Apremilast

Antipsoriasis · phosphodiesterase inhibitors

Indications

Active psoriatic arthritis (in combination with disease-modifying antirheumatic drugs or alone) in patients who have had an inadequate response or who have been intolerant to a prior disease-modifying antirheumatic drug therapy. Moderate to severe chronic plaque psoriasis that has not responded to standard systemic treatments or photochemotherapy, or when these treatments cannot be used due to intolerance or contra-indications.

Dosage

Adults: Initially 10 mg once a day on Day 1, then 10 mg two times daily on day 2, then 10 mg in the morning and 20 mg in the evening on day 3, then 20 mg two times daily on day 4, then 20 mg in the morning and 30 mg in the evening on day 5, then maintenance 30 mg two times daily, doses must be taken approx. 12 hrs apart. Consider review of treatment if no response within 24 wks of initiation. Children: >6 yrs: Wt >20 kg; Same as adults. <6 yrs: Wt < 20 kg: Not recommended.

Adverse Effects

Headache, cough, fatigue, GI upset, RTI, anorexia, insomnia, depression, back pain.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Caution advised or effect undetermined. Precautions: Severe renal impairment. History of psychiatric disorders. Elderly.

Interactions

Strong CYP3A4 inducers (eg, rifampicin, phenobarbital, carbamazepine, phenytoin, St John's wort). Drugs likely to cause psychiatric symptoms.

Advice to Patient

Take with or without meals. Do not crush, chew, or split tabs. Inform prescriber if there is drastic change in weight, or if you experience mood changes, depression or suicidal thoughts.

Pharmacokinetics

Absorption: Well absorbed. Metabolism: Hepatic. Bioavailability: Approx. 73%. Half-life elimination: Approx. 6-9 hrs. Time to peak: Approx. 2.5 hrs. Excretion: Urine (58%). Faeces (39%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.