1 What is Otezla?

Brand: Otezla

Generic: Apremilast

Otezla belongs to the group of medicines termed as disease-modifying antirheumatic drugs. This drug is widely used in adult patients with active psoriatic arthritis.

Psoriatic arthritis is a form of arthritis that usually affects the distal joints (those closest to the nail) in fingers or toes of some individuals who have psoriasis.

The disease can develop slowly with mild symptoms, or it can develop quickly and be severe. The symptoms of psoriatic arthritis include stiffness, pain, throbbing, swelling, and tenderness in one or more joints, swollen fingers, and toes, nail changes, reduced range of motion, generalized fatigue, etc.

This medicine is also used to treat moderate to severe plaque psoriasis for whom phototherapy or systemic therapy is appropriate.

This medicine is available only with your doctor's prescription. This product is available in the following dosage forms:

  • Tablet

2 What to Know Before Using

Before using Otezla, you must know all about the risks and complications associated with it. The suitable drug therapy is usually chosen by a doctor with the active participation of the patient.

There are some important factors such as drug interactions, the presence of any metabolic impairment, history of hypersensitivity reaction, pregnancy, lactation etc. which may alter the desired therapeutic effects of a medicine.

Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects. If you have had any allergic reactions to any medicine then you must tell your doctor about that. The use of apremilast is contraindicated in those who are hypersensitive to this drug or any of the ingredients of the formulation.

Make sure you inform your doctor if you have any other medical problems, especially:

  • Depression 
  • Mental illness— this drug may make these conditions worse
  • Severe kidney disease— use with caution because the toxicity may be increased because of slower removal of the medicine from the body

Because of drug-drug interactions, certain medicines should not be used along with this medicine. It is always recommended to consult with your doctor if you are in need of some other medications or even any over-the-counter medicine for another health problem in order to avoid unwanted toxic effects.

Besides, any of the following drugs should not be taken concurrently:

  • Carbamazepine
  • Enzalutamide
  • Fosphenytoin
  • Mitotane
  • Phenobarbital
  • Phenytoin
  • Primidone
  • Rifabutin
  • Rifampin
  • Rifapentine

Animal reproduction studies have shown an adverse effect, and there are no adequate and well-controlled studies in pregnant women. Thus, this drug should be used during pregnancy only if clearly needed.

Besides, caution should be exercised when used in lactating women because there are no adequate studies in women for determining infant risk when using this medication during breastfeeding.

3 Proper Usage

To use Otezla properly, you must follow all instructions given by your doctor. This medicine comes with patient information. You should read and follow the instructions carefully before using this medicine. The dosage schedule and the duration of drug therapy should be individualized and determined based on the physician’s advice.

The therapeutic dose may also vary with the patient’s condition or requirement and the strength of the medicine as well; however, the dosage schedule oral dosage form (tablets) for treatment of psoriatic arthritis and plaque psoriasis is listed below:


  • Day 1: 10 milligrams (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 daily.

Children—Use and dose must be determined by your doctor.

If you miss a dose of this medicine, take it as soon as possible. But, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use this drug in larger amounts, more often, or for a longer time than your doctor ordered.

Further, it is advised to store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. However, outdated medicines should be disposed of by an appropriate way.

4 Precautions to Take

Before using Otezla, there are some precautions you must take. Firstly, regular visits to your doctor are recommended to check that this medicine is working properly or not.

Additionally, the following guidelines should be followed to prevent unwanted complications as well as for the better prognosis of the patients:

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors, such as feeling sad or hopeless, getting upset easily, or feeling nervous or hostile. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you notice any of these side effects, check with your doctor right away.

This medicine may decrease your weight by 5-10%. Thus, your weight should be monitored regularly during treatment episode with this medicine. If unexplained or clinically significant weight loss occurs, evaluate weight loss and consider discontinuation of apremilast.

Make sure you tell your doctor if you are pregnant, planning to become pregnant, or are breastfeeding.

Do not use any prescription or nonprescription medicine, herbal preparation, or dietary supplement without checking with your doctor.

5 Potential Side Effects

Make sure you meet with your doctor in using Otezla to avoid unwanted potential side effects. Along with the beneficial effects, this medicine may cause some unwanted effects that may not need any medical attention.

These side effects usually go away during the treatment episode as your body adjusts to the medicine. Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted side effects.

Sometimes you may need to consult with the doctor if you notice any of the following toxic effects:

More common:

Less common:

  • Acid or sour stomach
  • Back pain
  • Belching
  • Burning, itching, pain in the hairy areas, pus at the root of the hair
  • Decreased appetite
  • Heartburn
  • Indigestion
  • Muscle aches
  • Upper abdominal or stomach pain
  • Vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.