Apremilast (Otezla)

What is it text.

Apremilast blocks an enzyme called PDE4 inside immune cells. PDE4 helps drive inflammation. By blocking it, apremilast lowers several inflammatory signals that cause the redness, scaling, and joint swelling of psoriasis and psoriatic arthritis. It works throughout the body but does not broadly shut down the immune system the way some other systemic drugs do.

Educational overview only — follow your own prescription.

• Treatment starts with a 5-day starter pack that slowly raises the dose to ease stomach side effects.
• The usual maintenance dose is 30 mg twice a day.
• It can be taken with or without food; do not crush or split tablets.
• A once-daily extended-release form (Otezla XR) is also available.
• People with severe kidney disease need a lower dose.
• No routine blood test monitoring is required.

• Diarrhea
• Nausea
• Headache
• Weight loss
• Cold-like symptoms or upper respiratory infection
• Stomach upset (often early on, and it may ease over time)

• New or worsening depression, mood changes, or thoughts of self-harm — call your doctor right away
• Severe diarrhea, nausea, or vomiting, especially in older adults, which can lead to dehydration
• Noticeable weight loss — your doctor may check your weight
• Signs of an allergic reaction, such as swelling or trouble breathing — seek urgent care

• People allergic to apremilast
• Use with caution in people with a history of depression or thoughts of self-harm
• Use with caution in people who are underweight, because it can cause weight loss
• Severe kidney disease requires a lower dose