Otezla (apremilast) can cause side effects that range from mild to serious. More common side effects include headache, upper respiratory infection, and nausea. If side effects from Otezla become difficult to tolerate, talk with your doctor.

Otezla is used to treat the following conditions:

The active ingredient in Otezla is apremilast. (An active ingredient is what makes a drug work.) The drug comes as tablets that you swallow.

Keep reading to learn about the common, mild, and serious side effects Otezla can cause. To learn more about Otezla, including its uses, dosage, and cost, read this Otezla overview.

Some people may experience mild or serious side effects during their Otezla treatment. Examples of Otezla’s commonly reported side effects may include:

Your doctor will recommend Otezla if they think that the improvement you may get from this treatment outweighs your risk for side effects.

The above list doesn’t include all possible side effects of Otezla. Keep reading to learn about some potential mild and serious side effects of Otezla.

* For more information about this side effect, see the “Tips for managing side effects” section.

Examples of mild side effects that have been reported with Otezla include:

In most cases, these side effects should be temporary. Some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop using Otezla unless your doctor tells you to.

Otezla may cause mild side effects other than the ones listed above. See Otezla’s prescribing information for details.

* For more information about this side effect, see the “Tips for managing side effects” section.

With Otezla, serious side effects aren’t common, but they can occur. Serious side effects that have been reported with Otezla include:

* For more information about this side effect, see the “Tips for managing side effects” section.

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 medication 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.

Otezla is approved for the treatment of moderate to severe plaque psoriasis in children ages 6 years and older. The drug is prescribed for this use in children who weigh at least 20 kilograms (kg), which is about 44 pounds (lb).

In studies, side effects of Otezla were mostly the same in children as side effects in adults who took the drug to treat plaque psoriasis.

If your child has been prescribed Otezla and you have questions about side effects, talk with your child’s doctor.

Allergic reaction

For some people, Otezla can cause an allergic reaction.

This side effect wasn’t reported in the drug’s studies, but allergic reactions were reported after Otezla was approved for use.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Otezla.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Otezla, they may have you switch to a different treatment.

Here are answers to some commonly asked questions about Otezla’s side effects.

What side effects would stopping Otezla cause?

Stopping Otezla doesn’t cause side effects or withdrawal symptoms. (Withdrawal refers to symptoms that can occur if you stop taking a drug your body is dependent on.) But keep in mind that stopping this medication could cause symptoms of your condition to come back. Be sure to talk with your doctor before stopping Otezla.

Do Otezla’s side effects go away?

Typically, the more common side effects of Otezla go away within about 2 weeks after starting the drug. These side effects can include non-severe nausea, diarrhea, and vomiting.* It can take a few weeks for your body to get used to the medication, and your side effects may go away after this time.

If you’re experiencing side effects that don’t go away during Otezla treatment, talk with your doctor.

* See the “Tips for managing side effects” section for details about these side effects.

Is hair loss a side effect of Otezla?

No. Hair loss wasn’t a side effect that occurred in studies of Otezla.

However, if you have plaque psoriasis on your scalp, scratching may lead to temporary hair loss. Treatments such as Otezla may reduce scalp plaques, which can help reduce hair loss from scratching. Talk with your doctor if you’re experiencing hair loss that’s severe or causes concern.

How long do Otezla’s side effects last?

It depends. For most people, the more common side effects* of Otezla usually go away after your body gets used to the medication. This typically happens within about 2 weeks after starting the drug.

Also keep in mind that side effects can depend on factors such as your age, other health conditions you have, or other medications you’re taking.

If you have side effects of Otezla that become severe or don’t go away, talk with your doctor.

* See the “Tips for managing side effects” section for details about these side effects, including non-severe nausea, diarrhea, and vomiting.

Is cancer associated with Otezla use?

No. Cancer wasn’t a side effect that happened in studies of Otezla.

However, people with psoriasis may have a slightly increased risk for certain types of cancer. For more details, see this article about the connection between psoriasis and cancer. And if you have questions or concerns about your cancer risk, talk with your doctor.

Does Otezla have long-term side effects?

