Key takeaways
- Otezla (apremilast) is a prescription medication used to manage autoimmune conditions such as plaque psoriasis, psoriatic arthritis, and mouth sores from Behçet’s disease.
- Otezla comes as an oral tablet in three strengths: 10 milligrams (mg), 20 mg, and 30 mg. Otezla XR is an extended-release oral tablet available in one strength of 75 mg.
- The usual adult dosage of Otezla is 30 mg twice per day or Otezla XR 75 mg once per day, but doctors may recommend a lower dose for the first 6 days to reduce digestive side effects. For children with plaque psoriasis or psoriatic arthritis who are at least 6 years of age and weigh at least 44 pounds, dosage is determined by body weight.
Otezla comes in two forms: an oral tablet (Otezla) and an extended-release oral tablet (Otezla XR). Unless otherwise noted, the information in this article refers to both forms of Otezla.
This drug is prescribed to treat:
- plaque psoriasis in certain adults and children
- psoriatic arthritis in adults and some children
- mouth sores in adults with Behçet’s disease
Otezla belongs to a group of drugs called phosphodiesterase 4 inhibitors. It contains the active ingredient apremilast.
This article describes the dosages of Otezla, as well as its strengths and how to take it.
The following are details about Otezla’s forms, strengths, and typical dosing. Be sure to follow your doctor’s instructions. They’ll recommend the best dosage for your needs.
What are Otezla’s forms?
Otezla comes in two forms: an oral tablet (Otezla) and an extended-release oral tablet (Otezla XR). With extended-release tablets, the drug is released slowly into your body over time.
What strengths does Otezla come in?
Otezla comes in the following strengths:
- 10 milligrams (mg)
- 20 mg
- 30 mg
Otezla XR is available in one strength of 75 mg.
What are the usual dosages of Otezla in adults?
The following information describes Otezla dosages that are commonly used or recommended. But be sure to follow your doctor’s dosing instructions. They’ll determine the best dosage to fit your needs.
To decrease the risk of nausea, vomiting, and diarrhea, your doctor will likely recommend a special dosing schedule during the first 6 days of Otezla. The following table details these dosing instructions.
| Day of treatment | Morning dose | Evening dose |
|---|---|---|
| Day 1 | 10 mg | –– |
| Day 2 | 10 mg | 10 mg |
| Day 3 | 10 mg | 20 mg |
| Day 4 | 20 mg | 20 mg |
| Day 5 | 20 mg | 30 mg |
| Day 6 and beyond | 30 mg | 30 mg or 75 mg Otezla XR once daily |
By the sixth day, you’ll be taking your maintenance dose.
Maintenance dosage for plaque psoriasis
Starting on day 6, the recommended maintenance dosage for plaque psoriasis is Otezla 30 mg taken twice per day or Otezla XR 75 mg taken once per day.
Maintenance dosage for psoriatic arthritis
Starting on day 6, the recommended maintenance dosage for psoriatic arthritis is Otezla 30 mg taken twice per day or Otezla XR 75 mg taken once per day.
Maintenance dosage for mouth sores from Behçet’s disease
Starting on day 6, the recommended maintenance dosage for mouth sores from Behçet’s disease is Otezla 30 mg taken twice per day or Otezla XR 75 mg taken once per day.
What are the dosages of Otezla for children?
Otezla is prescribed to treat psoriatic arthritis and moderate to severe plaque psoriasis in children ages 6 years and older. The drug is approved for these uses in children who weigh at least 20 kilograms (kg), or about 44 pounds (lb).
Pediatric dosing is determined by a child’s weight. To reduce the risk of nausea, vomiting, diarrhea, your child’s doctor will likely recommend a special dosing schedule during the first 6 days of Otezla. The following table lists the typical dosing schedule for children with psoriatic arthritis or plaque psoriasis.
| Day of treatment | Dosage for children weighing 20 to less than 50 kg | Dosage for children weighing 50 kg or more |
|---|---|---|
| Day 1 | • Morning dose: 10 mg • Evening dose: none | • Morning dose: 10 mg • Evening dose: none |
| Day 2 | • Morning dose: 10 mg • Evening dose: 10 mg | • Morning dose: 10 mg • Evening dose: 10 mg |
| Day 3 | • Morning dose: 10 mg • Evening dose: 20 mg | • Morning dose: 10 mg • Evening dose: 20 mg |
| Day 4 | • Morning dose: 20 mg • Evening dose: 20 mg | • Morning dose: 20 mg • Evening dose: 20 mg |
| Day 5 | • Morning dose: 20 mg • Evening dose: 20 mg | • Morning dose: 20 mg • Evening dose: 30 mg |
| Day 6 and beyond | • Morning dose: 20 mg • Evening dose: 20 mg | • Morning dose: 30 mg • Evening dose: 30 mg or 75 mg Otezla XR once daily |
By the sixth day, your child will be taking their maintenance dose.
For more information about Otezla’s dosage for children, talk with your child’s doctor or a pharmacist.
Is Otezla used long term?
Yes, if it’s effective and well tolerated, Otezla is usually a long-term treatment. Your doctor will help determine whether ongoing treatment is right for you.
Dosage adjustments
The dosage of Otezla your doctor prescribes may depend on several factors, such as:
- your kidney health
- whether you experience side effects
- other medical conditions you may have
- body weight, for children
- the form of the drug you’re prescribed
For adults and children weighing at least 50 kg with severe kidney disease or kidney failure, the recommended maintenance dosage of Otezla is 30 mg once per day. For children weighing 20 kg to 50 kg with severe kidney disease, the recommended maintenance dosage is 20 mg once daily. You’ll take only the morning doses mentioned in the earlier dosing schedule for the first 6 days of treatment. This gives your kidneys more time to remove the drug between doses.
If you have side effects from Otezla, such as severe nausea, vomiting, or diarrhea, your doctor may adjust your dosage or recommend a different treatment.
The following are answers to some common questions about Otezla, dosage, and cost.
Yes. Otezla’s daily dosage is usually 60 mg per day. This dosage is divided into two 30-mg doses. You take one tablet in the morning and one in the evening.
Adults with plaque psoriasis, psoriatic arthritis, and mouth sores from Behçet’s disease will likely take the same dosage. For children taking Otezla for plaque psoriasis, their doctor will prescribe a dosage based on the child’s body weight.
If you have questions about your daily dosage of Otezla, talk with your doctor or pharmacist.
The price for Otezla can vary. Your cost may depend on which form of the drug you’re prescribed (Otezla vs Otezla XR), your treatment plan, your insurance coverage, and whether you qualify for the Otezla copay card.
Check out this Otezla coupons page for more information, or talk with your doctor or pharmacist.
Discover more about Otezla
Otezla and Otezla XR both come as a tablet that you swallow. You can take Otezla with or without food.
Do not chew, crush, or split Otezla tablets. If you have difficulty swallowing tablets, there are pill swallowing strategies that may help.
To help manage your condition, it’s important to take your dose of Otezla as prescribed.
If you miss an Otezla dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. You should not take two doses of Otezla at once to make up for a missed dose. This may increase your risk of Otezla side effects.
If you need help remembering to take your dose of Otezla on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Do not take more Otezla than your doctor prescribes. This could lead to severe side effects.
What to do in case you take too much Otezla
If you think you have taken too much Otezla, call your doctor right away. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. If you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
Disclaimer: Healthline 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.
