Apremilast
About Apremilast
Apremilast is a prescription medication used to treat moderate to severe plaque psoriasis and active psoriatic arthritis. It is also prescribed to treat painful mouth ulcers associated with Behçet's disease. By targeting specific pathways involved in inflammation, this medication helps clear skin plaques and reduce joint swelling and stiffness from within.
To get the best results, you should take Apremilast consistently every day, typically twice a day after an initial period of gradually increasing the dose. You can take this tablet with or without food, making it easy to fit into your daily routine. Combining your medical treatment with a balanced diet, regular gentle exercise, and proper skin moisturising can significantly improve your therapeutic results.
While taking Apremilast, you might experience mild side effects like nausea, diarrhea, or tension headaches, especially during the first few weeks of starting the treatment. However, if you experience severe diarrhea, significant unexplained weight loss, or changes in your mood such as depression, you must consult your doctor immediately.
Before starting Apremilast, tell your healthcare provider if you have a history of depression, kidney disease, or severe digestive problems. Do not take this medicine if you have a known allergy to any of its ingredients.
Certain medicines, particularly strong seizure medications or tuberculosis treatments, can make Apremilast less effective, which is why sharing your full medication list with your pharmacist is crucial. If you are pregnant, planning to become pregnant, breastfeeding, or are an older adult, talk to your doctor to weigh the benefits and risks of this treatment.
Uses of Apremilast
Medicinal Benefits
Apremilast offers several important benefits that help control inflammation, relieve symptoms, and improve quality of life, including:
- Convenient Oral Relief: Unlike many other advanced treatments for psoriasis or psoriatic arthritis that require injections or infusions, Apremilast offers the convenience of a simple oral tablet.
- Improved Joint Mobility: By calming chronic inflammation, this medication helps you move more freely and comfortably, making daily physical tasks easier to manage.
- Clearer Skin: Many patients experience a significant clearing of skin plaques, leading to reduced itching, scaling, and physical discomfort.
- Targeted Inflammation Control: It works specifically on the inflammatory pathways inside your cells, helping to prevent flare-ups before they start.
Directions for Use
- Take Apremilast with or without food as advised by your doctor.
- Follow your doctor’s recommendations on the dosage and timing of this medication to achieve optimal results.
- Swallow Apremilast as a whole with a glass of water.
- Do not crush, chew, or break it.
Storage
Side Effects of Apremilast
Common Side Effects (Usually mild):
- Mild diarrhoea or loose stools
- Nausea or upset stomach
- Tension headaches or migraines
- Common cold symptoms, such as a runny or stuffy nose
Serious Side Effects (Call a doctor right away):
- Severe, persistent diarrhea, nausea, or vomiting that leads to dehydration
- Unexplained, rapid weight loss
- New or worsening depression, anxiety, or suicidal thoughts
- Signs of an allergic reaction, such as skin rash, itching, hives, or swelling of the face, lips, and throat
Medicines Containing this Salt
View AllDrug Warnings
- Monitor Your Weight Regularly: Weigh yourself weekly when starting this treatment and inform your doctor if you experience significant, unexplained weight loss.
- Prepare for the Starting Phase: Be aware that your doctor will use a starter pack to gradually increase your dose; do not skip this step as it helps prevent severe stomach upset.
- Report Mood Changes Immediately: Alert a family member or close friend that you are taking this medication so they can help monitor you for signs of depression or mood shifts.
- Check Your Kidney Health: Ensure your doctor checks your kidney function before starting, as a lower dose may be required if your kidneys do not filter waste efficiently.
- Review Your Complete Drug List: Tell your doctor about all other medicines you take, as certain liver enzyme-inducing drugs can significantly lower the levels of Apremilast in your blood, making it less effective.
Drug Interactions
Apremilast may interact with certain medicines, which can reduce its effectiveness or require dose adjustments. Inform your doctor about all prescription medicines, over-the-counter products, vitamins, and herbal supplements you are taking, including:
- Strong CYP3A4 Inducers (such as rifampin, phenytoin, phenobarbital, carbamazepine, or St. John’s wort): These medicines can significantly lower Apremilast levels in the body, reducing its effectiveness.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeLimit intake of alcohol, as this may increase the risk of serious side effects.
Pregnancy
cautionIf you are pregnant, inform your doctor before taking Apremilast. Consult your doctor if you become pregnant while taking Apremilast.
Breast Feeding
cautionIt is not known whether Apremilast may pass into breast milk or not. If you are breastfeeding, inform your doctor before taking Apremilast.
Driving
safe if prescribedApremilast has no or negligible influence on the ability to drive and use machines.
Liver
cautionApremilast to be taken with caution, especially if you have a history of liver problems. Your doctor may adjust the dose of this medicine based on your condition.
Kidney
cautionApremilast to be taken with caution, especially if you have a history of kidney diseases. Your doctor may adjust the dose of this medicine based on your condition.
Children
unsafeApremilast is not recommended for use in children and adolescents below 17 years.
