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apremilast

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Brand names: Otezla

PDE4 Inhibitor Rx

Apremilast (Otezla/Otezla XR) is a medicine that can help adults and children manage psoriatic arthritis and psoriasis. It can also help adults with oral ulcers from Behçet's Disease.

Drug Pricing (NADAC)

Brand Price

$87.90/unit

Generic Available

No

AMGEN INC

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Apremilast is used to treat active psoriatic arthritis in adults and children 6 years and older.

Common side effects

Diarrhea, Nausea, Headache

Key warnings

Apremilast can cause serious side effects.

How It Works

Apremilast is a type of medicine called a phosphodiesterase 4 (PDE4) inhibitor. It works by blocking PDE4 in your body. This helps to reduce inflammation and other symptoms of these conditions.

How to Take It

Take apremilast as directed by your doctor. To help avoid stomach problems, you'll start with a low dose and increase it over 5 days. Adults usually take 30 mg twice a day or 75 mg once a day. Children's doses depend on their weight.

Pregnancy & Breastfeeding

Apremilast may increase the risk of fetal loss during pregnancy. Talk to your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.

Storage

Store Otezla tablets below 86°F (30°C). Store Otezla XR tablets between 68°F and 77°F (20°C and 25°C).

Side Effects (from patient reports)

Based on 134,820 FDA adverse event reports.

Diarrhea
24,315
Nausea
21,927
Psoriasis
20,247
Headache
17,679
Medicine not working
15,315
Stomach discomfort
8,065
Psoriatic arthritis
7,852
Pain
6,595
Rash
6,479
Vomiting
6,346

FDA Adverse Event Report Analysis

Detailed analysis of 143,174 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2012–2025.

Total Reports

143,174

Death-Related Reports

5,453

Hospitalization Reports

10,932

Top Indication

Psoriasis

Gender Distribution

Female 90,394 (66%)
Male 46,320 (34%)

Age Distribution

0–17 403
18–44 19,476
45–64 40,417
65–74 12,401
75+ 5,085

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DIARRHOEA 24,315
2 NAUSEA 21,927
3 PSORIASIS 20,247
4 HEADACHE 17,679
5 DRUG INEFFECTIVE 15,315
6 ABDOMINAL DISCOMFORT 8,065
7 PSORIATIC ARTHROPATHY 7,852
8 PAIN 6,595
9 RASH 6,479
10 VOMITING 6,346
11 ARTHRALGIA 6,226
12 FATIGUE 6,026
13 DEPRESSION 5,414
14 OFF LABEL USE 5,024
15 WEIGHT DECREASED 4,955

Reactions in Death Reports

SYSTEMIC LUPUS ERYTHEMATOSUS 1,750
TYPE 2 DIABETES MELLITUS 1,746
PSORIATIC ARTHROPATHY 1,731
GLOSSODYNIA 1,729
GENERAL PHYSICAL HEALTH DETERIORATION 1,721
RASH 1,714
SYNOVITIS 1,712
HYPOAESTHESIA 1,707
INFUSION RELATED REACTION 1,704
HYPERTENSION 1,703

Reactions in Hospitalization Reports

PSORIATIC ARTHROPATHY 2,086
RASH 2,053
FATIGUE 2,009
OFF LABEL USE 1,980
DIARRHOEA 1,929
RHEUMATOID ARTHRITIS 1,924
HEADACHE 1,920
NAUSEA 1,917
SYNOVITIS 1,894
PAIN 1,893

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Apremilast can cause serious side effects. It can cause allergic reactions like swelling and trouble breathing. It can also cause or worsen depression or suicidal thoughts. Tell your doctor right away if you have any of these side effects.

Known Drug Interactions

7 DRUG INTERACTIONS 7.1 Strong CYP450 Inducers Co-administration with strong CYP450 inducers (such as rifampin) decreases apremilast exposure and may result in loss of efficacy of OTEZLA/OTEZLA XR [see Warnings and Precautions (5.5) and Clinical Pharmacology (12.3) ] .

Mechanism: Rifampin causes your body to break down apremilast much faster than normal, which can make it stop working.

What to do: Taking these together may make apremilast not work as well, so your doctor may need to monitor your treatment closely.

Common Questions

Can I take apremilast if I am allergic to it?
No, you should not take apremilast if you are allergic to apremilast or any of the other ingredients in the medicine.
What should I do if I experience severe diarrhea, nausea, or vomiting?
Contact your doctor. They may lower your dose or have you stop taking apremilast.
Can apremilast affect my mood?
Yes, apremilast can cause or worsen depression or suicidal thoughts. Tell your doctor right away if you notice any mood changes.
Will apremilast cause me to lose weight?
Apremilast can cause weight loss. Your doctor will monitor your weight regularly.
Can I take apremilast with other medicines?
Some medicines can interact with apremilast. Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What if I have kidney problems?
If you have severe kidney problems, your doctor may need to adjust your dose of apremilast.
Can children take apremilast?
Yes, apremilast can be used in children 6 years and older who weigh at least 44 pounds (20 kg) for psoriatic arthritis and moderate to severe plaque psoriasis.
How long does it take for apremilast to work?
It may take several weeks or months to see the full effects of apremilast.
Can I stop taking apremilast if my symptoms improve?
Do not stop taking apremilast without talking to your doctor first.
Will apremilast cure my condition?
Apremilast helps manage the symptoms of your condition. It is not a cure.
What are the common side effects of apremilast?
The most commonly reported side effects of apremilast include Diarrhea, Nausea, Headache, Upper respiratory tract infection (like a cold). Based on 134,820 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does apremilast interact with other medications?
Yes, apremilast has 1 known drug interactions. Notable interactions include rifampin. Always inform your doctor about all medications you are taking.
What drug class is apremilast?
apremilast belongs to the PDE4 Inhibitor drug class. It requires a prescription (Rx). Apremilast is used to treat active psoriatic arthritis in adults and children 6 years and older.
Is apremilast safe during pregnancy?
Apremilast may increase the risk of fetal loss during pregnancy. Talk to your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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Medication Guides

Related Health & Safety Data

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What the FDA Data Shows for apremilast

The FDA label for apremilast (sold under brand names such as Otezla) classifies it as a prescription-only medication in the PDE4 Inhibitor class. Apremilast is used to treat active psoriatic arthritis in adults and children 6 years and older. Official labeling lists 4 commonly reported side effects, including Diarrhea, Nausea, Headache.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 134,820 voluntary reports. The database also lists 1 documented drug interaction derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: December 23, 2025

All federal data sources used on this page