What is Otezla?
If you have certain medical conditions, your doctor may recommend that you use Otezla. This prescription drug is used in certain adults to treat:
- plaque psoriasis, which is an inflammatory skin disease
- psoriatic arthritis, which is a type of arthritis that occurs in people with psoriasis
- mouth sores in people with Behçet’s disease
If you’d like to know more about these conditions and how Otezla is used to treat them, see the “What is Otezla used for?” section below.
Otezla comes as tablets that you’ll take by mouth.
Otezla contains the drug apremilast. It’s a disease-modifying antirheumatic drug (DMARD). Apremilast is only available as the brand-name drug Otezla. It doesn’t come as a generic drug.
Read on to learn about Otezla’s possible side effects, cost, uses, and more.
What are Otezla’s side effects?
Like most drugs, Otezla may cause mild or serious side effects. The lists below describe some of the more common side effects that Otezla may cause. These lists don’t include all possible side effects.
Your doctor or pharmacist can tell you more about the potential side effects of Otezla. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that Otezla can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Otezla’s prescribing information.
Mild side effects of Otezla can include:
- respiratory infections
Mild side effects of many drugs may go away within a few days or a couple of weeks. If they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Otezla can occur, but they aren’t common. If you have serious side effects from Otezla, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects can include:
- severe belly pain
- severe nausea or vomiting
- severe headache
- weight loss*
- severe diarrhea*
- allergic reaction*
* For more information about this side effect, see the “Side effect focus” section below.
Side effect focus
You can read below to learn more about some of the side effects Otezla may cause.
You may lose your appetite while you’re taking Otezla. You may also lose some weight.
Be sure to tell your doctor if you lose three pounds (1.4 kilograms) or more in 7 days or less. Changes that may occur with weight loss include having:
- loose clothes or jewelry
- dry skin
- fatigue (lack of energy)
- increased thirst
What might help
While you’re taking this drug, your doctor may monitor your weight. They might ask you to check your weight at home.
If you notice that you’re losing weight without trying, talk with your doctor. Tell your doctor if your weight loss is happening because of severe nausea, vomiting, or diarrhea.
In some cases, your doctor may have you stop taking Otezla. Don’t stop taking Otezla without first talking with your doctor.
To help manage weight loss, your doctor may recommend that you eat plenty of nutritious calories every day. To regain weight that you’ve lost, try to avoid eating unhealthy empty calories. Instead, choose foods that are high in calories and nutrients. If you have trouble choosing nutritious foods to eat, talk with your doctor.
Some people may have changes in mood or depression while taking Otezla. This may be more common in people who’ve had depression in the past.
If you have depression or you’ve had it in the past, let your doctor know before you start taking Otezla.
Be sure to monitor your moods while you’re taking Otezla. Talk with your doctor right away if you have any changes in mood, feelings of depression, or suicidal thoughts.
What might help
If you’ve had depression in the past, your doctor will consider the risks and benefits of prescribing Otezla for you. If the benefits of using Otezla outweigh the risks, your doctor will likely prescribe the drug. They’ll monitor your moods regularly.
It’s important to identify depression early. Doing so can help reduce the harmful effects of depression.
If you have depression that’s related to using Otezla, your doctor may prescribe counseling or medications to treat the depression. If needed, your doctor may have you stop taking Otezla. Don’t stop taking Otezla without first talking with your doctor.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
You may have diarrhea while you’re taking Otezla. In fact, the most common side effect of Otezla is diarrhea. With diarrhea, you may have more frequent, loose, or watery stools.
Some people may have severe diarrhea while taking Otezla. With severe diarrhea, you can have:
- blood in your stool
- less urine production
Tell your doctor if you have diarrhea, or any of these other symptoms, during treatment.
You may have a higher risk of complications because of severe diarrhea if you:
- are older in age
- take blood pressure medications
- take medications that lower the amount of blood in your body
What might help
If you have diarrhea while you’re taking Otezla, you’ll need to replace fluid and electrolytes that your body is losing. When you lose fluid and electrolytes through diarrhea, you can get dehydrated. (With dehydration, you have a low fluid level in your body.)
For diarrhea that’s not severe, you can rehydrate by drinking diluted fruit juice or electrolyte drinks. Eating foods that are low in fiber may help. Some foods that may help improve diarrhea include:
- white rice
- soup or broth
Certain over-the-counter medications may also help treat diarrhea. Be sure to talk with your doctor before taking any medications with Otezla.
If you have severe diarrhea with Otezla, call your doctor. They may lower your dosage of the drug. If needed, your doctor may even have you stop taking Otezla. Don’t stop taking the medication without first talking with your doctor.
Sometimes, for severe diarrhea, you may need intravenous (IV) fluids and electrolytes. (You’ll get IV fluids as an injection into your vein that’s given over a period of time.)
Some people may be allergic to apremilast or any of the other ingredients in Otezla.
Symptoms of a mild allergic reaction can include:
- flushing (warmth, swelling, or 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. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Otezla. If you think you’re having a medical emergency, call 911 or your local emergency number.
What does Otezla cost?
