Otezla (apremilast)

What is Otezla?

Otezla is a brand-name prescription drug. It’s approved for use in adults to treat the following conditions:

• plaque psoriasis
• psoriatic arthritis, which is a form of arthritis that can occur in people with psoriasis
• ulcers (mouth sores) in people with Behçet’s disease

Otezla contains the drug apremilast. It belongs to a class of medications called disease-modifying antirheumatic drugs (DMARDs). A medication class describes a group of drugs that work in the same way. Drugs in this class can slow down or stop certain conditions that are caused by an overactive immune system.

Otezla comes as tablets you take by mouth. It’s available as 10-mg, 20-mg, and 30-mg tablets.

Effectiveness

In people with plaque psoriasis, research has shown Otezla to completely or nearly completely clear plaques in about 20% of people after 16 weeks. And about 30% of people have clearer skin and fewer plaques after 16 weeks.

Research has also shown that for people with psoriatic arthritis, Otezla improved symptoms by 20% in about 30% to 40% of people who took it.

And in people with Behçet’s disease, research has shown that Otezla completely cleared mouth ulcers in:

• about 53% of people after 12 weeks
• about 30% of people after 6 weeks of treatment; in these people, their mouth ulcers stayed completely clear for another 6 weeks

Otezla generic

Otezla contains the drug apremilast. It’s not available as a generic drug. (A generic drug is an exact copy of the active drug in a brand-name medication.) Apremilast is only available as Otezla.

Otezla side effects

Otezla can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Otezla. This list doesn’t include all possible side effects.

For more information on the possible side effects of Otezla, or for tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Otezla, you can do so through MedWatch.

More common side effects

The more common side effects of Otezla include:

• diarrhea
• nausea
• headache
• respiratory infection
• vomiting
• belly pain
• fatigue (lack of energy)
• insomnia (trouble sleeping)
• decreased appetite
• weight loss
• back pain

Most of these effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

* This is a partial list of mild side effects from Otezla. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Otezla’s prescribing information.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911or your local emergency number if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• allergic reaction
• severe diarrhea, nausea, or vomiting
• depression
• thoughts of suicide

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Otezla. But it’s not known how many people using Otezla have had an allergic reaction to the drug.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have a severe allergic reaction to Otezla. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight loss

Loss of appetite and weight loss are common side effects of Otezla. They can occur in 10% to 12% of people who take it. The loss of 5% to 10% of body weight is most common, but some people have had weight loss of over 10% of their body weight.

If you experience severe weight loss while taking Otezla, talk to your doctor. They may recommend that you stop taking this drug.

Cancer

People who have psoriasis have a slightly increased risk for certain types of cancer. There’s also a concern that some of the medications used for treating psoriasis might increase the risk of some types of cancer.

Clinical studies on apremilast, the drug contained in Otezla, so far show that it doesn’t increase the risk of cancer in people who have psoriasis.

Depression

Although not common, depressed mood can occur in some people who take Otezla. Less than 2% of people experience this side effect. And less than 1% of people experience serious or more severe depression. Suicidal thoughts or behaviors occur in less than 1% of people taking Otezla.

Depression in people taking Otezla might be more likely for those who have had depression in the past.

If you experience mood changes or depressed mood while taking Otezla, be sure to talk with your doctor.

Headaches

Headache is a common side effect that people who take Otezla report. It occurs in up to 14% of people taking the drug, depending on the condition being treated.

In most cases, people experience a milder tension-type headache. But about 2% of people may experience a migraine headache, which is more severe.

These side effects usually go away with continued use of Otezla. If they don’t go away or become bothersome, talk with your doctor.

Diarrhea

Diarrhea commonly occurs in people who take Otezla. In fact, up to about 41% of people taking the drug have diarrhea. Most of the time, the diarrhea isn’t severe and usually goes away with continued use of the drug.

However, severe diarrhea has occurred in some people taking Otezla, and in some cases, it can lead to dehydration (low fluid level) and electrolyte imbalances.

If you have diarrhea that doesn’t go away or you have severe diarrhea while taking Otezla, talk with your doctor. They may lower your dosage or have you stop taking the drug.

Nausea

Nausea is a common side effect of Otezla. It occurs in up to 17% of people who take the drug. In most cases, the nausea isn’t severe and usually goes away with continued use of the drug.

However, in some cases, it can be severe and may include vomiting. Severe nausea and vomiting can lead to dehydration (low fluid level) and electrolyte imbalances.

