Apremilast 30mg tablets
Requires a prescription from a doctor or prescriber
Apremilast, also known as Otezla, is a phosphodiesterase 4 (PDE4) inhibitor used to treat various types of symptoms resulting from certain inflammatory autoimmune diseases.
Official documents, adverse reaction reporting, and safety monitoring
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Official medicine documents
Yellow Card
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Drug safety updates
MHRA alerts for Apremilast
Safety monitoring data
Yellow Card reports
The MHRA Yellow Card scheme collects reports of suspected side effects from healthcare professionals and patients. View the Drug Analysis Profile (iDAP) for real-world adverse reaction data.
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Suspected adverse reactions reported for Apremilast
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Submit a Yellow Card report to the MHRA
Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
The European Medicines Agency (EMA) collects suspected adverse reaction reports from across the EU/EEA through the EudraVigilance system. Search for safety data on this medicine.
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Suspected adverse reactions reported for Apremilast
About EudraVigilance
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EudraVigilance data is published by the European Medicines Agency (EMA). A suspected adverse reaction is not necessarily caused by the medicine.
5 branded products available
MHRA licensed products
View all licensed products for Apremilast on the MHRA register
Otezla 30mg tablets
Apremilast 30mg tablets
Apremilast 30mg tablets
Apremilast 30mg tablets
Apremilast 30mg tablets
This is the NHS Drug Tariff indicative price used for reimbursement purposes. It may not reflect the price paid by patients or pharmacies.
View full Drug TariffSource: NHS Drug Tariff via NHSBSA. Derived from dm+d VMPP (Virtual Medicinal Product Pack) pricing data. Contains public sector information licensed under the Open Government Licence v3.0.
WHO defined daily dose (DDD)
60 mg
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via the NHS dm+d supplementary mapping files (NHSBSA). Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Guidelines from the National Institute for Health and Care Excellence
NICE clinical guidance(11)
Apremilast for treating active psoriatic arthritis (TA433)
Apremilast for treating moderate to severe plaque psoriasis (TA419)
Dimethyl fumarate for treating moderate to severe plaque psoriasis (TA475)
Deucravacitinib for treating moderate to severe plaque psoriasis (TA907)
Brodalumab for treating moderate to severe plaque psoriasis (TA511)
Tofacitinib for treating active psoriatic arthritis after inadequate response to DMARDs (TA543)
Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs (TA445)
Tildrakizumab for treating moderate to severe plaque psoriasis (TA575)
Certolizumab pegol for treating moderate to severe plaque psoriasis (TA574)
Upadacitinib for treating active psoriatic arthritis after inadequate response to DMARDs (TA768)
Ixekizumab for treating active psoriatic arthritis after inadequate response to DMARDs (TA537)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
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Search for this medicine at major UK pharmacy chains. These links open the retailer's own website — results depend on their current online catalogue.
Supply & safety information
Official UK regulator monitoring and safety alerts
Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. Shortage and safety information sourced from MHRA drug safety updates (gov.uk, Crown Copyright under OGL v3.0).
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 8 · Randomised trials: 34 · 2009–2026
Showing the 50 most relevant studies, sorted by most relevant.
April W. Armstrong, Melinda Gooderham, Richard B. Warren, et al.
Journal of the American Academy of Dermatology, 2022
- Anti-Inflammatory Agents, Non-Steroidal
- Psoriasis
- Heterocyclic Compounds
Christopher J Edwards, Francisco J. Blanco, Jeffrey Crowley, et al.
Annals of the Rheumatic Diseases, 2016
- Anti-Inflammatory Agents, Non-Steroidal
- Skin
- Thalidomide
Maurizio Cutolo, Gary E. Myerson, Roy Fleischmann, et al.
The Journal of Rheumatology, 2016
- Anti-Inflammatory Agents, Non-Steroidal
- Thalidomide
- Arthritis, Psoriatic
Kristian Reich, Melinda Gooderham, L. Green, et al.
Journal of the European Academy of Dermatology and Venereology, 2016
- Etanercept
- Anti-Inflammatory Agents, Non-Steroidal
- Diarrhea
Kim Papp, Kristian Reich, Craig L. Leonardi, et al.