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers, and which pharmacy you use. To find current prices for Otezla in your area, visit WellRx.com.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Otezla manufacturer’s website to learn about a copay card that may lower the cost of the drug for you.
What are some frequently asked questions about Otezla?
Below, you’ll find answers to some commonly asked questions about Otezla.
Is Otezla a biologic drug?
No, Otezla isn’t a biologic drug. Biologics are drugs made from living cells. They work against a specific part of your immune system.
Certain nonbiologic drugs, including Otezla, also act on your immune system. But they don’t target a specific part of your immune system. Nonbiologic drugs are made from chemicals rather than from living cells.
If you have more questions about how Otezla works, talk with your doctor or pharmacist.
How does Otezla compare to Humira?
Otezla and Humira are both used to treat plaque psoriasis and psoriatic arthritis. They each also have other uses.
Unlike Otezla, Humira is a biologic drug. This means Humira is made from parts of living cells. Otezla, on the other hand, is made from chemicals.
Otezla comes as tablets that you’ll take by mouth twice each day. But you’ll take Humira as an injection under your skin. Usually, it’s taken once every 2 weeks, after the first week of treatment.
If you have more questions about the differences between Otezla and Humira, talk with your doctor.
What are some alternatives to Otezla?
Your doctor may recommend that you take something other than Otezla, depending on the condition you’re treating.
Alternatives for plaque psoriasis, psoriatic arthritis, or mouth ulcers caused by Behçet’s disease may include biologics and nonbiologics. Biologics are drugs made from parts of living cells. Nonbiologics are drugs made from chemicals.
Alternative drugs for plaque psoriasis or psoriatic arthritis include the following:
- other nonbiologic drugs such as:
- tofacitinib (Xeljanz)
- biologic drugs such as:
- secukinumab (Cosentyx)
- etanercept (Enbrel)
- adalimumab (Humira)
- infliximab (Remicade)
- brodalumab (Siliq)
- ustekinumab (Stelara)
- ixekizumab (Taltz)
- guselkumab (Tremfya)
Alternative treatments for mouth ulcers related to Behçet’s disease include these options:
- other nonbiologic drugs such as:
- azathioprine (Azasan, Imuran)
- cyclosporine (Neoral)
- cyclophosphamide (Cytoxan, Neosar)
- corticosteroids, such as triamcinolone, betamethasone, dexamethasone, and prednisone
- biologic drugs such as:
- etanercept (Enbrel)
- infliximab (Remicade)
- adalimumab (Humira)
- magic mouthwash
Note: Some of the drugs listed above are used off-label for these conditions. With off-label use, a drug that’s approved for certain conditions is used for another condition.
If you’d like to know more about treatments other than Otezla, talk with your doctor. They can help you find the treatment that’s best for you.
Does stopping Otezla cause withdrawal?
If you stop taking Otezla, you likely won’t have withdrawal symptoms. But, the symptoms you were taking Otezla to treat may start coming back.
Talk with your doctor before stopping Otezla. They can tell you what to expect if you quit taking this medication.
What is Otezla used for?
Your doctor may prescribe Otezla for you if you have certain conditions. This drug is used in adults to treat:
- Plaque psoriasis. With plaque psoriasis, you have patches on your skin that are red or darker colored. Sometimes, they can look scaly and white. This condition is an inflammatory skin disease that’s caused by your immune system attacking your own cells. For this use, Otezla is prescribed for people who could have used systemic therapy (which affects your whole body) or light therapy.
- Psoriatic arthritis. With psoriatic arthritis, you have arthritis, which causes achy, stiff joints. And you have psoriasis, which causes the skin issues described just above. This condition is also caused by your immune system attacking certain cells in your body.
- Mouth sores in people with Behçet’s disease. With Behçet’s disease, you can have several symptoms, such as problems with your eyes and skin, and joint pain. Mouth sores are one of the earliest symptoms of the condition. Otezla can be used to treat these mouth sores. Behçet’s disease is also caused by your immune system attacking certain cells in your body.
Otezla treats these conditions by helping to lower the activity of your immune system.
What should be considered before taking Otezla?
Before taking Otezla, talk with your doctor about whether this drug is right for you.
Let your doctor know if you’re taking any other medications. Some medications may interfere with how Otezla works.
Other considerations you’ll need to discuss with your doctor may include whether you:
- are pregnant or breastfeeding
- have any other medical conditions
Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.
Before taking Otezla, be sure to tell your doctor about all medications you take (including prescription and over-the-counter types). Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Otezla.
Interactions with drugs or supplements
Otezla can interact with drugs that affect a certain enzyme (type of protein) in your body. This certain enzyme helps your body to clear many different medications, including Otezla. Drugs that boost the activity of this enzyme may decrease levels of Otezla in your body. This can make Otezla less effective.
Examples of drugs that may make Otezla less effective include:
- the antibiotic rifampin
- the seizure drugs:
- carbamazepine (Tegretol)
- phenytoin (Dilantin)
This list does not contain all types of drugs that may interact with Otezla. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Otezla.
