What You Need To Know Before You Take Otezla
Do not take Otezla:
- if you are allergic to apremilast or any of the other ingredients of this medicine .
- if you are pregnant or think you may be pregnant.
Warnings and precautions Depression and suicidal thoughtsSevere kidney problemsIf you are underweightGut problemsChildren and adolescentsOther medicines and Otezla
- rifampicin an antibiotic used for tuberculosis
- phenytoin, phenobarbital and carbamazepine medicines used in the treatment of seizures or epilepsy
- St Johns Wort a herbal medicine for mild anxiety and depression.
Pregnancy and breast-feeding Driving and using machinesOtezla contains lactose
Otezla Side Effects You Should Know About
The most common side effects that can occur with Otezla are diarrhea, nausea and vomiting, upper respiratory tract infections, weight loss, headache, and stomach pain. Over time, many of these side effects will subside. Your doctor will slowly increase your Otezla dose over the first 5 days to lessen side effects.
In most patients, diarrhea and nausea occurred within the first 2 weeks of treatment and tended to go away over time without stopping Otezla
|Most common side effects|
*In plaque psoriasis studies data from manufacturer.
Severe diarrhea, nausea, and vomiting can occur within the first few weeks of starting Otezla, and in some cases, patients were hospitalized. Older patients may be at a greater risk, especially if they are at risk of low blood pressure or dehydration, or taking medications that can worsen these effects.
If you develop severe diarrhea, nausea or vomiting, tell your doctor immediately. Side effects of severe diarrhea or vomiting typically improve quickly with dose reduction or discontinuation of Otezla. Do not stop taking Otezla unless recommended by your doctor.
If you notice that you are having signs or symptoms of depression or worsened depression, suicidal thoughts, or other mood changes while taking Otezla, contact your doctor immediately. Your family members should also help to monitor you for these changes. Before starting treatment with Otezla, tell your doctor if you have ever had problems with mood or depression.
Toxicity Or Side Effects Develop
Both conventional systemic drugs and biologics can have severe side effects.
Liver toxicity has been associated with long-term use of the conventional drug methotrexate, while kidney toxicity has been associated with long-term use of cyclosporine.
Because of this risk, conventional systemic drugs like methotrexate, oral retinoids, and cyclosporine are typically only given for a short time.
Biologics also have side effects. Because they affect the immune system, they can increase the risk of infections, such as tuberculosis and pneumonia, as well as staph and fungal infections.
If your healthcare provider finds that any of these toxicities or serious side effects occur, youll probably need to change treatments.
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Ive Always Used Creams For My Psoriasis How Does A Pill Help Treat My Psoriasis
Creams and other medications applied to the skin work by being absorbed through the skin. They reduce inflammation and excessive cell growth in the area around where the medication is applied. These drugs are usually the first medications used for psoriasis.
Pills used for psoriasis work from the inside out. They work throughout the body by blocking the bodys production of chemical messengers that cause inflammation and cell overgrowth on the skin.
Safety Data From Palace 4
PALACE 4 reported low levels of AEs and SAEs. Again, diarrhoea and nausea were the two most commonly reported side effects. In the first year of therapy, these were reported in 10.3% of those on apremilast 20 mg and 10.9% of those on 30 mg. For those continuing in the trial for a second year, the rates were very low in year 2 . In PALACE 4, discontinuation due to AEs was rare. With apremilast 20 mg 5.6% in year 1, 1.7% in year 2. With apremilast 30 mg 5.2% in year 1, 3.5% in year 2
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What Should Be Considered Before Taking Otezla
Before taking Otezla, talk with your doctor about whether this drug is right for you.
Let your doctor know if youre taking any other medications. Some medications may interfere with how Otezla works.
Other considerations youll need to discuss with your doctor may include whether you:
- are pregnant or breastfeeding
- have any other medical conditions
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 you are taking before you start receiving Otezla.
Potential interactions that could reduce the effectiveness of Otezla:
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Are There Other Treatment Options For Psoriatic Arthritis
Yes. There are various medications available to treat the signs and symptoms of psoriatic arthritis. The medications range from anti-inflammatory meds such as ibuprofen, to disease modifying agents like methotrexate, to injectable biologics like Enbrel or Humira.
It is important to talk to your doctor and find out which option may be right for you.
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Folic Acid A Must For Ra Patients Taking Methotrexate
Though it may not seem like a supplement could do much to ease methotrexates potentially uncomfortable side effects, the Arthritis Foundation calls folic acid an absolute must. This is because it doesnt interfere with the drugs positive treatment effects, yet it does ease the angst that some people with RA develop in their gastrointestinal tract when taking this prescribed medication in its normal dose.
