Adult Dosing

Active psoriatic arthritis

• To reduce risk of GI symptoms associated with initial therapy, titrate to recommended dose 30 mg PO bid according to the following schedule
• Day 1: 10 mg PO qAM
• Day 2: 10 mg PO qAM and qPM
• Day 3: 10 mg PO qAM and 20 mg PO qPM
• Day 4: 20 mg PO qAM and qPM
• Day 5: 20 mg PO qAM and 30 mg PO qPM
• Day 6: 30 mg PO bid

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of active psoriatic arthritis

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Mild-to-moderate renal impairment: No dosage adjustments
• CrCl <30 mL/min: Reduce dose to 30 mg PO qDay

Hepatic Dose Adjustment

• Hepatic impairment: No dosage adjustments

• Depression has been reported in patients receiving apremilast. Evaluate patient for a history of depression and/or suicidal thoughts or behavior before starting with apremilast treatment
• Weight decrease between 5-10 % have been reported in patients treated with apremilast
• Coadministration with strong CYP inducers (eg, rifampin, carbamazepine, phenobarbital phenytoin) may occur and result in a loss of efficacy of apremilast; therefore, coadministration is not recommended

Pregnancy Category:C

Breastfeeding: Safety Unknown, manufacture advises to use cautiously when administrating to nursing mothers

• GI: Diarrhea, nausea, vomiting, upper abdominal pain, GERD, dyspepsia
• NEURO: Migraine
• CNS: Headache
• RESP: URI
• EENT: Nasopharyngitis
• METABOLIC: Weight decrease
• DERM: Rash

• Phosphodiesterase-4 Enzyme Inhibitors; Exact mechanism of action is unknown; however it is found it increases intracellular cAMP levels
• Metabolized by CYP oxidative metabolism with subsequent glucuronidation and non-CYP mediated hydrolysis
• Excreted in urine (58%) and fecas (39%)
• Half-life: 6-9 hrs

US Trade Name(s)

• Otezla

US Availability

Otezla

• TABS: 10, 20, 30 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Dermatologic

Antipsoriatic Agents

Phosphodiesterase-4 Enzyme Inhibitors