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Updated December 2018
Apremilast (brand name: Otezla(r)) is a medicine used to treat psoriatic arthritis, and moderate to severe plaque psoriasis. It is an immunosuppressive medicine, which means that it works by reducing the activity of the immune system.
In psoriatic arthritis this action helps to reduce inflammation and thus reduce pain and swelling in your joints.
In psoriatic arthritis, treatment with apremilast can improve your general physical function by reducing the swelling and pain in the inflamed joints.
Apremilast has also been shown to improve the quality of life in patients with psoriatic arthritis. This means that the impact of your condition on daily activities, relationships and other factors should be less than it was before.
Apremilast is taken by mouth in tablet form. There are three different strengths of apremilast tablets: 10mg, 20mg and 30mg.
Sometimes when you start apremilast tablets, you may feel sick, get indigestion or an upset stomach or diarrhoea. To reduce the risk of these side effects, your doctor will start you on a treatment ‘Starter pack’ which starts at a much lower dosage.
Your treatment will start at the lower dose and will gradually be increased (also called “titrated”) over the first 6 days of treatment. The ‘Starter pack’ has a schedule of which tablets to take, morning and night, during these first 6 days.
After the titration period, the usual dose is 30mg twice daily: one 30mg tablet in the morning and one 30mg tablet in the evening. By the end of day 6 you will have reached this recommended dose.
The tablets should be swallowed whole, not chewed or broken, with water. They can be taken with or without food.
Do not crush, split or chew the tablets.
Apremilast may be used with other arthritis medicines including:
There are separate information sheets for the medicines mentioned above.
Take your apremilast at the same time each day, one tablet in the morning and one in the evening.
If you have severe kidney problems your doctor may tell you to only take apremilast once a day, in the morning.
Your doctor will tell you how long to continue taking your apremilast tablets. Do not stop taking your treatment unless advised by your doctor or unless side effects develop.
Take it as soon as you remember. If it is close to the time for the next dose, just skip the missed dose. Take the next dose at the regular time. Do not take a double dose to make up for the dose that you missed. If you are not sure what to do, ask your doctor or pharmacist.
You might experience side effects with your treatment. Tell your doctor if you are concerned about possible side effects.
Tell your doctor or pharmacist immediately if any of side effects you experience get worse, or if you notice any side effects not listed in this leaflet.
These medicines can affect apremilast or may affect how well it works. You may need to change the dose of these medicines while you take apremilast.