If your nausea doesn’t go away or you have severe nausea or vomiting while taking Otezla, talk with your doctor. Your doctor may lower your dosage or have you stop taking Otezla.

Otezla cost

As with all medications, the cost of Otezla can vary. To find current prices for Otezla in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Otezla, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Otezla, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Otezla, or if you need help understanding your insurance coverage, help is available.

Amgen, the manufacturer of Otezla, offers a copay card that may reduce the cost of Otezla. The manufacturer also has a program called Otezla SupportPlus, which may assist you in finding ways to lower the cost of Otezla.

For more information and to find out if you’re eligible for support, call 844-468-3952 or visit the program website.

Generic version

Otezla is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Uses for Otezla

The Food and Drug Administration (FDA) approves prescription drugs such as Otezla to treat certain conditions.

Otezla is FDA-approved to treat three conditions, which are described in more detail below:

• plaque psoriasis
• psoriatic arthritis
• mouth ulcers caused by Behçet’s disease

For plaque psoriasis and psoriatic arthritis, Otezla is often used in combination with other medications such as methotrexate (Otrexup, Rasuvo, Trexall, others), sulfasalazine (Azulfidine), leflunomide (Arava), or others.

Otezla for psoriatic arthritis

Otezla is approved to treat active psoriatic arthritis in adults. Psoriatic arthritis is a condition that has both the swollen, sore joints of arthritis and the skin lesions of psoriasis. Skin lesions caused by psoriasis are usually itchy, scaly red patches. In some cases, the lesions can affect your scalp.

Effectiveness for psoriatic arthritis

In clinical studies, Otezla improved symptoms of this condition by 20% in about 30% to 40% of people who took it. In comparison, 18% to 19% of people taking a placebo (treatment with no active drug) had that same result.

Otezla for plaque psoriasis

Otezla is approved to treat moderate to severe plaque psoriasis in adults. This is the most common form of psoriasis. It’s characterized by thick red patches of skin that often have a silver or white scaly layer.

Effectiveness for plaque psoriasis

In clinical studies, about 30% of people taking Otezla had clearer skin and fewer plaques. In comparison, about 5% of people taking a placebo (treatment with no active drug) had that same result. For about 20% of people, their plaques cleared completely or almost completely. And 4% of people taking a placebo had the same result.

Otezla for mouth ulcers caused by Behçet’s disease

Otezla is approved to treat mouth ulcers that occur with Behçet’s disease.

Behçet’s disease is an autoimmune disease. It causes damage to certain blood vessels that can lead to sores in your mouth, rashes, and other symptoms.

Effectiveness for Behçet’s disease

In a clinical study, 53% of people who took Otezla had their mouth ulcers completely cleared after 12 weeks. In comparison, 22% of people taking a placebo (treatment with no active drug) had that same result.

For 30% of people who took Otezla for 6 weeks, their mouth ulcers completely cleared and stayed cleared for another 6 weeks. In comparison, 5% of people taking a placebo had the same result.

Also, during the study, people taking Otezla had an average of 1.5 mouth ulcers. People taking the placebo had an average of 2.6 mouth ulcers.

Otezla for other conditions

In addition to the uses listed above, Otezla may be used off-label for other uses. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Otezla is used for certain other conditions. Below is information on other possible uses for Otezla.

Otezla for other forms of psoriasis (off-label)

There are several forms of psoriasis, but Otezla is only approved to treat plaque psoriasis.

However, Otezla is used off-label for adults with guttate psoriasis, nail psoriasis, palmoplantar psoriasis, pustular psoriasis, and scalp psoriasis. It’s not recommended for off-label use in treating erythrodermic psoriasis.

If you have questions about treatment options for psoriasis, talk with your doctor.

Otezla for eczema (not a known use)

Eczema, also called atopic dermatitis, can result in long-lasting or recurring rashes on the face, head, or arms and legs.

In 2012, one small study evaluated Otezla for treating adults with eczema and found that it reduced itching and the severity of eczema. However, currently the American Academy of Dermatology doesn’t recommend Otezla for treating eczema.

If you’d like to know about treatment options for eczema, talk with your doctor.

Otezla for rheumatoid arthritis (not a known use)

Currently, the American College of Rheumatology doesn’t recommend Otezla for treating rheumatoid arthritis (RA).

One clinical study evaluated Otezla in people with RA who didn’t respond adequately to treatment with methotrexate. Otezla didn’t improve symptoms any better than taking a placebo pill.