It’s possible, but unlikely. Long-term side effects include those that may start at any time you’re taking a drug, even if you’ve taken it for a long time. It also includes side effects that may not go away, even after you stop taking the drug.

Examples of long-term side effects reported in Otezla’s studies include:

Talk with your doctor to learn more about possible side effects of Otezla and how long they may last.

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 Suicide and Crisis 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.

While taking Otezla, you may be able to take steps to make side effects easier to manage.

If you have problems with side effects, they do not go away, or they become worse, talk with your doctor or pharmacist. They can discuss options for managing side effects or other available treatment options.

Otezla and weight loss

Many people lose weight when taking Otezla. Adults and children reported weight loss in studies. This side effect can occur partly because of how the drug works and partly because of some of its more common side effects.

Otezla’s possible side effects include diarrhea, nausea, vomiting, and reduced appetite. Many people who take Otezla lose weight due to these side effects. However, these side effects usually go away within about 2 weeks after starting Otezla as your body gets used to the medication. Unexplained weight loss may also occur while taking Otezla.

What might help

If you have nausea or reduced appetite from Otezla, it’s important that you still try to get enough calories. Try eating small, frequent meals or snacks. Eat foods that are bland and still provide some nutrients, such as applesauce, bananas, and broth.

If you experience severe weight loss while taking Otezla, discuss this with your doctor. Depending on your condition and other health factors, they may recommend that you stop Otezla treatment.

If your child is taking Otezla to treat moderate to severe plaque psoriasis, their doctor will likely monitor their growth for unexpected changes. This will include their body weight and height. If there are changes to your child’s growth during Otezla treatment, their doctor will likely recommend that they stop taking the drug. Do not make any changes to your child’s treatment plan without first talking with their doctor.

Note: Otezla isn’t approved by the Food and Drug Administration (FDA) for weight loss, and it’s not prescribed for weight loss. If you’re interested in weight loss treatments, talk with your doctor about ways to help you maintain a moderate weight.

Diarrhea

Diarrhea is one of the most common side effects of Otezla. For most people, this side effect isn’t severe. It usually goes away within about 2 weeks after starting Otezla as your body gets used to the medication.

For most people who took Otezla in studies, diarrhea wasn’t severe. However, if you lose too much fluid due to diarrhea, you could become dehydrated.

Very rarely, Otezla caused severe dehydration due to diarrhea in studies. In some of these cases, treatment in the hospital was necessary. In reports of people taking Otezla since the drug was approved, severe diarrhea has been described during the first few weeks of taking the drug. (See the “Warnings for Otezla” section for details.)

What might help

If you have diarrhea during your first few weeks of Otezla treatment, it’s important to keep yourself well hydrated. Drinking plenty of water can help prevent dehydration. Electrolyte replacement beverages, such as sports drinks, can also help keep you hydrated.

To help relieve diarrhea, you may want to consider asking your doctor if it’s safe for you to take an anti-diarrheal medication. Some over-the-counter (OTC) drug options may include Imodium A-D (loperamide hydrochloride) and Pepto Bismol (bismuth subsalicylate).

If you have diarrhea that’s severe or doesn’t improve after trying OTC or home remedies, talk with your doctor. They may recommend a lower dose of Otezla. In some cases, this side effect can be severe and even require hospitalization.

Nausea and vomiting

Nausea and vomiting are two of the more common side effects of Otezla. For most people, nausea tends to go away within about 2 weeks after starting Otezla as your body gets used to the medication.

For most people who took Otezla in studies, nausea and vomiting weren’t severe. However, nausea may lead to vomiting, which can increase your risk for becoming dehydrated.

Very rarely, Otezla caused severe dehydration due to severe vomiting in studies. In some of these cases, treatment in the hospital was necessary. In reports of people taking Otezla since the drug was approved, severe nausea and vomiting have been described during the first few weeks of taking the drug. (See the “Warnings for Otezla” section for details.)

What might help

There are a few things you can do to try to prevent or reduce nausea. For example:

  • Take small, frequent sips of water or other clear liquids.
  • Eat small, frequent meals or snacks. Include bland foods such as bananas, crackers, toast, and broth.
  • Get some fresh air by going for a short walk or opening a window.
  • Try natural remedies that may help prevent or reduce nausea, such as ginger or acupressure.

