Most Frequent Side Effects of Otezla
Otezla (apremilast), used for plaque psoriasis, psoriatic arthritis, and Behçet's disease, commonly causes diarrhea, nausea, and headache. These affect more than 10% of patients in clinical trials, often starting within the first few weeks and decreasing over time.[1][2]
How Bad Are They and When Do They Happen?
Diarrhea hits about 17% of users, nausea around 17%, and upper respiratory tract infections 8-13%. Headaches occur in 8-13%, tension headaches specifically around 8%. Most are mild to moderate; severe cases lead to discontinuation in under 3%.[1][3] Symptoms peak early due to the drug's dose-escalation schedule, which ramps up from 10mg to 30mg twice daily over five days to minimize issues.
Side Effects by Condition Treated
In psoriasis trials, diarrhea (16%), nausea (16%), and headache (12%) topped the list. Psoriatic arthritis patients saw similar rates: diarrhea (17%), nausea (16%), upper respiratory infections (12%). Behçet's disease data mirrors this, with nausea and diarrhea most common.[1][2]
Weight Loss Concerns
Weight loss of 5-10% body weight occurs in 10-12% of patients, more often with higher BMI. It's usually unintentional and stabilizes, but doctors monitor it closely.[1][3]
Less Common but Notable Effects
Vomiting (3%), nasopharyngitis (3%), and upper abdominal pain (3%) appear less often. Depression reports are low (1%), with no increased suicidal risk in trials.[1][2]
What Happens If Side Effects Persist?
About 4-6% stop treatment due to GI issues. Taking Otezla with food helps, and anti-diarrheals or anti-nausea meds can manage symptoms. Consult a doctor for severe or ongoing problems.[3]
Warnings for Specific Groups
Avoid in moderate to severe kidney impairment; dose adjustments needed for milder cases. No major pregnancy data—use only if benefits outweigh risks.[1]
Sources
[1]: Otezla Prescribing Information (FDA)
[2]: Drugs.com - Otezla Side Effects
[3]: Otezla Official Site - Safety