Apremilast belongs to a group of medicines called phosphodiesterase 4 inhibitors, which help to reduce inflammation and swollen joints. It is used to treat adults with psoriatic arthritis who have not responded to at least 2 standard DMARDs given either alone or in combination.
How does it work?
Apremilast works by reducing the activity of an enzyme in the body called ‘phosphodiesterase 4’, which is involved in the process of inflammation. By reducing the activity of this enzyme, it can help to control the inflammation associated with psoriatic arthritis
Who can get it?
Apremilast is only available to adults on prescription (POM)
How is it used?
Apremilast is administered orally and is started with a low dose and is gradually increased. Initially 10 mg daily on day 1, then 10 mg twice daily on day 2, then 10 mg in the morning and 20 mg in the evening on day 3, then 20 mg twice daily on day 4, then 20 mg in the morning and 30 mg in the evening on day 5, then maintenance 30 mg twice daily, doses should be taken approximately 12 hours apart; review treatment if no response within 24 weeks of initiation.
What are the side effects?
Very common side effects (may affect more than 1 in 10 people)
- diarrhoea
- nausea
- headaches, migraines or tension headaches
- upper respiratory tract infections such as cold, runny nose, sinus infection
Common side effects (may affect up to 1 in 10 people)
- cough
- back pain
- vomiting
- feeling tired
- stomach pain
- loss of appetite
- frequent bowel movements
- difficulty sleeping (insomnia)
- indigestion or heartburn
- inflammation and swelling of the tubes in your lungs (bronchitis)
- common cold (nasopharyngitis)
- depression
Uncommon side effects (may affect up to 1 in 100 people)
- rash
- hives (urticaria)
- weight loss
- allergic reaction
- bleeding in the bowel or in the stomach
- suicidal ideation or behaviour
Serious side effects – depression and suicidal thoughts
- Tell your doctor straight away about any changes in behaviour or mood, feelings of depression, thoughts of suicide or suicidal behaviour (this is uncommon).
If you would like to read other people’s experience of this treatment, or have any comments to share, good or bad, you might like to go to iWantGreatCare for Apremilast or iWantGreatCare for Otezla.
Apremilast is known commercially as Otezla and is marketed in the UK by Amgen Ltd
