Two medicines, side by side
Allopurinol vs apremilast
Allopurinol is labeled for gout; apremilast for psoriasis. Their labels share no use, so they are not alternatives to each other. Drugs@FDA records approvals of allopurinol since 1966 and of apremilast since 2014. Pharmacies paid $0.0315 per allopurinol 100 mg tablet and $90.57 per Otezla 30 mg tablet (NADAC, October 7, 2026); the strengths differ and one is a brand and one a generic, so the two prices are not like for like. In FDA's classes, allopurinol is a xanthine oxidase inhibitor and apremilast a phosphodiesterase 4 inhibitor.
Check it at the source: the allopurinol FDA label on DailyMed (effective May 21, 2026); the apremilast FDA label on DailyMed (effective September 2, 2026).
Highlights of the allopurinol record
Allopurinol (Zyloprim) · label of May 21, 2026
Used for
From the label: indicationsAllopurinol tablet is indicated for: The management of adults with signs and symptoms of primary or secondary gout (acute attacks, tophi, joint destruction, uric acid lithiasis, and/or nephropathy) The management of adult and pediatric patients with leukemia, lymphoma and solid tumor malignancies who are receiving cancer therapy which causes elevations of serum and urinary uric acid levels The management of adult […]
On the market
- Earliest approval on file
- August 19, 1966
- Generic labelers
- 44 labelers
- Pharmacy cost
- $0.0315 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 6
Highlights of the apremilast record
Apremilast (Otezla) · label of September 2, 2026
Used for
From the label: indicationsOTEZLA/OTEZLA XR, an inhibitor of phosphodiesterase 4 (PDE4), is indicated for the treatment of: Adult patients with: Active psoriatic arthritis ( 1.1 ) Plaque psoriasis who are candidates for phototherapy or systemic therapy ( 1.2 ) Oral ulcers associated with Behçet's Disease ( 1.3 ) Pediatric patients 6 years of age and older with: Active psoriatic arthritis ( 1.1 ) Moderate to severe plaque psoriasis who are […]
On the market
- Earliest approval on file
- March 21, 2014
- Generic labelers
- none listed
- Pharmacy cost
- $90.57 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Allopurinol label of May 21, 2026, Apremilast label of September 2, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do allopurinol and apremilast differ on the record?
In FDA's classes, allopurinol is a xanthine oxidase inhibitor and apremilast a phosphodiesterase 4 inhibitor.
How each works, in its label's words: Allopurinol, “Allopurinol is a structural analogue of the natural purine base, hypoxanthine.”; Apremilast, “Apremilast is an oral small molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP).”
Half-life, in each label's words: Allopurinol, “Elimination The half-life of allopurinol and oxipurinol are approximately 1 hour to 2 hours and 15 hours following oral …”; Apremilast, “Elimination The plasma clearance of apremilast is about 10 L/hr in healthy subjects, with a terminal elimination …”
Generics: allopurinol since 1985; apremilast since 2021 (Drugs@FDA).
| Allopurinol | Apremilast | |
|---|---|---|
| Labeled for | Gout | Psoriasis |
| Pharmacologic class | Xanthine Oxidase Inhibitor | Phosphodiesterase 4 Inhibitor |
| How it works (label) | Allopurinol is a structural analogue of the natural purine base, hypoxanthine. Allopurinol acts on purine catabolism, without disrupting the biosynthesis of purines. | Apremilast is an oral small molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP). PDE4 inhibition results in increased intracellular cAMP levels. |
| Half-life (label) | Elimination The half-life of allopurinol and oxipurinol are approximately 1 hour to 2 hours and 15 hours following oral dose of allopurinol, respectively. | Elimination The plasma clearance of apremilast is about 10 L/hr in healthy subjects, with a terminal elimination half-life of approximately 6-9 hours. |
| Earliest approval on file (Drugs@FDA) | August 19, 1966 | March 21, 2014 |
| First generic approved | December 10, 1985 | February 17, 2021 |
| Generic labelers (NDC) | 44 labelers | none listed |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0315 per tablet (Allopurinol 100 mg tablet) | $90.57 per tablet (Otezla 30 mg tablet) |
| 12-month price change | -20% | +5% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 6 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 155,998 | 145,481 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to allopurinol
- every medicine labeled for the same conditions