Apremilast belongs to a group of medicines called phosphodiesterase 4 (PDE4) inhibitors. It works by regulating inflammation involved in psoriasis. It is used to treat adults with moderate to severe chronic plaque psoriasis who have failed to respond to, or are intolerant to other systemic therapies including ciclosporin, methotrexate or PUVA.
How does it work?
Apremilast blocks an enzyme called phosphodiesterase 4 (PDE4). This changes the levels of chemical messengers inside immune cells and helps regulate the production of substances involved in inflammation. This can reduce the inflammation and other symptoms associated with psoriasis.
Who can get it?
Apremilast is available on prescription and treatment should be started by a specialist experienced in treating psoriasis. It can be used in adults with moderate to severe plaque psoriasis and is also licensed for children and adolescents aged 6 years and over who weigh at least 20 kg and are candidates for systemic therapy.
How is it used?
Apremilast is administered orally and is started with a low dose and is gradually increased over the first 6 days of treatment to twice daily doses. Your dermatologist will assess how well the treatment is working. It is recommended that apremilast is stopped if there has not been an adequate response after 16 weeks.
What are the side effects?
Very common side effects (may affect more than 1 in 10 people)
Common side effects (may affect up to 1 in 10 people)
- cough
- back pain
- vomiting
- feeling tired
- stomach pain
- loss of appetite
- frequent bowel movements
- difficulty sleeping (insomnia)
- indigestion or heartburn
- headaches, migraines or tension headaches
- upper respiratory tract infections such as cold, runny nose, sinus infection
- inflammation and swelling of the tubes in your lungs (bronchitis)
- common cold (nasopharyngitis)
- depression
Uncommon side effects (may affect up to 1 in 100 people)
- rash
- Your weight may be monitored during treatment. Tell your doctor if you experience significant or unexplained weight loss.
- allergic reaction
- bleeding in the bowel or in the stomach
- Some people taking apremilast have experienced depression or suicidal thoughts or behaviour. Tell your doctor promptly if you notice changes in your mood or thoughts of harming yourself.
Apremilast is known commercially as Otezla and as generic apremilast tablets and is marketed in the UK by Amgen Limited
Reviewed: August 2026
Version ID: 2/APR/PST/08/26