If you’d like to learn about treatment options for RA, talk with your doctor.

Otezla and alcohol

Drinking alcohol while taking Otezla might add to or worsen some side effects from Otezla, especially if you drink too much.

Worsened side effects can include diarrhea, nausea, vomiting, headache, and fatigue.

Dosage for Otezla

When you start taking Otezla, your doctor will gradually increase your dosage until you reach the standard dose. Your doctor may follow a specific schedule that the drug manufacturer recommends.

The following information describes the dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you.

Forms and strengths

Otezla comes as tablets that are taken by mouth. It’s available in the following strengths:10 mg, 20 mg, and 30 mg.

Dosage for psoriatic arthritis, plaque psoriasis, and Behçet’s disease

When you first start taking Otezla, your doctor will likely increase your dosage gradually over 5 days. This is to help reduce gastrointestinal (GI) upset.

The 5-day dosing schedule for Otezla is as follows:

• Day 1:
  • Morning: 10 mg
• Day 2:
  • Morning: 10 mg
  • Evening: 10 mg
• Day 3:
  • Morning: 10 mg
  • Evening: 20 mg
• Day 4:
  • Morning: 20 mg
  • Evening: 20 mg
• Day 5:
  • Morning: 20 mg
  • Evening: 30 mg

On day 6 and after, the typical dosage of Otezla is 30 mg twice daily, taken in the morning and evening.

Dosage considerations

If you have kidney disease, your doctor may prescribe a different dosage. During the 5-day starting period, you may only take the morning doses and skip the evening dose. On day 6 and after, your dosage would then be 30 mg once daily.

Your doctor may also prescribe a lower dosage if you’ve experienced troubling side effects such as serious diarrhea, nausea, or vomiting.

What if I miss a dose?

If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, just take that one dose. Don’t try to catch up by taking two doses at once.

Otezla withdrawal

Stopping Otezla doesn’t cause withdrawal symptoms. However, you should still talk with your doctor before stopping this medication. And keep in mind that if you do stop taking it, the symptoms of your condition may return.

Otezla support

The manufacturer of Otezla offers information and support for people taking Otezla through a special program. This program, called SupportPlus, also provides information on how to reduce costs for the drug. Learn more at https://www.otezla.com/supportplus.

Alternatives

Several types of drugs can be used to treat psoriasis, psoriatic arthritis, and Behçet’s disease, which are the conditions Otezla is approved to treat.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Other DMARDs

Otezla belongs to a class of medications called disease-modifying antirheumatic drugs (DMARDs). Other DMARDs that may be used to treat psoriasis, psoriatic arthritis, or Behçet’s disease include:

• leflunomide (Arava)
• methotrexate (Otrexup, Rasuvo, Trexall, others)
• sulfasalazine (Azulfidine)

Medications from other drug classes

Medications in other drug classes may also be used as alternatives to Otezla for certain diseases. Examples of these drugs include:

• retinoids for psoriasis, psoriatic arthritis, or Behçet’s disease, such as:
• acitretin (Soriatane)
• isotretinoin (Absorica, Amnesteem, Claravis, others)
• immunosuppressants for psoriasis, psoriatic arthritis, or Behçet’s disease, such as:
• azathioprine (Azasan, Imuran)
• cyclosporine (Gengraf, Neoral, Sandimmune)
• biologics for psoriasis or psoriatic arthritis, such as:
• abatacept (Orencia)
• adalimumab (Humira)
• brodalumab (Siliq)
• certolizumab (Cimzia)
• golimumab (Simponi, Simponi Aria)
• guselkumab (Tremfya)
• etanercept (Enbrel)
• infliximab (Inflectra, Remicade, Renflexis, others)
• ixekizumab (Taltz)
• secukinumab (Cosentyx)
• ustekinumab (Stelara)

Herbs and supplements

Some people also use herbs and dietary supplements in an effort to treat psoriasis, psoriatic arthritis, or Behçet’s disease. Examples of these supplements include:

• aloe cream
• fish oil
• saffron
• St. John’s wort ointment

Be sure to talk with your doctor before trying any herb or dietary supplement for treating psoriasis or psoriatic arthritis. For most of these supplements, either there’s very little research showing that they work, or research findings are inconsistent.

Otezla vs. Humira

You may wonder how certain drugs, such as Humira, compare to Otezla.

Otezla and Humira (adalimumab) belong to different classes of medication. A medication class describes a group of drugs that work in the same way. Otezla is a disease-modifying antirheumatic drug (DMARD). Humira, on the other hand, is a biologic therapy that’s in a class of drugs called tumor necrosis factor-alpha (TNF-alpha) inhibitors.

