Why is this medication prescribed?

Apremilast is prescribed for the treatment of certain inflammatory conditions. Specifically, it is used for:

• Psoriasis: It helps manage moderate to severe plaque psoriasis in adults.
• Psoriatic Arthritis: It is used to reduce symptoms and improve function in adults with psoriatic arthritis.
• Behçet’s Disease: Apremilast can also be prescribed for oral ulcers associated with Behçet’s disease.

Apremilast works by modulating the immune system to reduce inflammation. It is a type of drug called a phosphodiesterase inhibitor, which helps decrease the production of inflammatory cytokines.

How should this medicine be used?

Apremilast is typically taken orally in the form of tablets. Here’s how it should be used:

• Dosage: The usual starting dose is 10 mg once daily, which is gradually increased over several days to the target dose of 30 mg twice daily. Your healthcare provider will determine the appropriate dosage for you based on your condition and response to the medication.
• Administration: You can take Apremilast with or without food. If you experience gastrointestinal side effects, taking it with food might help reduce these effects. Do not crush, chew, or break the tablets.
• Consistency: Try to take the medication at the same times each day to help remember your doses.
• Missed Dose: If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
• Adherence: It’s important to follow your healthcare provider’s instructions and not stop taking Apremilast abruptly without consulting them.
• Monitoring: Regular follow-up appointments are important to monitor for any side effects or necessary dose adjustments.

If you have any specific questions or concerns about how to use Apremilast, it’s best to discuss them with your healthcare provider.

Other uses for this medicine

Apremilast is primarily prescribed for:

• Plaque Psoriasis: Moderate to severe plaque psoriasis in adults.
• Psoriatic Arthritis: To reduce symptoms and improve function in adults.
• Behçet’s Disease: Specifically for oral ulcers associated with Behçet’s disease.

What special precautions should I follow?

Special Precautions for Apremilast:

• Infections: Apremilast may increase the risk of infections. Inform your healthcare provider if you have a history of recurrent infections or if you develop signs of an infection while on the medication.
• Diarrhea: Diarrhea is a common side effect. Stay hydrated and inform your doctor if diarrhea persists or becomes severe.
• Depression and Mood Changes: Apremilast may cause mood changes, including depression. Report any new or worsening symptoms of depression or suicidal thoughts to your healthcare provider.
• Weight Loss: Some people may experience weight loss while taking Apremilast. Monitor your weight and discuss any significant changes with your doctor.
• Drug Interactions: Inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements, as Apremilast can interact with other medications.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits with your healthcare provider.
• Liver Function: Apremilast is metabolized by the liver, so those with liver problems should be monitored closely. Your doctor may need to adjust your dose or monitor your liver function more frequently.
• Allergic Reactions: Watch for any signs of an allergic reaction, such as rash, itching, swelling, or difficulty breathing, and seek immediate medical attention if they occur.

If you have any specific health conditions or concerns, it’s important to discuss them with your healthcare provider to ensure Apremilast is appropriate for you.

What special dietary instructions should I follow?

There are no specific dietary restrictions while taking Apremilast, but maintaining a balanced diet and staying hydrated can help manage some side effects.

• Food Intake: Apremilast can be taken with or without food. If you experience gastrointestinal side effects, taking it with food might help reduce discomfort.
• Hydration: Stay well-hydrated, especially if you experience diarrhea.

What should I do if I forget a dose?

• Missed Dose: If you miss a dose, take it as soon as you remember.
• Close to Next Dose: If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule.
• Do Not Double Dose: Do not take two doses at the same time to make up for a missed dose.
• Consult Your Doctor: If you have missed multiple doses or are unsure about what to do, contact your healthcare provider for guidance.

What side effects can this medication cause?

Apremilast can cause various side effects. Some of the common and serious side effects include:

Common Side Effects:

• Diarrhea: One of the most frequent side effects. It usually improves over time.
• Nausea: Feeling queasy or having an upset stomach.
• Headache: Mild to moderate headaches are possible.
• Weight Loss: Some people may experience a decrease in weight.
• Upper Respiratory Tract Infections: Symptoms like a sore throat or nasal congestion.
• Fatigue: Feeling unusually tired or weak.
• Abdominal Pain: Discomfort or pain in the stomach area.

Serious Side Effects:

• Severe Diarrhea: Persistent or severe diarrhea requiring medical attention.
• Depression or Mood Changes: New or worsening symptoms of depression, including suicidal thoughts or behavior.
• Infections: Symptoms of serious infections, such as fever, chills, or severe cough.
• Allergic Reactions: Severe allergic reactions such as rash, itching, swelling, or difficulty breathing.
• Liver Problems: Symptoms such as jaundice (yellowing of the skin or eyes), dark urine, or severe abdominal pain.
• Severe Weight Loss: Significant or rapid weight loss that may require medical evaluation.
• Diarrhea and Nausea: Drink plenty of fluids to stay hydrated. If these side effects persist or become severe, consult your healthcare provider.
• Mood Changes: Report any changes in mood or mental health to your healthcare provider immediately.
• Infections: Practice good hygiene and report any signs of infections.

Always consult your healthcare provider if you experience any side effects, especially if they are severe or concerning. Your provider can offer guidance on how to manage side effects or adjust your treatment if necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Apremilast:

Storage:

• Store Apremilast at room temperature, typically between 68°F to 77°F (20°C to 25°C).
• Keep it in a dry place, away from excess moisture and humidity.
• Protect from light by keeping the medication in its original container.
• Keep out of reach of children and pets.

Disposal:

• Do not dispose of Apremilast in household trash or flush it down the toilet.
• Use a drug take-back program or a community pharmacy that offers disposal services.
• Check the FDA’s website or local waste disposal guidelines for specific instructions on medication disposal.

In case of emergency/overdose

• Contact Emergency Services: If you suspect an overdose, contact emergency medical services or go to the nearest emergency room immediately.
• Provide Information: Be ready to provide details about the medication and the amount taken.
• Overdose Symptoms:
  • Severe nausea or vomiting
  • Severe diarrhea
  • Severe abdominal pain
  • Any other unusual or severe symptoms

What other information should I know?

• Regular Monitoring: Regular follow-up with your healthcare provider is essential to monitor your response to the medication and manage any side effects.
• Inform Healthcare Providers: Inform all healthcare providers about your use of Apremilast, especially if you are undergoing surgery or other treatments.
• Medical History: Make sure your healthcare provider is aware of your full medical history, including any liver conditions, infections, or mental health issues.
• Pregnancy and Breastfeeding: Discuss the risks and benefits of Apremilast if you are pregnant or breastfeeding with your healthcare provider.

If you have any further questions or need clarification, consult your healthcare provider or pharmacist for personalized advice.