Otezla’s Side Effects: What to Know

Medically Reviewed By Elizabeth Scheffel, PharmD

Otezla: Introduction

Otezla is a brand-name prescription drug. It belongs to a class of drugs called phosphodiesterase-4 inhibitors, which are a type of disease-modifying antirheumatic drug (DMARD).

This medication contains the active drug apremilast. And it comes as an oral tablet.

Otezla is approved by the Food and Drug Administration (FDA) for use in adults to treat the conditions listed below:

Doctors may prescribe Otezla for long-term use. Similar to other drugs, Otezla may cause side effects. Read below for information about possible side effects, including common, mild, and serious ones.


For a general overview of Otezla, including details about its uses, see this article. If you’d like to take Otezla, search here to find a healthcare professional who might prescribe it.

Otezla: More common side effects

Some of Otezla’s side effects may be more common than others. These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Otezla.

In Otezla’s clinical studies, these were some side effects that occurred more often:

* For more information about this side effect, see “Otezla: Side effects explained” below.

Otezla: Mild side effects

Otezla can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Otezla’s side effects, view the drug’s prescribing information.

Otezla’s mild side effects include:

The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about side effects with Otezla.


Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Otezla and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Otezla: Side effects explained” below.

Otezla: Serious side effects

It’s possible to have serious side effects with Otezla. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Otezla’s side effects, view the drug’s prescribing information.

Call your doctor right away if you have serious side effects with Otezla. However, if you think you’re having a medical emergency or have life threatening side effects, call 911 or your local emergency number.

Serious side effects of Otezla and their possible symptoms include:

* For more information about this side effect, see “Otezla: Side effects explained” below.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Otezla: Common questions about side effects

Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.

Does Otezla cause cancer?

It’s not likely. Cancer wasn’t reported as a side effect in clinical studies of Otezla.

However, people with psoriatic arthritis or plaque psoriasis may have a higher risk of certain cancers. Examples include skin, breast, and liver cancer. Keep in mind that Otezla is used to treat psoriatic arthritis and plaque psoriasis. So, it’s possible you may have a higher risk of cancer while taking Otezla because of the condition the drug is treating.

To learn more about your risk of cancer while taking Otezla, talk with your doctor.

Will drinking alcohol cause certain side effects with Otezla?

It’s possible. Consuming alcohol while taking Otezla could worsen certain side effects of the drug.

For details, see “Consuming alcohol during Otezla treatment” in the “Otezla: Precautions” section below.

Are there side effects from stopping Otezla? Also, does the drug have long-term side effects?

It’s not likely that Otezla will cause withdrawal side effects. These are symptoms that can happen if you suddenly stop taking a drug your body has become dependent on. (With dependence, your body needs the drug in order to function like usual.)

Withdrawal side effects weren’t reported in clinical studies of Otezla.

Most side effects of Otezla should go away within a few days or weeks after you’ve started taking the drug. In some cases, Otezla may cause side effects that last much longer. For example, Otezla can cause depression. And this condition can be long lasting for some people.

If you’re concerned about stopping Otezla or having long-term side effects with the drug, talk with your doctor.

Does Otezla cause muscle pain, liver problems, eye problems, or constipation?

No, Otezla probably doesn’t cause muscle pain, liver problems, eye problems, or constipation. These weren’t reported as side effects in clinical studies of the drug.

That said, psoriatic arthritis and psoriasis may cause liver problems. Additionally, psoriatic arthritis, psoriasis, and Behçet’s disease can affect the eyes. Keep in mind that Otezla is used to treat these conditions. So, it’s possible you may have liver problems or eye problems with Otezla because of these conditions rather than the drug itself.

If you’re concerned about muscle pain, liver problems, eye problems, or constipation with Otezla, talk with your doctor. They can discuss your risk of these symptoms with the drug.

Can Otezla cause hair loss as a side effect? Is the drug used for hair growth?

Hair loss wasn’t a side effect reported in clinical studies of Otezla.

In some cases, doctors may use Otezla off-label for hair growth. (With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.)

If you’re concerned about hair loss or want to learn more about using Otezla for hair growth, talk with your doctor.

Will I have weight gain, dizziness, heart problems, or sun sensitivity with Otezla?

It isn’t likely that Otezla will cause weight gain, dizziness, or sun sensitivity. And Otezla isn’t likely to cause heart problems, such as QT prolongation (a type of abnormal heart rhythm) or heart palpitations.

These weren’t reported as side effects in clinical studies of the drug. In fact, weight loss, rather than weight gain, was common in studies of Otezla. For details, see “Otezla: Side effects explained” below.

Other medications used to treat the same conditions as Otezla may cause some of these side effects. For example, ustekinumab (Stelara) may cause dizziness. And adalimumab (Humira) may cause certain heart conditions, such as heart failure.

To learn more about weight gain, dizziness, heart problems, or sun sensitivity with Otezla, talk with your doctor or pharmacist.

Otezla: Side effects explained

Here’s detailed information about some of Otezla’s side effects.

Headache

Headache may occur with Otezla. In fact, this side effect was common in clinical studies of the drug.

