Apremilast

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Generic Name: Apremilast Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: C

Uses

What is Apremilast used for?

Apremilast is used to treat a certain type of arthritis (psoriatic arthritis). Apremilast is also used to treat a certain type of skin condition (moderate to severe plaque psoriasis). Apremilast belongs to a class of drugs known as phosphodiesterase 4 (PDE4) inhibitors. For the treatment of psoriatic arthritis, it decreases pain and swelling, and may help improve flexibility in the affected joints. For the treatment of plaque psoriasis, it may help to reduce the redness, thickening, and scaling of the skin that occurs with this condition.

How should I take Apremilast?

Take this medication by mouth with or without food as directed by your doctor, usually twice daily. The manufacturer directs not to crush, split, or chew the tablet before taking it. However, many similar drugs (immediate-release tablets) can be crushed, split, or chewed. Follow your doctor’s directions on how to take this medication.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Tell your doctor if your condition does not improve or if it worsens.

How do I store Apremilast?

Apremilast is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Apremilast in the bathroom or the freezer. There may be different brands of Apremilast that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Apremilast down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Apremilast?

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, mental/mood disorders (such as depression).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Apremilast during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Apremilast. Apremilast is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Apremilast?

Diarrhea, nausea/vomiting, loss of appetite, headache, or weight loss may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Tell your doctor right away if you have any serious side effects, including: severe nausea/vomiting/diarrhea.

Infrequently, people who take this medication may experience depression, suicidal thoughts/attempts, or other mental/mood problems. Tell your doctor right away if you or your family/caregiver notice any unusual/sudden changes in your mood, thoughts, or behavior including signs of depression, suicidal thoughts/attempts, thoughts about harming yourself.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Apremilast?

Other medications can affect the removal of apremilast from your body, which may affect how apremilast works. Examples include certain drugs used to treat seizures (such as carbamazepine, phenobarbital, phenytoin, primidone), rifamycins (such as rifampin, rifabutin), among others.

Apremilast may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Apremilast?

Apremilast may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Apremilast?

Apremilast may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Apremilast.

What is the dose of Apremilast for an adult?

Usual Adult Dose for Psoriatic Arthritis

Initial dose:

-Day 1: 10 mg orally once a day (AM)

-Day 2: 10 mg orally twice a day (AM and PM)

-Day 3: 10 mg orally once a day (AM); 20 mg orally once a day (PM)

-Day 4: 20 mg orally twice a day (AM and PM)

-Day 5: 20 mg orally once a day (AM); 30 mg orally once a day (PM)

Maintenance dose: 30 mg orally twice a day (AM and PM)

Renal Dose Adjustments

Severe renal impairment (CrCl less than 30 mL/min):

-Initial dosage: Titrate using only the AM schedule listed above and skip the PM doses.

-Maintenance dose: 30 mg orally once a day (AM)

Liver Dose Adjustments

No adjustment recommended

What is the dose of Apremilast for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Apremilast available?

Apremilast is available in the following dosage forms and strengths:

  • Oral tablet.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Apremilast, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: November 20, 2018 | Last Modified: November 20, 2018

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