apremilast at a glance
Medicine class
Oral selective immunosuppressant and PDE4 inhibitor
Form
Film-coated tablets swallowed whole
Food
May be taken with or without food
Key safety checks
Mood, gastrointestinal symptoms, body weight and kidney function
What is apremilast used for?
Selected products are licensed for:
Active psoriatic arthritis in adults when a previous disease-modifying antirheumatic treatment was ineffective or not tolerated; it may be used alone or with another DMARD.
Moderate-to-severe chronic plaque psoriasis in adults when specified systemic treatments were ineffective, unsuitable or not tolerated.
Oral ulcers associated with Behçet’s disease in adults who are candidates for systemic treatment.
For the selected Otezla product, moderate-to-severe plaque psoriasis in children aged 6 years or older who weigh at least 20 kg and are candidates for systemic treatment.
How does apremilast work?
Apremilast inhibits phosphodiesterase-4 inside inflammatory cells. This raises cyclic AMP and changes the balance of inflammatory signals, reducing mediators including TNF-alpha, IL-23 and IL-17 while influencing anti-inflammatory IL-10.
apremilast preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg, 20 mg, 30 mg
How to take apremilast
Take apremilast exactly as prescribed and follow any initiation pack in its labelled order.
Swallow tablets whole.
Tablets may be taken with or without food.
Do not alter the initiation sequence or treatment without checking with the prescriber or pharmacist.
apremilast side effects
Common or expected effects
- Diarrhoea or nausea
- Headache
- Upper respiratory tract infection
- Vomiting, indigestion or upper abdominal pain
- Reduced appetite
- Back pain or fatigue
- Insomnia or depression
Get urgent medical advice
- New or worsening depression, altered behaviour or suicidal thoughts
- Severe or persistent diarrhoea, nausea or vomiting, particularly with dehydration
- Facial or throat swelling, breathing difficulty, hives or another severe allergic reaction
- Vomiting blood, black stools or other signs of gastrointestinal bleeding
- Unexplained clinically significant weight loss
apremilast in pregnancy
Apremilast is contraindicated during pregnancy. Pregnancy should be excluded before starting, and effective contraception is required during treatment. Anyone planning pregnancy or becoming pregnant while taking it should contact their specialist promptly.
apremilast while breastfeeding
The selected product information advises against apremilast during breastfeeding because transfer into human milk is unknown and risk to the infant cannot be excluded. A specialist should assess alternative treatment and feeding options.
apremilast interactions
Strong enzyme inducers can substantially reduce apremilast exposure and may make treatment less effective.
Rifampicin
Strong CYP3A4 induction reduces apremilast exposure, so combined use is not recommended.
Carbamazepine, phenytoin or phenobarbital
These strong enzyme inducers may reduce apremilast exposure and clinical response.
Common questions about apremilast
Answers are fully visible for fast scanning and source review.
What is apremilast used for?
It is licensed for specified cases of plaque psoriasis, active psoriatic arthritis and Behçet’s-related oral ulcers. Exact indications vary by product and age group.
Can apremilast be taken with food?
Yes. Tablets may be taken with or without food and should be swallowed whole.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.