Different headache types have been reported with Otezla. Examples include tension headache and sinus headache, which both cause pain and pressure around the forehead.

What you can do

While you’re taking Otezla, tell your doctor if you have any bothersome or severe headaches. Your doctor can suggest ways to help ease your symptoms.

For example, they may recommend that you take over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil). It’s important to talk with your doctor or pharmacist before taking any new medications with Otezla. Your healthcare professional can recommend whether the combination of drugs is safe to take.

Nausea

Nausea is a possible side effect of Otezla. Mild nausea was common in clinical studies of the drug. In rare cases, more severe nausea is possible.

Your risk of nausea with Otezla may be higher if you:

  • are 65 years of age or older
  • recently started taking Otezla within the last few weeks
  • take medications that cause low blood pressure

What you can do

Before taking Otezla, tell your doctor about all other medications you take. They can advise if any of your medications may increase your risk of nausea with Otezla.

If you have nausea that’s bothersome or doesn’t go away, talk with your doctor. They may lower your dosage of Otezla. Or they may suggest nausea treatments to help ease your symptoms.

Weight loss

You may have weight loss with Otezla. A small amount of weight loss was common in people during clinical studies of the drug. Although it was rare, a larger amount of weight loss (at least 10% of body weight) was also reported in the studies.

What you can do

Your doctor may check your weight from time to time while you’re taking Otezla. If you notice a large amount of weight loss or weight loss that occurs quickly, tell your doctor. They’ll likely check for other possible causes of your weight loss. And they may have you stop taking Otezla.

Joint pain

Joint pain can occur with Otezla. This was a less common side effect in clinical studies of the drug.

You may have other symptoms along with joint pain, such as joint:

  • swelling
  • stiffness
  • redness or discoloration

Additionally, psoriatic arthritis, which Otezla is used to treat, may cause joint pain. So, it’s possible you may have this type of discomfort because of your condition rather than the medication.

What you can do

Talk with your doctor about any joint pain you have while taking Otezla. This side effect may go away as your body gets used to the drug. If your joint pain doesn’t go away or is bothersome, your doctor can recommend ways to help ease your symptoms.

Abdominal pain

Abdominal pain is a possible side effect of Otezla. Mild abdominal pain was common in clinical studies of the drug. However, more severe abdominal pain may rarely occur.

Abdominal pain may happen with other related side effects of Otezla, including:

What you can do

If you have abdominal pain while you’re taking Otezla, talk with your doctor. They can suggest ways to help ease your discomfort.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Otezla. A more severe allergic reaction is rare but possible.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
• itching trouble breathing
rash • swelling in your throat or mouth
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids

If you have an allergic reaction to Otezla, call your doctor right away. This is important to do because the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Otezla: Precautions

Be sure to talk with your doctor about your health history before you take Otezla. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health.

The conditions and factors to consider include those described below.

Kidney problems. Before taking Otezla, tell your doctor if you have kidney problems. They may give you a lower dosage of Otezla than usual.

Depression or suicidal thoughts and behaviors. Before starting Otezla treatment, tell your doctor if you have a history of depression or suicidal thoughts and behaviors. The drug may worsen these conditions. Your doctor can advise whether Otezla is safe for you to take.

Allergic reaction. If you’ve had an allergic reaction to Otezla or any of its ingredients, your doctor will likely not prescribe Otezla. Ask your doctor what other medications may be better options for you.

Consuming alcohol during Otezla treatment

There aren’t any known interactions between Otezla and alcohol. However, consuming alcohol while taking Otezla could worsen certain side effects of the drug. Examples of these side effects include:

If you drink alcohol, your doctor can advise how much is safe for you to drink with Otezla.

Pregnancy and breastfeeding during Otezla treatment

It isn’t known if Otezla is safe to take during pregnancy or while breastfeeding.

Animal studies have shown harm to offspring exposed to the drug during pregnancy. However, animal studies don’t always predict what happens in humans.

If you take Otezla during pregnancy, your doctor may suggest that you enroll in a pregnancy registry. Pregnancy registries collect information about a drug’s effects when it’s used during pregnancy. To learn more about Otezla’s pregnancy registry, call 877-311-8972. You can also visit the registry website, or talk with your doctor.

Before taking Otezla, tell your doctor if you’re pregnant or planning a pregnancy. Also tell your doctor if you’re breastfeeding or planning to do so. They can help you decide if Otezla is the right treatment for your condition.

Otezla: What to discuss with your doctor

Talk with your doctor or pharmacist to find out more information about Otezla. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them for you.

In addition to discussing Otezla with your doctor, you may find the following articles helpful in learning more.

  • Overview of Otezla. To read an overview of Otezla, see this article.
  • Drug comparison. To learn how Otezla compares with Humira, read this article. For a comparison to Stelara, see this article. And to learn how Otezla and biologics are alike and different, check out this article
  • Details about the conditions Otezla is used to treat. To learn more about the conditions Otezla treats, see these articles about Behçet’s disease, plaque psoriasis, and psoriatic arthritis.

Disclaimer: Healthgrades 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.

Medical Reviewer: Elizabeth Scheffel, PharmD
Last Review Date: 2022 Mar 2
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.