Additionally, one piece of research published in the journal Arthritis Research & Therapy explains that methotrexate toxicity can become an issue for patients with RA, especially if they take this drug over long periods. Essentially, one of the main problems occurs when it comes time for patients to be taken off methotrexate as withdrawal occurs as much as 50 percent of the time.
As a result, some doctors are hesitant to prescribe this drug as a treatment option to patients with RA. However, folic acid reduces this concern for these doctors in that it helps reduce methotrexate toxicity. Even in smaller doses, it has proven to be effective in this regard. There are other ways to reduce toxicity as well, such as by taking additional substances, like calcium folinate for instance.
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Is Otezla A Biologic Drug
No, Otezla isnt a biologic drug. Biologics are drugs made from living cells. They work against a specific part of your immune system.
Certain nonbiologic drugs, including Otezla, also act on your immune system. Nonbiologic drugs are made from chemicals rather than from living cells.
If you have more questions about how Otezla works, talk with your doctor or pharmacist.
Otezla For Other Conditions
In addition to the uses listed above, Otezla may be used off-label for other uses. Off-label drug use is when a drug thats approved for one use is used for a different one thats not approved. And you may wonder if Otezla is used for certain other conditions. Below is information on other possible uses for Otezla.
Otezla for other forms of psoriasis
However, Otezla is used off-label for adults with guttate psoriasis, nail psoriasis, palmoplantar psoriasis, pustular psoriasis, and scalp psoriasis. Its not recommended for off-label use in treating erythrodermic psoriasis.
If you have questions about treatment options for psoriasis, talk with your doctor.
Otezla for eczema
Eczema, also called atopic dermatitis, can result in long-lasting or recurring rashes on the face, head, or arms and legs.
In 2012, one small evaluated Otezla for treating adults with eczema and found that it reduced itching and the severity of eczema. However, currently the American Academy of Dermatology doesnt recommend Otezla for treating eczema.
If youd like to know about treatment options for eczema, talk with your doctor.
Otezla for rheumatoid arthritis
Currently, the doesnt recommend Otezla for treating rheumatoid arthritis .
One evaluated Otezla in people with RA who didnt respond adequately to treatment with methotrexate. Otezla didnt improve symptoms any better than taking a placebo pill.
Side Effects And Risks
Otezla and Humira have some similar side effects and some that differ. Below are examples of these side effects.
|Both Otezla and Humira|
In addition, Otezla is approved to treat mouth sores caused by Behçets disease. And Enbrel is approved to treat certain other forms of arthritis.
See this article for more information about Enbrel. Your doctor or pharmacist can also provide more information about how Otezla and Enbrel compare.
What Are Otezlas Side Effects
Like most drugs, Otezla may cause mild or serious side effects. The lists below describe some of the more common side effects that Otezla may cause. These lists dont include all possible side effects.
Your doctor or pharmacist can tell you more about the potential side effects of Otezla. They can also suggest ways to help reduce side effects.
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Ra And Methotrexate: Does Methotrexate Reduce Inflammation
If you have rheumatoid arthritis , youre probably very familiar with the pain and joint swelling that this particular type of arthritis can cause. If youve had it for some time, you may even be experiencing the joint deformities that can occur as RA progresses. As you know, any joint deformity can take a significant toll on your joint function as well as your overall quality of life.
RA usually attacks the joints of the hands and feet first, which means even simple activities like tying a shoe, brushing your teeth, combing your hair, or getting dressed in the morning can become painful enterprises. Leisurely pursuits like gardening or taking long walks may have lost their appeal as well, largely as a result of the pain and inflammation these joint-based movements can trigger.
Although there is currently no cure for RA, there are medications that a doctor can prescribe to slow the progression of joint destruction and deterioration. One of the most popular and also most effective of these is a folate analog called methotrexate . Its a treatment option with one of the longest and most well-established safety profiles of any rheumatoid arthritis drug on the market.
Can I Have Immunisations Whilst On Otezla
It is important that when having vaccinations, you check with your Dermatology/Rheumatology team as to whether you need to stop or delay taking Otezla as they will have the most up-to-date advice regarding the continuing of your treatment at this time. If you are taking Otezla, you should not receive a live vaccine .
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Natural Alternatives To Otezla
Many healthcare professionals will stress the importance of non-pharmacologic treatment usually in addition to any pharmacologic treatment. Physical and occupational therapy play an important role in the ongoing health and use of the joints. Phototherapy will help with the dermatological manifestations on PsA. Massage therapy and exercise also play an important role. Smoking and obesity are risk factors for psoriatic arthritis. Naturally, most treatment plans include a timeline for smoking cessation and weight loss.
