Otezla, the brand name of apremilast, is a prescription medication used in treating patients with moderate to severe plaque psoriasis. It is often used in conjunction with phototherapy. Aside from being used to treat plaque psoriasis, it is also approved for use in treating patients with psoriatic arthritis and Behçet’s disease.

How Much Does Otezla Cost?

It is difficult to answer questions about the pricing of Otezla or any other drug due to the amount that it can vary due to location and insurance. However, when it comes to the original price from the manufacturer of the drug, a 30-day supply costs $3,591.69. What individuals pay, comes down to their coverage. Those with private insurance may be able to pay a $0 copay on their prescription. Those accessing Otezla through Medicaid will typically be able to receive the drug at no cost. For individuals on Medicare, the cost will depend entirely on co-insurance status. For anyone uninsured or underinsured, Otezla does offer patient assistance programs to help patients get the medication. You can head to the Otezla page detailing pricing and insurance here.

How Does Otezla Work?

Otezla is unique in that it doesn’t work the same as other medications used to treat plaque psoriasis and psoriatic arthritis. It works by blocking an enzyme known as PDE4, or phosphodiesterase-4. PDE4 is located in the immune cells and is responsible for producing some of the body’s inflammatory molecules. By blocking PDE4, Otezla can reduce inflammation and in turn decrease the severity of the symptoms of all three conditions that it is used to treat: plaque psoriasis, psoriatic arthritis, and oral ulcers associated with Behçet’s disease.

What are the side effects of Otezla?

Just like any other medicine, Otezla produces a range of possible side effects. We have listed below the most common side effects. Oftentimes they are minor, but you should check with your doctor immediately if you experience any of them as they can require medical attention.

• Diarrhea
• Decreased appetite
• Insomnia
• Back pain
• Nausea or vomiting
• Stuffy or runny nose
• Fatigue
• Abdominal pain
• Bronchitis
• Upper respiratory tract infection
• Sinus headache

Diarrhea, headache, and nausea are the most common side effects of Otezla.

Allergic reaction – In some rare cases, patients can experience allergic reactions. Seek emergency medical care if you experience any of the following symptoms after taking Otezla.

• Skin rash
• Wheezing
• Tightness in the throat or chest
• Difficulty talking or breathing
• Swelling of the face, lips, tongue, or throat

This is not a complete list of the possible side effects of Otezla. For more information, you should speak to your doctor or read the patient information label.

What should I avoid while taking Otezla?

There are many potential drug interactions for Otezla. We have listed below some of the most common, but this is not a complete list and you should inform your doctor about any medications (including over-the-counter drugs and supplements) you are taking before you start receiving Otezla.

Potential interactions that could reduce the effectiveness of Otezla:

• Carbamazepine
• Phenobarbital
• Phenytoin
• Primidone
• Rifampin

Potential severe drug interactions:

• Apalutamide
• Carbamazepine
• Enzalutamide
• Fosphenytoin
• Mitotane
• Primidone

How long does Otezla take to work?

Most patients taking Otezla will understandably want to know when they can expect to see improvement. The answer will vary depending on the condition being treated and its severity. However, the good news is that many patients do report seeing some improvement within the first few weeks. The following is a more detailed breakdown based on clinical testing of how long you can expect results to take based on which condition you’ve been prescribed Otezla to treat:

• Psoriatic arthritis – At least a 20% improvement was reported within 16 weeks by 32% to 41% of patients taking Otezla.
• Plaque psoriasis – 28.8% to 33.1% of those with plaque psoriasis experienced at least a 75% improvement within 16 weeks.
• Behçet’s disease – 52.9% of patients with Behçet’s Disease were completely free of oral ulcers after 12 weeks of treatment. Of those patients, 30% were already ulcer-free after just 6 weeks.

In addition to the above results, patients with psoriatic arthritis also reported an increased ability in physical function and performing daily activities. It is worth noting, that the patients above being treated for psoriatic arthritis could use other drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) or disease-modifying antirheumatic drugs (DMARDs) during testing, and patients being treated for psoriasis could use topical creams. Those being treated for ulcers associated with Behçet’s Disease did not use any additional treatments. When looking at studies such as these, it's important to keep in mind that every patient is unique and you can’t truly predict how long you will need treatment to see results.

Can I drink alcohol while taking Otezla?

Drinking alcohol while taking Otezla isn’t especially dangerous. However, it can add to or worsen side effects, especially if you drink large quantities. If you’re planning to drink while taking Otezla you should speak with your doctor and discuss healthy limits to avoid impacting your treatment negatively. Furthermore, depending on the condition you’re using Otezla to treat, you could worsen disease symptoms through heavy alcohol consumption.

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