Otezla (apremilast) is a brand-name tablet prescribed for psoriatic arthritis, plaque psoriasis, and mouth ulcers due to Behçet’s disease. As with other drugs, Otezla can cause side effects, such as diarrhea and nausea.

Otezla can cause certain side effects, some of which are more common than others. These side effects may be temporary, going away in a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Otezla in clinical trials:

* For more information about this side effect, see the “Side effect specifics” section.

Mild side effects can occur with Otezla. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Otezla’s prescribing information.

Mild side effects that have been reported with Otezla include:

  • decreased appetite
  • back pain
  • heartburn
  • abdominal pain
  • infection, such as respiratory infection
  • fatigue
  • insomnia
  • mild nausea, vomiting, or diarrhea*
  • weight loss*
  • headache*
  • joint pain*

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Otezla and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

* For more information about this side effect, see the “Side effect specifics” section.

Otezla may cause serious side effects. Though serious side effects from this drug aren’t common, they can occur. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Otezla’s prescribing information.

If you develop serious side effects while taking Otezla, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported include:

For more information about these side effects, see the “Side effect specifics” section.

Allergic reaction and hypersensitivity

For some people, Otezla can cause an allergic reaction. This is also known as a hypersensitivity reaction. Hypersensitivity reactions didn’t occur in Otezla’s clinical trials, but they’ve been reported since the drug was approved for use.

In general, symptoms of an allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Otezla, your doctor may recommend taking a different medication instead.

Otezla may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Does Otezla cause any long-term side effects, such as cancer?

It’s not common for Otezla to cause long-term side effects. And the drug has not caused cancer in clinical trials.

However, other long-term side effects are possible with Otezla. For example, weight loss can be a long-term side effect of taking Otezla in some people. (For more information about this side effect, see the “Side effect specifics” section.)

If you have concerns about long-term side effects from taking Otezla, talk with your doctor or pharmacist.

Can I have withdrawal symptoms from stopping Otezla?

No, you should not experience withdrawal from stopping Otezla. (With withdrawal, you may experience uncomfortable symptoms after stopping a drug that your body has become dependent on.)

However, stopping Otezla may worsen the symptoms of the condition you’re taking it to treat. For example, if you take Otezla to treat psoriatic arthritis (PsA) and you stop treatment, your symptoms of PsA may come back.

If you’d like to stop treatment with Otezla, talk with your doctor. They can advise whether you should expect any side effects after stopping the drug.

Is hair loss a side effect of Otezla?

No, you should not experience hair loss from Otezla treatment. Hair loss wasn’t a side effect that people taking the drug reported in clinical trials. Otezla isn’t known to cause hair growth either.

However, plaque psoriasis can cause hair loss if the condition affects your scalp. (Otezla is used to treat plaque psoriasis.

If you notice hair loss during your treatment with Otezla, talk with your doctor. They can help determine what may be causing your hair loss and the best way to manage it. If you have additional concerns about Otezla and hair loss, talk with your doctor or pharmacist.

Does Otezla cause sun sensitivity?

No, sun sensitivity was not reported in clinical trials of Otezla. So you should not experience sun sensitivity during your treatment.

Other drugs that may be used to treat your condition may cause sun sensitivity. For example, methotrexate (Trexall) may cause sun sensitivity as a side effect. Similar to Otezla, methotrexate can be used to treat plaque psoriasis or PsA.

However, sunlight may help treat plaque psoriasis in certain people.

If you have concerns about sun sensitivity during Otezla treatment, talk with your doctor or pharmacist.

Should I expect muscle pain with Otezla treatment?

No, muscle pain should not occur from taking Otezla. This was not a side effect reported by people taking this drug in clinical trials. However, back pain and joint pain are side effects that people experienced during Otezla treatment. (For more information about joint pain with Otezla, see the “Side effect specifics” section.)

If you experience pain during your treatment, talk with your doctor. They can help determine what type of pain you’re experiencing and what may be causing it. They may also be able to recommend treatment options for you.

As you look into treatment options for your condition, you may have questions about the cost of certain medications. You may also wonder if there are savings options, such as a copay card, or whether your insurance covers your treatment.

The price you’ll pay for Otezla can vary. It will depend on your treatment plan, any insurance coverage you have, and the pharmacy you use.

