৳ 25/unit
Pack: ৳ 250
৳ 25/unit
Pack: ৳ 250
At a glance
Apremilast is a phosphodiesterase 4 (PDE4) inhibitor used for the treatment of moderate to severe plaque psoriasis and active psoriatic arthritis in adult patients who are candidates for phototherapy or systemic therapy.
Indications
- Active psoriatic arthritis
- Moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy
Pharmacology
Apremilast is a novel, orally available small molecule inhibitor of type-4 cyclic nucleotide phosphodiesterase (PDE-4). PDE-4 is a cyclic adenosine monophosphate (cAMP)-specific phosphodiesterase that is predominantly located in inflammatory cells.
By inhibiting PDE-4, apremilast increases intracellular levels of cAMP and thereby inhibits the production of multiple proinflammatory mediators including TNF-alpha, interleukin-2 (IL-2), interferon-gamma, leukotrienes, and nitric oxide synthase.
Dosage
Recommended Dose Titration (to reduce GI symptoms):
| Day | Morning | Evening |
|---|---|---|
| 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 onwards | 30 mg | 30 mg |
Maintenance Dose: 30 mg twice daily from Day 6
Severe Renal Impairment (CrCl <30 mL/min): Reduce dose to 30 mg once daily. Use only morning schedule; skip evening doses.
Hepatic Impairment: No dosage adjustment required.
Side effects
Common (>10%):
- Nausea
- Diarrhea
- Headache
Other (1-10%):
- Upper respiratory tract infection
- Vomiting
- Nasopharyngitis
- Abdominal pain
- Hypersensitivity
- Gastroesophageal reflux disease
- Dyspepsia
- Fatigue
- Decreased appetite
- Cough
- Rash
- Insomnia
Weight Loss: 5-10% body weight loss reported during treatment.
Use in pregnancy
[CONSULT YOUR DOCTOR] Apremilast may be unsafe to use during pregnancy (Pregnancy Category C). Animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and potential risks before prescribing.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
Serious Precautions:
- Inform your doctor immediately if you experience new or worsened depression, suicidal thoughts, or other mood changes
- Monitor weight regularly - apremilast may cause weight loss
- Caution during pregnancy - animal studies have shown harmful effects on the developing baby
- Caution during breastfeeding - apremilast was detected in milk of lactating mice
- Dose adjustment needed in severe renal impairment
- Mild stomach upset may occur early during treatment but usually resolves
Overdose effects
There is no known specific antidote for apremilast overdose. In the event of an overdose, undertake general supportive measures.
Storage conditions
Store at cool & dry place below 30°C, protected from light & moisture. Keep out of reach of children.