Daily Medication Pearl: Apremilast (Otezla)

Apremilast is indicated for the treatment of psoriatic arthritis, plaque psoriasis, and oral ulcers associated with Behçet disease.

Medication Pearl of the Day: Apremilast (Otezla)

Indication: Apremilast, an inhibitor of phosphodiesterase 4 (PDE4), is indicated for the treatment of adult patients with active psoriatic arthritis; adult patients with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy; and adult patients with oral ulcers associated with Behçet’s disease.


  • Dosing: To reduce the risk of gastrointestinal symptoms, titrate to recommended dose of 30 mg twice daily from 10 mg, once a day, to twice a day, then 20 mg, then 30 mg within 6 days.
  • Dosage form: Tablets 10 mg, 20 mg, and 30 mg.
  • Adverse events (AEs): The most common AEs (≥ 5%) are diarrhea, nausea, headache, and upper respiratory tract infection.
  • Mechanism of action: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.
  • Manufacturer: Amgen