Otezla (apremilast) is a brand-name oral tablet that’s prescribed for psoriatic arthritis, plaque psoriasis, and mouth ulcers related to Behçet’s disease. Otezla has interactions with some other drugs and certain supplements. Examples include certain antibiotics and certain antiseizure drugs.

An interaction occurs when one substance causes another substance to have a different effect than expected.

To learn more about Otezla’s interactions, keep reading. For additional information about Otezla, including details about its uses and whether you’ll take Otezla forever, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing Otezla due to the risk of harm. These are known as contraindications. The contraindications of Otezla include:

Having had an allergic reaction to Otezla or any of its ingredients

If you’ve had an allergic reaction to Otezla or any of its ingredients, your doctor will likely not prescribe Otezla. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Otezla, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Otezla.

There’s no known interaction between Otezla and alcohol.

However, drinking alcohol while taking Otezla could worsen some of the drug’s side effects. Examples include fatigue, nausea, and headache. (For details about possible side effects of Otezla, see this article.)

If you have questions about drinking alcohol while taking Otezla, talk with your doctor or pharmacist.

Before you start treatment with Otezla, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Otezla interacts with supplements, herbs, or vitamins, see the “Otezla and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Otezla. Keep in mind that this table doesn’t include all drugs that may interact with Otezla. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Otezla
certain antibiotics• rifampin (Rifadin, Rimactane)
• rifapentine (Priftin)
could make Otezla less effective
certain antiseizure drugsphenytoin (Dilantin, Phenytek)
carbamazepine (Carbatrol, Tegretol, others)
• fosphenytoin (Cerebyx)
could make Otezla less effective
certain cancer drugs• mitotane (Lysodren)
• enzalutamide (Xtandi)
• apalutamide (Erleada)
could make Otezla less effective
ivacaftor/lumacaftor (Orkambi)could make Otezla less effective

Here’s a closer look at certain drug interactions of Otezla.

Certain antibiotics

Antibiotics are used to treat bacterial infections.

Interaction result. Taking Otezla with certain antibiotics could make Otezla less effective.

Interaction explained. Otezla is broken down in your body by specific enzymes. An enzyme is a type of protein.

Certain antibiotics speed up the activity of these enzymes. When the activity of these enzymes speeds up, Otezla may leave your system more quickly than usual. This can lead to a lower level of Otezla in your body. As a result, the drug may not work as well for treating your condition.

Examples of antibiotic drugs. Antibiotics that may interact with Otezla include rifampin (Rifadin, Rimactane) and rifapentine (Priftin).

Steps you or your doctor may take. If you need antibiotics during Otezla treatment, be sure the doctor prescribing the antibiotic knows that you’re taking Otezla. They’ll advise you on whether the specific antibiotic you need can be taken with Otezla. Your doctor can tell you if an antibiotic that isn’t known to interact with Otezla may be used instead.

Certain antiseizure drugs

Antiseizure drugs are used to treat seizures.

Interaction result. Taking Otezla with certain antiseizure drugs could make Otezla less effective.

Interaction explained. Otezla is broken down in your body by specific enzymes.

Certain antiseizure drugs can speed up the activity of these enzymes. As a result, taking certain antiseizure drugs with Otezla may cause Otezla to leave your system more quickly than usual. This can lead to lower levels of the drug in your body. And having a low level of Otezla may mean the drug won’t work as well as it should for treating your condition.

Examples of antiseizure drugs. Here are some antiseizure drugs that may interact with Otezla:

Steps you or your doctor may take. Before starting Otezla treatment, be sure to tell your doctor if you take antiseizure drugs. They’ll recommend whether these medications can be taken together. If needed, your doctor can advise you on a treatment alternative for Otezla that doesn’t interact with certain antiseizure drugs.

Certain cancer drugs

Cancer drugs are treatments given for cancer.

Interaction result. Taking Otezla with certain cancer drugs could make Otezla less effective.

Interaction explained. Specific enzymes in the body help break down Otezla.

Certain cancer drugs speed up the activity of these enzymes. In doing so, certain cancer drugs may cause Otezla to leave your system more quickly than usual. This can lead to a lower level of Otezla in your body, which may make the drug less effective for treating your condition.

Examples of cancer drugs. Here are some cancer drugs that may interact with Otezla:

Steps you or your doctor may take. Before you take Otezla, talk with your doctor about any cancer treatments you’re already using. They can tell you whether Otezla is safe to take in combination with these treatments. If needed, your doctor can recommend a treatment other than Otezla that doesn’t interact with certain cancer drugs.

Otezla may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Otezla.

Otezla interactions with supplements

Before you start treatment with Otezla, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Otezla interactions with herbs

Otezla may interact with the herbal supplement St. John’s wort, which is used to help treat depression and other conditions. Taking Otezla with this supplement could make Otezla less effective.

It’s important to talk with your doctor or pharmacist before taking any herbal supplements in combination with Otezla.

Otezla and vitamins

There are no specific reports of vitamins interacting with Otezla. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Otezla.

Otezla and food

There are no specific reports of food interactions with Otezla. If you’d like to learn more about eating certain foods during Otezla treatment, talk with your doctor.

Otezla and vaccines

There are no specific reports of vaccines interacting with Otezla. To learn more about getting certain vaccines during Otezla treatment, talk with your doctor.

Otezla and lab tests

There are no specific reports of lab tests interacting with Otezla. To learn more about getting specific lab tests during Otezla treatment, talk with your doctor.

OTEZLA AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Otezla. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Otezla. The impact of cannabis may affect how well you stick to your Otezla treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Otezla. Before you take this drug, be sure to talk with your doctor about your health history. Otezla may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Otezla include:

  • Kidney problems. If you have kidney problems such as kidney failure, be sure to tell your doctor before taking Otezla. They may give you a lower dosage of the drug. To learn about the dosage of Otezla, see this article.
  • Depression. Otezla may worsen depression in people who already have this condition. If you have depression, talk with your doctor before starting Otezla treatment. They can advise you on whether the drug is a safe treatment option.
  • Pregnancy. It’s not known whether Otezla is safe to take while pregnant. If you’re pregnant or planning a pregnancy, talk with your doctor before you start Otezla treatment. For details about Otezla’s use during pregnancy, see this article. You can also talk with your doctor.
  • Breastfeeding. It’s not known whether Otezla passes into breast milk or whether the drug causes side effects in a child who is breastfed. For more information about taking Otezla while breastfeeding, talk with your doctor. You can also view more details in this article.
  • Allergic reaction. If you’ve had an allergic reaction to Otezla or any of its ingredients, your doctor will likely not prescribe Otezla. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

You can take certain steps to help prevent interactions with Otezla. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Otezla label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Otezla doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Otezla by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Otezla. These resources might help:

  • Overview of Otezla. For a general overview of Otezla, you can see this article.
  • Side effects. If you’re interested in the side effects of Otezla, see this article. Another option is to refer to the Otezla prescribing information.
  • Dosage specifics. To learn about the dosage of Otezla, see this article.
  • Drug comparison. For information about how Otezla compares with Humira, read this article.
  • Cost. If you’d like to learn about Otezla and cost, see this article.
  • Facts about plaque psoriasis and psoriatic arthritis. To learn more about these conditions, see our psoriasis hub and arthritis hub.

Disclaimer: Medical News Today 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.