to make up for a missed dose. This may increase your risk of side effects.
To help manage your condition, it’s important to take your dose of Otezla as prescribed.
If you need help remembering to take your dose of Otezla on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Do not take more Otezla than your doctor prescribes, as this can lead to serious side effects.
What to do in case you take too much Otezla
Call your doctor right away if you think you’ve taken too much Otezla. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
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 another 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.
