Complete Guide to Otezla: Side Effects, How it Works, & FAQ
speciality medications
Otezla, a psoriasis and psoriatic arthritis drug that leverages the active ingredient “apremilast,” is a convenient and effective medication—and, therefore, a go-to for patients and doctors alike.
It’s easy to take, it has a slightly different mechanism of action than other medications on the market, and (critically) it’s been demonstrated to work.
But how, exactly, does Otezla work?
And how long does it take?
And are there any Otezla side effects you need to know about in the meantime?
If you or a loved one has been prescribed Otezla, these are things you need to know.
This comprehensive guide and FAQ should help.
Foundational Medication Knowledge: What is Otezla?
Otezla has been approved to treat moderate to severe plaque psoriasis and active psoriatic arthritis since 2014. As opposed to many other similar medications, Otezla is a simple oral medication.
Patients can self-administer their treatment at home, instead of needing to figure out the logistics of infusions or injections (the administration methods typical when dealing with biologic medications; more on those in a moment).
Since plaque psoriasis is already an unwieldy, often-frustrating disorder (one characterized by scaly, inflamed skin, and even joint inflammation in the case of psoriatic arthritis), being able to access a convenient treatment made a world of difference for many patients.
Why Do Doctors Prescribe Otezla?
Doctors prescribe Otezla for a few different reasons. It’s primarily approved for psoriatic arthritis and plaque psoriasis, but in some cases, it can be used off-label for other inflammatory conditions. One of these alternative uses is a condition called Behcet’s disease—a blood vessel inflammation disorder.
Doctors may recommend Otezla at first, once a patient presents with psoriasis, or wait until a patient has tried other options first. One reason for waiting is simple: Otezla is far from cheap, and while it’s convenient and effective, patients may wish to try a more affordable treatment first.
How Much Does Otezla Cost?
In the United States, a patient paying full retail price for Otezla may pay as much as $5,000.00 per month—or a whopping $60,000.00 per year.
That is an incredible amount of money to pay for one medication.
To make matters worse: Insurance may help some patients access this medication affordably, but, in some cases, it may not (or insurance may say it’ll help, but then change something unexpectedly).
Fortunately, American patients who want to try Otezla do have another option. By purchasing their medication through an international and online Canada drugs pharmacy, you can buy that same amount of brand-name medication for about $1,400.00 per month (or savings of up to 72%).
How Does Otezla Work?
Otezla’s active ingredient is classed as a PDE4 inhibitor, or a substance that inhibits the enzyme “phosphodiesterase 4” from doing its job properly.
Since PDE4’s usual job is to manage the production of cytokines, a part of the body’s inflammatory response, without PDE4 the inflammatory response is much reduced. Conditions like psoriatic arthritis and psoriasis are largely inflammatory in nature, which is why this anti-inflammatory mechanism of action is so helpful.
Once a patient administers their Otezla, the medication will absorb into the bloodstream and then and then manage the immune response at the cellular level. Once the drug is finished working, the patient’s liver will metabolize it and move it to the kidneys for excretion.
Usually, patients on Otezla notice benefits from the drug after 1-4 months (however, this will be unique to each patient, depending on the specifics of their condition and their medication adherence).
Is Otezla a Biologic?
Or is Otezla an immunosuppressant?
Many of the medications recommended for psoriatic arthritis (or psoriasis) treatment belong to a class of drugs termed biologics.
Biologics are a class of drugs that are made from living organisms. Often, they’re made using extremely cutting-edge biotechnological tools and techniques.
Typically, the materials that go into biologics include antibodies, proteins, or nucleic acids (the building blocks of DNA) that help the medication target specific parts of an overactive immune system.
Biologics, due to their inclusion of delicate living organisms, are a bit difficult to work with. Generally, patients will need to have them administered via an injection or IV infusion, which requires dealing with the logistics of out-of-home appointments and working with care providers.
This isn’t a bad thing, but it may not be the most convenient method for controlling psoriasis or psoriatic arthritis.
That’s where medications like Otezla, which is not a biologic, come in. Otezla is a small molecule drug, made of components that are synthesized in a lab. Because of this, these components can be packaged into easy-to-take oral tablets and provide a similar benefit with fewer required appointments.
Is Otezla an Immunosuppressant?
Above, we noted that Otezla works partially because it helps to lower the activity of a potentially overactive immune system.
Does this mean that Otezla is an immunosuppressant?
Otezla does act as an immunosuppressant because it literally suppresses some of the actions of the immune system, but it does so in a way that’s a little different from traditional immunosuppressants.
Traditional immunosuppressants, like cyclosporine and methotrexate, work by broadly suppressing the immune system (as if it were a simple on-off switch; these would flip the switch to “off”). This will shut down symptoms in a hurry, but it can also leave your body without the protection your immune system provides, leaving you at risk for complications and infections.
Otezla has a different approach. It’s more targeted than traditional immunosuppressants. By inhibiting just a part of the immune system—PDE4—instead of the whole thing, patients can enjoy the benefits of decreased inflammation while continuing to enjoy the rest of the benefits of a functioning immune system.
Common Otezla Side Effects
Although Otezla may come with a lower risk of infection than other drugs in the immunosuppressant category, it’s not without its own possible concerns.
If you or a loved one is taking Otezla, you should know about the following possible side effects:
- Gastrointestinal issues, such as nausea and diarrhea
- Headaches
- Upper respiratory tract infections
Generally, patients will experience these side effects shortly after beginning the medication. As your body gets used to the drug, the effects should go away.