Use

Both Otezla and Humira are FDA-approved for treating psoriasis and psoriatic arthritis. However, Humira is also FDA-approved to treat many other conditions, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and others.

In addition, Otezla is approved to treat mouth sores in people with Behçet’s disease.

Both medications can be taken by themselves or along with other medications for these uses.

Forms and administration

Otezla comes as a tablet that’s taken by mouth twice daily.

Humira is a self-administered injection that’s given every other week or every week, depending on the condition being treated.

Effectiveness

Both Otezla and Humira are effective for treating psoriasis and psoriatic arthritis. They haven’t been directly compared in clinical studies. One analysis of clinical research found that Humira may be more effective in treating psoriatic arthritis than Otezla.

When comparing drugs, keep in mind that your doctor will make treatment recommendations based on your individual needs. They’ll consider several factors, such as your age, gender, childbearing potential, other conditions you may have, your risk for side effects, and how severe your condition is.

Side effects and risks

Otezla and Humira have some similar side effects and some that differ. Below are examples of these side effects.

Costs

Otezla and Humira are both available only as brand-name drugs. They don’t have generic forms, which are typically less expensive than brand-name versions.

Humira usually costs more than Otezla. The actual amount you pay will depend on your insurance plan.

Otezla vs. Stelara

You may wonder how certain drugs, such as Stelara (ustekinumab), compare to Otezla.

Otezla and Stelara belong to different classes of medication. A medication class describes a group of drugs that work in the same way. Otezla is a disease-modifying antirheumatic drug (DMARD). Stelara is a biologic therapy that’s in a class of drugs called interleukin inhibitors.

Use

Both Otezla and Stelara are FDA-approved to treat psoriasis and psoriatic arthritis. Stelara is also FDA-approved to treat Crohn’s disease and ulcerative colitis.

In addition, Otezla is approved to treat mouth sores in people with Behçet’s disease.

Both medications can be taken by themselves or along with other medications for these uses.

Forms and administration

Otezla comes as a tablet that’s taken by mouth twice daily.

Stelara is available as a self-administered injection and as a solution that’s given by intravenous (IV) infusion. (With an IV infusion, the drug is injected into your vein over a period of time.) Stelara is taken once every 8 to 12 weeks, depending on the condition you’re treating.

Effectiveness

Both Otezla and Stelara are effective for treating psoriasis and psoriatic arthritis. These drugs haven’t been directly compared in clinical studies.

In separate clinical studies in people with psoriasis, about 20% of people taking Otezla had their skin become completely clear or almost completely clear at 16 weeks. In people receiving Stelara, about 50% to 75% had those same effects at 12 weeks.

In other studies, Otezla improved symptoms of psoriatic arthritis by 20% in about 30 to 40% of people who took it. In people receiving Stelara, about 40% to 50% of people had a 20% improvement in symptoms.

When comparing drugs, keep in mind that your doctor will make treatment choices based on your individual needs. They’ll consider several factors, such as your age, gender, childbearing potential, other conditions you may have, your risk of side effects, and how severe your condition is.

Side effects and risks

Otezla and Stelara have some similar side effects and some that differ. Below are examples of these side effects.

Costs

Otezla and Stelara are both only available as brand-name drugs. They don’t have generic forms, which are typically less expensive than brand-name versions.

Stelara costs much more than Otezla. The actual amount you pay will depend on your insurance plan, your location, and the pharmacy you use.

Otezla vs. biologics

Otezla and biologic therapies can both be used to treat psoriasis and psoriatic arthritis. But keep in mind that Otezla isn’t a biologic. (Biologics are drugs that are made from immune system cells.) Otezla, however, is made from chemicals (as many drugs are).

Otezla is a type of drug called an immunosuppressant. It works by lowering (suppressing) the activity of your immune system.

Here are some points to consider when comparing Otezla to biologic drugs:

• Otezla hasn’t been directly compared to biologic therapy in clinical studies.
• In some cases, biologic therapy may have more risks in terms of potentially serious side effects.
• Biologic drugs are often more expensive than Otezla.
• Otezla is a tablet that you take by mouth. Biologic therapies are all given by injection.

Keep in mind that your doctor will make treatment choices based on your individual needs. They’ll consider several factors, such as your age, gender, childbearing potential, other conditions you may have, your risk for side effects, and how severe your condition is.