To find out about your specific insurance coverage, talk with your insurance provider or pharmacist.

Learn more about some of the side effects that Otezla may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Otezla.

Nausea, vomiting, and diarrhea

Some people may experience digestive side effects, such as nausea, vomiting, and diarrhea while taking Otezla. These were the most common side effects reported in clinical trials of the drug. For most people, these side effects were mild or temporary.

It’s possible for nausea, vomiting, or diarrhea to become severe during Otezla treatment. Typically, severe symptoms occur during the first few weeks of treatment.

Severe nausea, vomiting, or diarrhea can lead to dehydration. This condition can become serious and may lead to other problems. These can include heart palpitations or kidney or liver damage. You may have an increased risk of developing dehydration if you:

  • are ages 65 years or older
  • have low blood pressure
  • take medications that can cause low blood pressure
  • take medications that increase the risk of dehydration

What you can do

If you develop nausea, vomiting, or diarrhea from taking Otezla, talk with your doctor. They can help determine whether your symptoms are severe and the best ways to manage them.

Sometimes, taking a medication with food may help decrease nausea. Otezla can be taken with or without food. So your doctor may recommend taking the drug with a meal or snack.

Your doctor may monitor you for these side effects throughout your Otezla treatment. If you develop severe symptoms, they may recommend decreasing your dose of Otezla. Or they may recommend pausing or stopping your treatment completely.

If you’re experiencing nausea, vomiting, or diarrhea during your treatment with Otezla, talk with your doctor about the best plan for you.

Otezla and weight loss

It’s possible for Otezla to cause weight loss. However, weight loss was not one of the most common side effects reported in clinical trials of Otezla.

Otezla can decrease appetite, which may lead to weight loss. It can also cause digestive side effects, such as nausea, vomiting, or diarrhea. In some cases, these side effects can be severe and may lead to weight loss.

What you can do

Your doctor will recommend monitoring your weight while you’re taking Otezla. If you notice unexpected weight loss or a large decrease in your body weight, tell your doctor.

If your weight loss is due to digestive side effects or a decrease in appetite, your doctor may recommend treatment options for these side effects. This may help you manage your weight loss. Sometimes, your doctor may recommend stopping treatment with Otezla. They may prescribe a different medication for your condition instead.

Headache

Otezla may cause headache. This was one of the most common side effects that people reported in clinical trials of the drug. Different types of headaches were reported, including tension headache, sinus headache, and migraine headache.

What you can do

If you’re experiencing headaches that are severe or bothersome during your treatment with Otezla, talk with your doctor. They may be able to recommend treatment options for your headaches. For example, they may recommend taking acetaminophen (Tylenol) to help relieve pain.

Joint pain

Joint pain can occur from taking Otezla. Joint pain was only reported in people taking Otezla to treat mouth ulcers due to Behçet’s disease. This side effect wasn’t reported in people taking Otezla for PsA or plaque psoriasis.

What you can do

If you experience joint pain during your treatment with Otezla, talk with your doctor. They can help determine whether Otezla may be causing your joint pain.

It’s important to note that people with PsA may experience joint pain from the condition itself. If this applies to you, your doctor can help determine whether Otezla is working to treat your condition or whether it’s worsening your joint pain.

Your doctor can recommend ways to treat your joint pain from Otezla. Sometimes, they may recommend an over-the-counter treatment option, such as acetaminophen (Tylenol).

Depression

Otezla can increase the risk of depression. In clinical trials, depression was not common. However, it can still occur.

Symptoms can include:

  • feeling sad or hopeless
  • changes in your appetite
  • insomnia or sleeping more often than usual
  • lack of interest in activities that you used to enjoy

In the drug’s clinical trials, some people developed suicidal thoughts as a symptom of severe depression. However, this was rare.

If you’ve ever had depression or other mood disorders, you may have an increased risk of new or worsening depression during Otezla treatment.

What you can do

It’s important that you and your caregivers are aware of the above symptoms of depression during your Otezla treatment.

If you develop symptoms of new or worsening depression, tell your doctor right away. They can help determine the best treatment plan for you. In some cases, they may recommend treatment for your depression, such as talk therapy or antidepressant medication. They may also recommend pausing or stopping Otezla treatment.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Before taking Otezla, discuss your health history with your doctor. Otezla may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.