There are natural supplements which may play a role in symptom relief. Turmeric and omega-3-fatty acids have anti-inflammatory properties thought to help with the pain and inflammation associated with psoriatic arthritis. Soaking in baths of epsom salt with magnesium is also thought to help with the inflammation and provide pain relief. A topical magnesium preparation may also be helpful. There is no vitamin that is a cure for psoriasis or psoriatic arthritis, but natural supplements and non-pharmacologic treatments may have an important place in therapy.
Key Facts About Otezla
- Otezla is a small molecule phosphodiesterase 4 inhibitor approved by the FDA for the treatment of plaque psoriasis, psoriatic arthritis, and oral ulcers associated with Behçets Disease.
- Otezla is taken as an oral tablet twice a day. Your doctor will start your dose slowly to help lessen side effects like stomach upset or diarrhea. If you have severe kidney disease, you will need a lower dose of Otezla.
- Otezlas generic name is apremilast, but a generic is not yet available for this drug. Amgen is the manufacturer for Otezla and it was first approved by the FDA in 2014.
- Otezla works in your immune system by blocking the phosphodiesterase type 4 enzyme in the cell to lower inflammation in the body. The PDE4 enzyme is a type of immune system protein that can be overactive in some people, leading to symptoms.
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How Does Otezla Compare To Humira
Unlike Otezla, Humira is a biologic drug. This means Humira is made from parts of living cells. Otezla, on the other hand, is made from chemicals.
Otezla comes as tablets that youll take by mouth, typically twice each day. But youll take Humira as an injection under your skin. Usually, its taken once every 2 weeks, after the first week of treatment.
If you have more questions about the differences between Otezla and Humira, talk with your doctor.
So What Is Psoriatic Arthritis And How Does It Differ From Rheumatoid Arthritis
Well, just like rheumatoid arthritis, it is an auto-immune disease. Both cause an erosive inflammatory arthritis in addition to chronic fatigue. And both can have symptoms that vary greatly from person to person. However the distribution of joint involvement differs between the two diseases and psoriatic arthritis involves the skin as well as the joints.
Both diseases can cause destruction of the small joints in your hands and feet as well as larger joints such as knees, hips, shoulders and even the vertebrae in your spine. Classic rheumatoid arthritis primarily involves the PIP joints and wrist, and is generally a symmetrical disease effecting both sides of the body equally. Also with rheumatoid arthritis, nodules specific to this disease are often present.
Both diseases can involve inflammation and scarring of major organs such as your heart and lungs and as in my case can involve your eyes. In addition, both can increase your risk of osteoporosis due the condition itself and also from some of the medications that are used to treat these conditions. After years of taking steroids for my arthritis, it resulted in a couple of compression fractures in my thoracic spine. And, both disorders can also result in joint destruction leading to severe crippling disabilities.
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Financial And Insurance Assistance
If you need financial support to pay for Otezla, or if you need help understanding your insurance coverage, help is available.
Amgen, the manufacturer of Otezla, offers a copay card that may reduce the cost of Otezla. The manufacturer also has a program called Otezla SupportPlus, which may assist you in finding ways to lower the cost of Otezla.
For more information and to find out if youre eligible for support, call 844-468-3952 or visit the program website.
How Long Does It Take To Start Working
While everyone will have a different experience with methotrexate, research suggests that some people will notice improvements within 3months of starting the medication. For some people, it may take longer. Your provider will likely ask you to get a lab test every 2 to 4 weeks over this time period to monitor the levels of methotrexate in your body and make sure you can continue safely taking it.
Its important that you dont stop taking methotrexate unless your provider tells you to. Your arthritis symptoms may return and they may even be worse than before. After about 6 months, your provider will likely reevaluate your treatment plan if your symptoms have not improved. The next step might be trying a combination of methotrexate with another medication.
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Why Your Next Move Should Be Taltz
JOINT SYMPTOM IMPROVEMENT FOR ADULTS WITH PSORIATIC ARTHRITIS
Taltz helped some patients experience improvement in PsA symptoms,* such as:
- Joint pain and stiffness
- Pain in tendons and ligaments where they are attached to bone
- Swelling of fingers and toes
*Evaluated at 6 months.
Select Safety Information
Your doctor should check you for tuberculosis before you start Taltz, and watch you closely for signs of TB during and after treatment with Taltz. If you have TB, or had it in the past, your doctor may treat you for it before you start Taltz.
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 youve 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.
- Behçets disease 52.9% of patients with Behçets Disease were completely free of oral ulcers after 12 weeks of treatment. Of those patients, 30% were already ulcer-free after just 6 weeks.
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