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Otezla (apremilast) is an oral medication called a phosphodiesterase 4 (PDE4) inhibitor, approved by the U.S. Food and Drug Administration (FDA) for treating psoriasis and psoriatic arthritis in adults and children ages 6 and older.
These insights are based on 956 comments about Otezla from MyPsoriasisTeam members. These are the experiences of a small number of members and are not meant to be medical advice.
Otezla works by inhibiting phosphodiesterase 4 (PDE4), an enzyme involved in inflammation. Normally, PDE4 breaks down a messenger molecule in cells called cyclic AMP (cAMP). When PDE4 is blocked, cAMP levels rise. This helps calm inflammation in the body by lowering certain inflammatory signals.
Doctors prescribe Otezla as an oral option for people who need systemic therapy (a treatment that works throughout the whole body) for their psoriasis and psoriatic arthritis. Otezla comes in tablets, and it’s especially useful for those who prefer pills over injections.
The medication follows a gradual starting schedule to help reduce stomach problems. You can take Otezla with or without food, and tablets should be swallowed whole.
These insights are based on 956 comments about Otezla from MyPsoriasisTeam members.Members report that gastrointestinal side effects are common when starting Otezla, particularly during the first few weeks. Many find that taking the medication with food helps reduce nausea, and most say these side effects improve over time if they can push through the initial adjustment period.
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The most common side effects affect the digestive system. In clinical trials on Otezla for plaque psoriasis, participants experienced:
Diarrhea and nausea both affected 17 percent of people in the clinical trials. About 9 percent of the people in the trials reported upper respiratory infection, and between 6 percent and 8 percent of trial participants had headaches.
Most digestive side effects happen within the first few weeks of treatment and lessen over time.
Otezla has some rare but serious side effects which require immediate medical attention. These include:
Always let your doctor know about any new or worsening symptoms.
Amgen, the manufacturer of Otzela, has a copay assistance program that helps eligible people with private health insurance reduce their out-of-pocket costs. Some pay as little as $0 per month with a copay card. To learn more, you can call Amgen’s patient support at 844-4OTEZLA or visit the website.
If you are on Medicare, Medicaid, or another government insurance program, talk to your healthcare team about other cost saving options.
Tell your healthcare provider about all medications and supplements you take. Otezla shouldn’t be used with strong enzyme inducers like rifampin, phenobarbital, carbamazepine, or phenytoin, as they can reduce its effectiveness.
Before you begin treatment with Otezla, let your doctor know if you have any of the following:
Besides plaque psoriasis, Otezla is FDA-approved to treat active psoriatic arthritis in adults and children 6 years and older and oral ulcers associated with Behcet’s disease in adults.
If you miss a dose, take it as soon as you remember. If it’s close to your next dose, skip the missed one. If you are pregnant, breastfeeding, or planning to be, talk to your doctor about whether it is safe for you to continue taking Otezla.
These answers are fact-checked by our editorial staff.
How effective is Otezla for clearing psoriasis symptoms?
In clinical trials, between 28 percent and 33 percent of people saw a 75 percent improvement in psoriasis symptoms after 16 weeks of treatment with Otezla, compared to about 6 percent who took placebo (an inactive treatment).
How long do stomach side effects from Otezla typically last?
According to the prescribing information, gastrointestinal side effects most often occur within the first few weeks of treatment and may improve over time with continued use.
Can Otezla cause depression?
Otezla is associated with increased depression risk. In clinical trials, approximately 1.3 percent of people taking Otezla reported depression compared to 0.4 percent on placebo.
Does Otezla cause weight changes?
Weight loss can occur with Otezla. In clinical trials, 12 percent of people lost between 5 percent and 10 percent of their body weight, and 2 percent experienced weight loss of 10 percent or more.
MyPsoriasisTeam is a site where people share their experiences with psoriasis, get advice, and find support from others who understand.
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