There are many different types of biologic therapies. Examples of these drugs include:

• tumor necrosis factor-alpha inhibitors, such as:
  • certolizumab (Cimzia)
  • etanercept (Enbrel)
  • adalimumab (Humira)
  • infliximab (Inflectra, Remicade, Renflexis, others)
  • golimumab (Simponi, Simponi Aria)
• interleukin 12 and 23 inhibitors, such as:
  • ustekinumab (Stelara)
• interleukin 17 inhibitors, such as:
  • brodalumab (Siliq)
  • secukinumab (Cosentyx)
  • ixekizumab (Taltz)
• interleukin 23 inhibitors, such as:
  • guselkumab (Tremfya)
• T-cell inhibitors, such as:
  • abatacept (Orencia)

Biologics are medications that can be made from sugars, proteins, or nucleic acids, or from microorganisms, tissues, or cells. Drugs are usually made from chemicals or plants.

Common questions about Otezla

Here are answers to some frequently asked questions about Otezla.

Does Otezla cause hair loss?

Hair loss isn’t a side effect that’s been found in clinical studies of Otezla. However, some people have experienced hair loss while taking Otezla. It’s not clear if Otezla is the cause.

Psoriasis, especially scalp psoriasis, can cause hair loss.

Is Otezla an anti-inflammatory drug?

No, Otezla isn’t classified as an anti-inflammatory drug. Although it does reduce inflammation, it doesn’t belong to the class of drugs called anti-inflammatories.

Is Otezla an immunosuppressant?

Yes, Otezla is an immunosuppressant. This means the drug lowers (suppresses) the activity of your immune system. Specifically, Otezla works by reducing inflammation that’s caused by an overactive immune system.

Is Otezla a biologic?

No, Otezla isn’t a biologic. Biologics are drugs that are made from immune system cells. Otezla, however, is made from chemicals (as many drugs are).

Otezla is a type of drug called an immunosuppressant. It works by lowering (suppressing) the activity of your immune system.

How does Otezla cause weight loss?

Many people who take Otezla lose weight. There may be several factors that lead to Otezla-related weight loss.

Otezla blocks an enzyme called phosphodiesterase-4 (PDE4). In addition to its effects on inflammation, this enzyme is involved in energy metabolism. In animals, blocking this enzyme caused them to be leaner, with smaller fat cells. The same effect may apply in humans.

Also, some people who take Otezla may have a reduced appetite or diarrhea as side effects. These effects might also cause weight loss.

I’ve always used creams for my psoriasis. How does a pill help treat my psoriasis?

Creams and other medications applied to the skin work by being absorbed through the skin. They reduce inflammation and excessive cell growth in the area around where the medication is applied. These drugs are usually the first medications used for psoriasis.

Pills used for psoriasis work from the inside out. They work throughout the body by blocking the body’s production of chemical messengers that cause inflammation and cell overgrowth on the skin.

I’ve heard that Otezla causes a lot of nausea and vomiting. How can I prevent this?

Yes, many people who take Otezla can have some nausea or vomiting. This is most likely to occur in the first 2 weeks of taking the medication. For most people, it’s not severe, and it often goes away with continued use of the drug.

To prevent nausea and vomiting, your doctor may need to lower your dosage. If your nausea doesn’t go away or becomes severe, talk with your doctor. If lowering the dose doesn’t help, you may need to stop taking Otezla.

How to take Otezla

Otezla is typically taken twice daily: once in the morning and once in the evening. For some people, such as those with kidney problems, it may be taken just once per day, in the morning.

Otezla can be taken on an empty stomach or with food.

Otezla tablets should be swallowed whole. They shouldn’t be crushed, split, or chewed.

How Otezla works

Otezla works in a unique way compared to other medications that are used to treat plaque psoriasis, psoriatic arthritis, or Behçet’s disease. It blocks an enzyme called phosphodiesterase-4 (PDE4), which is found in immune cells.

By blocking this enzyme, Otezla decreases the body’s production of inflammatory molecules. The actions of these molecules can lead to the symptoms of psoriasis, psoriatic arthritis, and Behçet’s disease. Therefore, decreasing their production helps reduce symptoms.

Otezla and pregnancy

There haven’t been enough studies in humans to know if Otezla is safe to use during pregnancy. Studies in animals have shown potential harm to the fetus when the mother is given the drug. However, animal studies don’t always predict the way humans would respond.

If you’re pregnant, talk with your doctor to decide if Otezla is safe for you to take.