Journal of the American Academy of Dermatology, 2015
- Psoriasis
- Thalidomide
- Phosphodiesterase 4 Inhibitors
C. Paul, Jennifer Clay Cather, Melinda Gooderham, et al.
British Journal of Dermatology, 2015
- Analysis of Variance
- Anti-Inflammatory Agents, Non-Steroidal
- Chronic Disease
Arthur Kavanaugh, Philip J. Mease, Juan J. Gómez‐Reino, et al.
Annals of the Rheumatic Diseases, 2014
- Methotrexate
- Psoriasis
- Thalidomide
Kim Papp, Jennifer Clay Cather, Les Rosoph, et al.
The Lancet, 2012
- Immunosuppressive Agents
- Psoriasis
- Quality of Life
Alexander Nast, Phyllis I. Spuls, G. E. van der Kraaij, et al.
Journal of the European Academy of Dermatology and Venereology, 2017
- Anti-Inflammatory Agents, Non-Steroidal
- Antibodies, Monoclonal
- Dermatologic Agents
Allard R.J.V. Vossen, Martijn B. A. van Doorn, Hessel H. van der Zee, et al.
Journal of the American Academy of Dermatology, 2018
- Anti-Inflammatory Agents, Non-Steroidal
- Thalidomide
- Hidradenitis Suppurativa
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
6-9 hours
Mechanism
The full mechanism of action of this drug is not fully established, however, it…
Food interactions
2 warnings
Human targets
3 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
73%
Half-life
6-9 hours
[A181226][L7501]
Protein binding
68%
[L7498]
Volume of distribution
87 L
[L7498]
Metabolism
45%
Elimination
3%
[L7498]
…
Clearance
10 L/h
[L7498]
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
[L7501]
Known interactions with other medicines. Always consult a healthcare professional.
Showing 50 of 1651 interactions
[L7505]
Overdose information
In healthy subjects receiving a maximum dose of 100 mg (given as 50 mg twice daily) for about 5 days, no significant toxicity was observed. In cases of an overdose, supportive and symptomatic treatment should be administered. Contact the local poison control center for the most recent overdose management for apremilast.
[L7502]
Apremilast may cause unwanted weight loss and worsen depression, leading to suicidal thoughts or actions. It is advisable to monitor for symptoms of depression and seek medical attention if they occur, especially in patients with pre-existing depression. The need for apremilast should be carefully assessed along with the risk of worsening depression and suicide. If weight loss occurs, the degree of weight loss should be evaluated, and consideration should be made for the possible discontinuation of apremilast.[L7501]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[A181229]
Food intake does not appear to affect apremilast absorption.
[L7501]
[A181226][L7501]
[L7498]
[L7498]
[A3737]
The CYP3A4 primarily mediates the oxidative metabolism of this drug, with smaller contributions from CYP1A2 and CYP2A6 enzymes.
[L7498]
The main metabolite of apremilast, M12, is an inactive glucuronide conjugate form of the O-demethylated drug.
[L7498]
Some other major metabolites, M14 and M16, are significantly less active in the inhibition of PDE4 and inflammatory mediators than their parent drug, apremilast. After an oral dose, unchanged apremilast (45%) and the inactive metabolite, O-desmethyl apremilast glucuronide (39%) are found in the plasma.
[A181235]
Minor metabolites M7 and M17 are active, but are only present in about 2% or less of apremilast concentrations, and likely not significant contributors to the actions of apremilast.
[A181235]
[L7498]
[L7498]
Proteins and enzymes this drug interacts with in the body
Cyclin D-CDK4 complexes are major integrators of various mitogenenic and antimitogenic signals. Also phosphorylates SMAD3 in a cell-cycle-dependent manner and represses its transcriptional activity. Component of the ternary complex, cyclin D/CDK4/CDKN1B, required for nuclear translocation and activity of the cyclin D-CDK4 complex
Involved in initiation and maintenance of cell cycle exit during cell differentiation; prevents cell proliferation and negatively regulates cell differentiation, but is required for the proliferation of specific cell types (e.g. erythroid and hematopoietic cells). Essential for cell proliferation within the dentate gyrus of the hippocampus and the subventricular zone of the lateral ventricles. Required during thymocyte development.