Habit Forming
Diet & Lifestyle Advise
- Stay Well Hydrated: Because mild diarrhoea or nausea can occur when you start Apremilast, drink plenty of water and electrolyte-rich fluids throughout the day to prevent dehydration.
- Protect and Moisturise Your Skin: Apply a thick, fragrance-free emollient to your skin within three minutes of bathing to lock in moisture and support the skin barrier.
- Engage in Low-Impact Exercise: If you have joint pain, engage in gentle activities like swimming, cycling, or yoga to keep your joints flexible without putting excessive stress on them.
- Eat an Anti-Inflammatory Diet: Focus on foods rich in omega-3 fatty acids (like salmon and flaxseeds) and colorful vegetables, which can help support your body's natural anti-inflammatory processes.
- Track Your Mood: Keep a daily journal of your mood and emotional well-being to easily notice any changes, and share these observations with your doctor.
Special Advise
- Apremilast is a well-tolerated medicine. Mild stomach upset may arise early during the treatment.
- Monitor your weight repeatedly as Apremilast may lead to weight loss.
- Inform your doctor immediately if you experience new or worsened depression, suicidal thoughts, unexplained weight loss, or other mood changes.
Patients Concern
Disease/Condition Glossary
Plaque Psoriasis: It is an inflammatory disease of the skin, leading to red, scaly, thick, itchy, painful patches on your skin and can also affect your nails and scalp. It can happen at any age and is most common in 50 to 69. Internal and external activities, including sunburn, mild trauma, systemic drugs, infections, and stress, can also cause psoriasis.
Psoriatic arthritis: Psoriatic arthritis is an inflammatory disorder of the joints, which affects a few people who have skin from psoriasis.
Behçet’s disease: It is an uncommon type of inflammatory illness that affects many parts of the body. The most common difficulty is mouth ulcers. It is a disease that results in blood vessel swelling in the body.
FAQs
Apremilast is used to treat plaque psoriasis (scaly, itchy, and red patches on the skin), psoriatic arthritis (inflammation in the joints in people with psoriasis), and oral ulcers caused by Behcet's disease.
Apremilast works by blocking the action of some chemical messengers that are responsible for inflammation.
Yes, Apremilast may cause depression as a side effect. The patient may also have suicidal thoughts. Apremilast should be avoided in people with a history of depression. In case you develop any of these symptoms, Inform your doctor immediately.
Yes, Apremilast may cause a reduction in appetite, which may further lead to weight loss. You should monitor your weight frequently while on treatment with Apremilast. In case of big weight loss, inform your doctor. Your doctor may consider stopping Apremilast.
Rifampicin is an antibiotic. You should not take rifampicin if you are taking Apremilast. Rifampicin interferes with the working of Apremilast by reducing its levels, making it less effective. As a result, you may not see any recovery after taking Apremilast.
As soon as you recall, take the missed dose. If the next dose is approaching, skip the missing dose and resume your regular dosing regimen. Do not duplicate the dose to make up for a missing one.
No, Apremilast is not an immunosuppressant. It belongs to a class of drugs called phosphodiesterase 4 (PDE4) inhibitors which work by blocking the action of PDE4 that is found in inflammatory cells.
Take Apremilast as advised by the doctor. Swallow it as whole with a glass of water. Do not break, crush or chew it.
If you get pregnant during treatment with Apremilast, inform your doctor immediately. You are recommended to avoid pregnancy during treatment with Apremilast as it may harm unborn baby.
Apremilast may cause side effects such as nausea, vomiting, diarrhoea, back pain or weight loss. If these side effects persist or worsen, please consult your doctor.
While there is no direct chemical interaction between alcohol and Apremilast, alcohol can dehydrate you and exacerbate skin inflammation or stomach upset. It is best to limit alcohol intake. Talk to your doctor about what is safe for you.
Hair loss is not a medically recognised or common side effect of Apremilast. If you experience unusual hair thinning or shedding, it may be due to other underlying health factors. Talk to your doctor to determine the cause.
Unlike many biological therapies, Apremilast is a selective oral treatment that targets specific inflammatory pathways rather than suppressing the entire immune system. This means it generally does not carry the same high risk of serious infections. Talk to your doctor for more details.
Unlike some other systemic treatments for psoriasis or arthritis, Apremilast does not typically require routine laboratory monitoring or frequent blood tests. However, your doctor may check your kidney function before starting. Talk to your doctor to plan your monitoring schedule.
There is limited data on the safety of Apremilast during pregnancy. It is generally recommended to discuss family planning with your healthcare provider before starting or while taking this medication. Talk to your doctor about alternative options if you are planning a pregnancy.
Mild nausea and diarrhoea are common when first starting Apremilast but usually improve within a few weeks. If your stomach issues are severe, cause dehydration, or persist beyond the first month, do not stop the medication abruptly. Talk to your doctor for advice on managing these symptoms.
No, you should not crush, chew, or break the Apremilast tablet. The tablets are formulated to release the active medicine safely in your digestive system, and breaking them can interfere with this process. Talk to your doctor or pharmacist if you have difficulty swallowing pills.
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