Otezla’s pregnancy registry

The manufacturer of Otezla has created a registry that gathers information about the safety of Otezla use during pregnancy. Women who are taking or have taken Otezla during pregnancy are encouraged to enroll in the registry.

The Otezla pregnancy registry records health information about women and babies who may have been affected by Otezla. This information helps doctors and other people using the drug to know more about the safety of Otezla use during pregnancy.

More information can be found about the registry by calling 877-311-8972 or by visiting this website.

Otezla and birth control

It’s not known if Otezla is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Otezla.

For more information about taking Otezla during pregnancy, see the “Otezla and pregnancy” section above.

Otezla and breastfeeding

There haven’t been enough studies to show whether Otezla appears in breast milk.

Until more is known, it’s best to avoid breastfeeding while taking this drug.

Otezla interactions

Otezla can interact with several medications. It can also interact with certain supplements.

Otezla and other medications

Below is a list of medications that can interact with Otezla. This list doesn’t contain all drugs that may interact with Otezla.

Different drug interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Before taking Otezla, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drug metabolism inducers

Several medications can make an enzyme called cytochrome P450 3A4 more active in your body. Taking these drugs with Otezla can cause your body to metabolize (get rid of) Otezla more quickly than usual. It can also make Otezla less effective.

Examples of these medications include:

• carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
• phenobarbital
• phenytoin (Dilantin, Phenytek)
• primidone (Mysoline)
• rifampin (Rifadin)

Herbs and supplements

Herbs and supplements can sometimes interact with medications.

St. John’s wort

St. John’s wort can make an enzyme called cytochrome P450 3A4 more active in your body. Because of this, taking St. John’s wort with Otezla can cause your body to get rid of Otezla more quickly than usual. This can make Otezla less effective.

Otezla overdose

Taking too much of this medication can increase your risk for serious side effects.

Overdose symptoms

Symptoms of an overdose of Otezla may include:

• severe diarrhea, nausea, and vomiting
• headache
• fatigue (lack of energy)
• dizziness

What to do in case of overdose

If you think you or your child has taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Overdose treatment

Treatment of an overdose will depend on the symptoms that occur. A doctor may order certain tests to monitor for side effects. In some cases, they may even prescribe intravenous (IV) fluids.

Otezla expiration, storage, and disposal

When Otezla is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date the medication was dispensed.

The purpose of such expiration dates is to guarantee the effectiveness of the medication during this time.

The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where the medication is stored. Otezla should be stored at room temperature, below 86°F (30°C).

Disposal

If you no longer need to take Otezla and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Precautions for Otezla

Before taking Otezla, talk with your doctor about any medical conditions you have. Otezla may not be appropriate for you if you have certain medical conditions. These include:

• Depression. Depressed mood can occur in some people who take Otezla. Some people experience thoughts of suicide while taking Otezla. Although this isn’t common, it may be more likely in people who have had depression in the past.
• Kidney problems. If you have kidney problems, you may need to take a lower dosage of Otezla.

Professional information for Otezla

The following information is provided for clinicians and other healthcare professionals.

Indications

Otezla is indicated in treatment of the following conditions in adults:

• psoriatic arthritis
• plaque psoriasis
• oral ulcers that occur with Behçet’s disease

Administration

Otezla tablets are administered by mouth. Dosages are given once daily on day 1 of treatment, followed by twice daily for the duration of treatment. Follow prescribing information for dosage titration guidelines.

Mechanism of action

Otezla is classified as an immunosuppressant disease-modifying antirheumatic drug (DMARD). It is an inhibitor of phosphodiesterase-4 (PDE4) specific for cyclic adenosine monophosphate (cAMP).

By inhibiting PDE4, Otezla blocks the degradation of cAMP and increases levels of cAMP intracellularly. This reduces the expression of inflammatory mediators and increases anti-inflammatory mediators.

Pharmacokinetics and metabolism

Otezla has a bioavailability of 73%. Peak plasma levels occur in about 2.5 hours after oral ingestion.

Otezla is metabolized by cytochrome P450 3A4 (CYP3A4). Minor metabolic pathways are through CYP1A2 and CYP2A6. Otezla also undergoes metabolism through non-CYP hydrolysis.

The elimination half-life is 6 to 9 hours.

Contraindications

Otezla is contraindicated in people with a known hypersensitivity to apremilast or any component of the tablet.

Storage

Otezla should be stored below 86°F (30°C).

Disclaimer: Medical News Today 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.