Talk with your doctor if you have nausea or vomiting that doesn’t go away or becomes severe. They may recommend a lower dose of Otezla for you. Or, they may prescribe medication for you to take as needed.

Depression

Depression has happened in people taking Otezla, but it isn’t common. And suicidal thoughts or behaviors are even more rare. These side effects may be more likely to develop if you have a history of depression.

Depression may cause symptoms such as feelings of hopelessness, loss of interest in things you used to enjoy, and difficulty concentrating.

What might help

If you notice mood changes while taking Otezla, talk with your doctor. They may recommend lowering your dose or stopping Otezla. They may also recommend that you get treatment for depression.

If you have thoughts of harming yourself, call 911 or your local emergency number.

Note: If you’ve been diagnosed with depression, Otezla may make your condition worse. If you’re currently being treated for depression, it’s important to continue with your treatment plan while taking Otezla. See the “Warnings for Otezla” section for more details.

Insomnia

Although it isn’t common, Otezla can cause insomnia.

Insomnia refers to difficulty falling or staying asleep. This side effect is usually mild. For most people, insomnia tends to go away within about 2 weeks after starting Otezla as your body gets used to the medication. Insomnia didn’t cause anyone to stop taking Otezla in studies.

What might help

For mild insomnia, following good sleep hygiene is usually helpful. Sleep hygiene refers to healthy habits that can help you get a good night’s sleep.

Here are some tips that might help improve your sleep quality:

  • Stick with a consistent sleep schedule, even on the weekends. This helps your body get used to falling asleep and waking up around the same time.
  • Follow a 30- to 60-minute routine of relaxing activities before bedtime. For example, try taking a warm bath or listening to soothing music.
  • Don’t have caffeine starting 7 hours before bedtime, because it can keep you awake.

There are also some insomnia treatments, like natural supplements and OTC sleep aids, that may help. Talk with your doctor or pharmacist to help you choose a safe option.

If you have insomnia that’s severe or causes concern, talk with your doctor.

Otezla may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Otezla. Factors to consider include those in the list below.

Kidney problems: If it’s possible that you may have kidney problems, your doctor may check your kidney function with a blood test. If you have kidney disease, let your doctor know before you start taking Otezla. Depending on the condition of your kidneys, your doctor may recommend a lower dosage of Otezla for you.

Allergic reaction: If you’ve had an allergic reaction to Otezla or any of its ingredients, you shouldn’t take Otezla. Ask your doctor what other medications are better options for you.

Depression or suicidal thoughts: If you have a history of depression or suicidal thoughts or actions, Otezla may make these worse. Some people have experienced depressed mood and thoughts of suicide while taking this drug.

Make sure to talk with your doctor about your history of mental health conditions before taking Otezla. Your doctor will help you consider the risks and benefits of Otezla. If you both decide that you’ll take Otezla, your doctor will monitor you closely during your treatment.

Also, if you’re currently being treated for depression, it’s important to continue your current treatment plan while taking Otezla. This may include continuing to take any prescribed medications and keeping therapist appointments.

Taking drugs that interact with Otezla: Certain drugs can interact with Otezla in a way that prevents Otezla from being effective. If you’re currently taking a medication that interacts with Otezla in this way, your doctor may prescribe a different medication for your condition.

Some examples of these drugs include:

Alcohol and Otezla

Drinking alcohol while taking Otezla could worsen some side effects of this medication, including:

Drinking alcohol can make some side effects of Otezla worse. Talk with your doctor about how much alcohol is safe for you to drink while taking Otezla.

Pregnancy and breastfeeding while taking Otezla

It isn’t known if Otezla is safe to take during pregnancy. Some animal studies have shown harmful effects on the fetus when Otezla was given to pregnant animals.

If you’re pregnant or planning to become pregnant while taking Otezla, talk with your doctor. They can help you consider the risks and benefits of continuing Otezla.

It isn’t known if Otezla is safe to take while breastfeeding. In animal studies, Otezla passed into breast milk when the drug was given to pregnant animals.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the risks and benefits of taking Otezla.

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.