If, however, the side effects do not go away with time or if you experience unexpected or severe side effects, go talk to your doctor at once. Do not stop the medication on your own—doing so can be very stressful on your body and lead to further side effects or complications.
How to Manage Otezla Side Effects
Experiencing these side effects can be frustrating, but with a few strategic and proactive lifestyle modifications, you should be able to mitigate them effectively.
For example, if you’re able to stay well-hydrated throughout your day, that can reduce headaches. Eating smaller, more frequent meals, and staying away from particularly spicy or processed foods can help you manage nausea.
If your healthcare provider approves them for your use, you may also be able to take over-the-counter nausea, headache, or diarrhea medication to address relevant symptoms.
As you’re noticing and figuring out how to manage Otezla side effects, prioritize an open line of dialogue with your doctor.
Frequently Asked Questions (FAQs) About Otezla
Over the years, we’ve realized that many patients taking Otezla for the first time have similar questions. Here are succinct, practical answers to questions you may have, too.
How Long Does It Take for Otezla to Work?
Generally speaking, patients taking Otezla should start to notice results within 1-4 months of starting treatment. This will vary from patient to patient depending on the severity of their condition and how otherwise healthy the patient is.
Whether you start seeing benefits quickly or not, it’s important to continue taking your medication. Ceasing suddenly could result in unwanted side effects.
If you’re not seeing progress as quickly as you’d like, talk to your healthcare provider; they may have options for you to explore.
Here’s a pro tip, though: Since human brains are not amazing at keeping track of slow, beneficial progress, challenge yourself to take consistent progress notes as you take Otezla, even if it doesn’t seem like anything notable is happening.
Looking back over previous weeks of notes may help you realize that you’re feeling better than you once were!
Can Otezla Be Taken with Other Medications?
While Otezla can be taken with other medications, you don’t necessarily have carte blanche to take any medication with Otezla—and particularly not without your healthcare provider’s express approval and oversight.
Some medications may have unexpected or unsafe interactions with Otezla, which makes mixing them a bad idea. Just make sure that before your doctor prescribes Otezla, they’re aware of all of the medications you may be taking.
Then, later on, if you get prescribed another medication, talk to your doctor again to reassess the safety of your Otezla treatment.
Is Long-term Use of Otezla Safe?
Generally speaking, yes—Otezla is safe for long-term use for most patients.
While that is true, it’s still a (very) good idea to invest in ongoing monitoring of your Otezla usage by a trusted healthcare professional. These visits will give you a chance to check-in with your doctor, discuss any symptoms or side effects, and ensure that taking Otezla is still a good strategy for you and your course of treatment.
If scheduling in-person appointments will be difficult logistically for you over the long-term, you may be able to opt for telemedicine, depending on the services offered at your doctor’s office.
Dr. Brynna Connor, M.D., a board-certified family medicine physician who specializes in regenerative medicine, points out that “Thankfully, you don't always need to see someone in-person to receive healthcare…Telemedicine, also known as telehealth, refers to a wide array of healthcare services that can be accessed virtually. Telehealth makes use of tools like phone calls, online video calls, smartphone apps, or text messages.”
If that sounds like a better option for you and your lifestyle, talk to your doctor about getting these types of visits set up.
How Should Otezla Be Stored?
You should store Otezla at room temperature, and you should ensure that the medication is not in a place that is too hot or too moist. Keep the medication in the container that it came in, and keep the lid of that container on at all times (unless you’re in the process of using it).
Make sure that you keep your Otezla in a place where children and pets cannot reach it.
Can Otezla Cause Weight Loss?
One potential side effect of Otezla is weight loss, yes. This should be no more than about 5% of your pre-Otezla weight, and this does not happen to all (or even most) of the people who take Otezla. One study mentions that weight loss was reported in around 14% of patients taking Otezla.
However, since this can happen, it’s worth talking about with your doctor—especially if you are in a place where losing any amount of weight would not be healthy or helpful.
If you need to be careful about managing your weight or if this could cause you to otherwise reconsider taking Otezla, talk this decision over with your doctor to see if you have other options.
Is Otezla Safe During Pregnancy and Breastfeeding?
Unfortunately, there are not enough high-quality scientific studies to confirm that Otezla is safe for pregnant or breastfeeding women.
This does not mean that you cannot take Otezla during this time, but it does mean that you and your qualified healthcare professional will need to carefully consider the potential risks to your child alongside the benefits to your health and go from there.
You may be able to take a safer medication for the duration of your pregnancy, then return to Otezla use afterward. Your specific healthcare provider is the best resource to turn to for these high-stakes conversations.
What Should I Do If I Miss a Dose of Otezla?
If you miss a dose of Otezla, what you should do depends largely on when you realize what’s happened.
Most people take Otezla daily—ideally, at about the same time each day.
If you remember your Otezla on the same day of your missed dose (just, say, later on in the day than normal), take the dose as soon as you remember.
If, when you have this realization, it’s almost time for your next dose anyway, just take that next dose. Don’t take two at once to make up for lost time.
If this happens to you a lot, talk to your doctor about strategies for staying on track with your medication.
Interested in Buying Otezla for an Affordable Price?
Now that you know more about Otezla side effects, mechanism of action, and how to make sure it works well for you, you may be wondering: How can I get Otezla for (significantly!) less than $5,000.00 per month?
As it turns out, you’re in the right place.
Through NorthWestPharmacy.com, a CIPA-approved online pharmacy website, you can buy Otezla and other brand-name medications through safe Canadian pharmacies and international drugs stores.
Check out our Otezla medication page to get started with your order. We look forward to serving you and supporting your healthcare needs.