Promotes the production of newborn neurons, probably by modulating G1 length. Promotes, at least in astrocytes, changes in patterns of gene expression, changes in the actin cytoskeleton including loss of stress fibers, and enhanced motility during cell differentiation. Prevents myeloid differentiation by interfering with RUNX1 and reducing its transcription transactivation activity, but promotes proliferation of normal myeloid progenitors.
Delays senescence. Promotes the proliferation of beta-cells in pancreatic islets of Langerhans. May play a role in the centrosome organization during the cell cycle phases PMID:23918663
Enzymes involved in drug metabolism — important for understanding drug interactions
Proteins that transport this drug across cell membranes
PMID:2897240 PMID:35970996 PMID:8898203 PMID:9038218 PMID:35507548
Catalyzes the flop of phospholipids from the cytoplasmic to the exoplasmic leaflet of the apical membrane. Participates mainly to the flop of phosphatidylcholine, phosphatidylethanolamine, beta-D-glucosylceramides and sphingomyelins .
PMID:8898203
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells PMID:2897240 PMID:35970996 PMID:9038218
ATC L04AA32
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Apremilast
Additional database identifiers
Drugs Product Database (DPD)
22541
ChemSpider
9736448
BindingDB
50248919
PDB
A9L
ZINC
ZINC000030691736
UniProt Accession
Q86V67_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:1773
GenAtlas
CDK4
GeneCards
CDK4
GenBank Gene Database
M14505
GenBank Protein Database
456427
Guide to Pharmacology
1976
UniProt Accession
CDK4_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:1777
GenAtlas
CDK6
GeneCards
CDK6
GenBank Gene Database
X66365
GenBank Protein Database
36623
Guide to Pharmacology
1978
UniProt Accession
CDK6_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:2637
GenAtlas
CYP3A4
GeneCards
CYP3A4
GenBank Gene Database
M18907
Guide to Pharmacology
1337
UniProt Accession
CP3A4_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:2610
GenAtlas
CYP2A6
GeneCards
CYP2A6
GenBank Gene Database
X13897
Guide to Pharmacology
1321
UniProt Accession
CP2A6_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:2596
GenAtlas
CYP1A2
GeneCards
CYP1A2
GenBank Gene Database
Z00036
Guide to Pharmacology
1319
UniProt Accession
CP1A2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:40
GenAtlas
ABCB1
GeneCards
ABCB1
GenBank Gene Database
M14758
GenBank Protein Database
307180
Guide to Pharmacology
768
UniProt Accession
MDR1_HUMAN
DrugBank citations
If you use DrugBank data in your research, please cite:
- DrugBank 6.02024Recommended citationKnox C., Wilson M., Klinger C.M., et alDrugBank 6.0: the DrugBank Knowledgebase for 2024Nucleic Acids Res. 2024 Jan 552(D1):D1265-D1275
- DrugBank 5.02018Wishart D.S., Feunang Y.D., Guo A.C., et alDrugBank 5.0: a major update to the DrugBank database for 2018Nucleic Acids Res. 2017 Nov 846(D1):D1074-D1082
- DrugBank 4.02014Law V., Knox C., Djoumbou Y., et alDrugBank 4.0: shedding new light on drug metabolismNucleic Acids Res. 2014 Jan 142(1):D1091-7
- DrugBank 3.02011Knox C., Law V., Jewison T., et alDrugBank 3.0: a comprehensive resource for 'omics' research on drugsNucleic Acids Res. 2011 Jan39(Database issue):D1035-41
- DrugBank 2.02008Wishart D.S., Knox C., Guo A.C., et alDrugBank: a knowledgebase for drugs, drug actions and drug targets.Nucleic Acids Research2008 Jan36(Database issue):D901-6
- DrugBank 1.02006Wishart D.S., Knox C., Guo A.C., et alDrugBank: a comprehensive resource for in silico drug discovery and exploration.Nucleic Acids Research2006 Jan 134(Database issue):D668-72