Otezla (apremilast) is a medication used to used to treat psoriasis and the joint pain and tenderness of psoriatic arthritis.
Otezla works by inhibiting an enzyme called phosphodiesterase 4 (PDE4) that is involved in the body’s inflammatory response. Otezla belongs to a class of drugs known as PDE4 inhibitors.
Otezla is available in 10 mg, 20 mg, and 30 mg oral tablets. The normal dose is 30 mg, usually taken twice a day. It is most often taken once in the morning and once in the evening. In some cases, it is only prescribed for once a day.
It can take up to 16 weeks for Otezla to work. It is important for patients starting Otezla to keep taking the medicine regularly in order to give it a chance.
Important Tests and Risks
There are several medications that can interact with Otezla. It is important for patients to make sure that their doctor is aware of all medications and supplements that they are taking along with Otezla.
How Otezla Works
Otezla inhibits an enzyme called PDE4 (phosphodiesterase 4) that breaks down a chemical messenger in the body called cyclic adenosine monophosphate (cAMP).
By inhibiting PDE4, less cAMP gets broken down. This increases cAMP levels, especially in inflammatory cells where PDE4 is the dominant enzyme responsible for breaking down cAMP.
An increase in cAMP levels “turns down” (or down-regulates) a number of cellular signals called cytokines that increase inflammation, including TNF-α, interleukin 17, interleukin 23, and others. The increase also “turns up” (or up-regulates) the cellular signal interleukin 10 which can reduce inflammation.
It is not understood how exactly these changes produces the specific effects seen in patients that take Otezla. However, it is understood that this medication can improve psoriasis symptoms, and can reduce the joint pain and tenderness experienced by psoriatic arthritis patients.
Side Effects of Otezla
Otezla can cause severe weight loss in some people. Patients who lose weight while taking this medication should tell their doctor.
Otezla can worsen depression. Patients should tell their doctor if they experience worsening depression or have thoughts of suicide while taking the medication.
Otezla can interact with a number of medications. It is important for doctors to be informed of all of the medications and supplements that a patient is taking so they can properly assess the risk of an interaction with Otezla.
MORE COMMON side effects of Otezla include:
- Nausea, stomach pain, & diarrhea – Some people feel unwell with stomach pain, nausea, and vomiting when they take Otezla. Otezla can also cause diarrhea.
- Nasal congestion & sore throat – Otezla can cause nasal congestion or a sore throat.
- Headache – Otezla can rarely cause a headache.
Who Should NOT Take Otezla
- Patients who are allergic to Otezla or any ingredient in this medicine
- Patients taking other medicines that may interact with Otezla
- Some patients with a history of depression or suicidal thoughts or actions
Otezla has not been studied in pregnancy. Patients should let their doctor know if they are planning to get pregnant or if they are breastfeeding.
When to Call a Doctor
People taking Otezla should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons for people taking Otezla to call a doctor include:
- Severe weight loss
- Depression or thoughts of suicide
- Nausea or diarrhea
- Pregnant or planning pregnancy
- Develop a rash