In addition to the drugs mentioned above, some natural health products and foods may also make Otezla less effective. These substances may include:
- grapefruit or grapefruit juice
- pomelo juice
- Seville orange juice
- the herb St. John’s wort
Check with your doctor or pharmacist before taking any supplements with Otezla. If you have concerns about consuming certain foods or drinks with Otezla, talk with your doctor or pharmacist.
Otezla may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Otezla. Factors to consider include those listed below.
- Depression. If you’ve had depression or suicidal thoughts in the past, taking Otezla may worsen these symptoms. Ask your doctor if Otezla is safe for you to take.
- Allergic reaction. If you’ve had an allergic reaction to Otezla or any of its ingredients, you shouldn’t take Otezla. Ask your doctor what other medications are better options for you.
- Severe kidney failure. If you have severe kidney failure, your doctor may need to lower your dosage of Otezla. Tell your doctor about any problems with your kidneys before you start taking Otezla.
Use with alcohol
Alcohol interacts with certain medications, but it doesn’t interact with Otezla. But, to be safe, check with your doctor to see if it’s safe for you to drink alcohol while you’re taking Otezla.
Pregnancy and breastfeeding
It’s not known if Otezla is safe for use in people who are pregnant or breastfeeding.
Always check with your doctor before taking Otezla during pregnancy or while breastfeeding. Your doctor can help you consider the possible risks and benefits of treatment.
How is Otezla taken?
Your doctor will explain how you should take Otezla. They will also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Otezla comes as tablets that you’ll take by mouth.
You’ll take Otezla twice each day. Usually, you’ll take the drug once in the morning and once in the evening.
When you first start taking the drug, your doctor may recommend that you take low doses of Otezla. For example, on day 1, your doctor may prescribe one lower strength pill taken once in the morning.
Then, your doctor may increase your dosage every day during the first week of treatment until you reach the recommended dose. After day 1, your dosage will increase to one pill twice each day. The strength of your doses may also increase.
Taking Otezla with other drugs
Sometimes doctors prescribe Otezla together with other medications. For example, if you have:
- plaque psoriasis, your doctor may prescribe Otezla with infliximab (Remicade), adalimumab (Humira), or ustekinumab (Stelara)
- psoriatic arthritis, your doctor may prescribe Otezla with methotrexate or cyclosporine
- Behçet’s disease, your doctor may prescribe Otezla with prednisone or magic mouthwash
Questions about taking Otezla
Here you’ll find answers to common questions about Otezla.
- What if I miss a dose of Otezla? If you miss a dose of Otezla, take the missed dose right away. If you don’t remember to take the missed dose until it’s time for your next dose, just skip the missed dose. Take your next dose as usual. But don’t take two doses at once to catch up for a missed dose.
- Will I need to use Otezla long term? Otezla is used to treat certain long-lasting conditions. If the drug is working well for you, your doctor may recommend that you take Otezla long term.
- Can Otezla be chewed, crushed, or split? No, you shouldn’t chew, crush, or split Otezla tablets. If you have trouble swallowing Otezla pills, let your doctor or pharmacist know.
- Should I take Otezla with food? You can take Otezla with or without food.
- How long does Otezla take to work? How long it takes for Otezla to work is different for each condition it’s used to treat. In studies, some people with plaque psoriasis or psoriatic arthritis had improvements after just 16 weeks. Some people with Behçet’s disease had improvements after 12 weeks. Talk with your doctor to learn how soon Otezla may work for your condition.
What should be done in case of overdose?
Don’t take more Otezla than your doctor prescribes. Using more than this can lead to serious side effects.
What to do in case you take too much Otezla
Call your doctor if you think you’ve taken too much Otezla. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number), or go to the nearest emergency room.
Ask your doctor
Before taking Otezla, talk with your doctor about whether this is a good treatment option for you. Your doctor can help you consider the pros and cons of taking this drug.
You can also talk with your doctor about other treatment options for plaque psoriasis and psoriatic arthritis. Ask them about plaque psoriasis remedies and natural options for psoriatic arthritis to help lessen your symptoms. You can also ask about ways to help manage and prevent mouth sores with Behçet’s disease.
Some questions about Otezla to ask your doctor may include:
- Do I have a high risk of side effects from Otezla?
- How long will I need to take Otezla?
- How long does Otezla take to start working?
- Can I stop taking Otezla if my symptoms improve?
- Will Otezla interact with any drugs I’m taking?
Check out the Healthline psoriasis newsletter to learn more about psoriasis and its treatment options.
Ask a pharmacist
Can turmeric help relieve my psoriatic arthritis?
Turmeric is commonly used in cooking, but it’s also available as a nutritional supplement. The active ingredient in turmeric is called curcumin. This ingredient has been shown to help reduce inflammation.
Studies have shown that turmeric may be able to help relieve symptoms of pain in some conditions. These symptoms may include joint pain that’s associated with inflammation from psoriatic arthritis. But, the studies were small, and their results weren’t always consistent. So, more studies are needed to fully understand how turmeric works to relieve joint pain.
Always talk with your doctor before using any natural or alternative therapies for your condition. This is especially important to do if you’re taking any medications. And even if a natural remedy helps improve your symptoms, don’t stop taking any prescribed medications without your doctor’s recommendation.
Neal Patel, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healthline 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.