Otezla has been approved for adults with moderate to severe plaque psoriasis and adults with active psoriatic arthritis. It is an oral systemic anti-inflammatory.
How Does It Work?
Otezla belongs to a class of drugs called phosphodiesterase-4 (PDE4) inhibitors. The drug reduces the activity of the enzyme PDE4, which then reduces inflammation throughout the entire body. This decreased inflammatory response is helpful for suppressing the inflammation associated with psoriasis and psoriatic arthritis.
How Is it Administered?
Otezla is available as a 30mg tablet. During the first five days of treatment, your dosage will be gradually increased to the recommended dose of 30mg twice a day orally. This will be the dose that you will stay on during the duration of your treatment.
What are its Side Effects?
The most frequently reported adverse reaction were mild weight loss, diarrhea and nausea, abdominal discomfort and indigestion, mild-moderate upper respiratory infections (e.g.: a runny nose or sore throat), flu-like symptoms, Other potential side effects include, but are not limited to: rash, allergic reactions, changes in your mood, fast heartbeat or palpitations.
Special Populations and Otezla
- Patients who are allergic to apremilast or any non-medicinal ingredients in the formulation should not take Otezla.
- Patients who have any of the following rare hereditary diseases should not take Otezla: galactose intolerance, lapp lactase deficiency, glucose-galactose malabsorption because lactose is a non-medicinal ingredient in Otezla
- Pregnant Women: Otezla is contradicted in women who are pregnant.
- Nursing women: Otezla is contraindicated in women who are breastfeeding.
- Fertility: The effects on human fertility have not been evaluated. However, animal studies did not indicate any harmful effects on fertility. Those who are planning on becoming pregnant are not advised to start Otezla.
- Kids < 18 years old: The safety and efficacy of Otezla in paediatric patients have not been studied yet, so for this patient population, Otezla is not recommended.
- Elderly patients >65 years old: Limited studies suggest that there is no difference in safety and efficacy between patients older than 65 years old and those under 65 years old. There has been limited studies in very elderly patients above 75 years old, so it should be used with caution in this patient population.
- Kidney Impairment: A dose reduction to 30mg of Otezla a day is recommended in patients with severe renal impairment (creatine clearance < 30mL/minute). Assessment of renal function is recommended prior to starting Otezla.
- Liver Impairment: Otezla is generally safe in patients with moderate and severe hepatic impairment and no dose adjustment is necessary.
What medications should I pay attention to when on Otezla?
- Otezla is not recommended in combination with potent immunosuppressants, including biologic therapies, cyclosporine and methotrexate
- Seizure medications- phenobarbital, carbamezepine, phenytoin
- St. John’s Wort
For detailed information on side effects, safety and if this medication is right for you, please speak to your doctor.