Aprezo
✅ Reduces psoriasis symptoms
✅ Controls psoriatic arthritis
✅ Minimizes skin inflammation
✅ Alleviates joint pain
✅ Enhances skin clarity
Aprezo contains Apremilast.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Aprezo?
Aprezo is an oral apremilast 30 mg tablet — a PDE4 inhibitor used to treat moderate-to-severe plaque psoriasis, active psoriatic arthritis, and oral ulcers of Behçet’s disease. It is the first-line oral systemic option for patients who cannot or prefer not to use methotrexate, ciclosporin, or biologics. Standard maintenance dose is 30 mg twice daily after a 5-day titration. Clinically equivalent to Amgen’s Otezla®.
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Aprezo is Glenmark’s oral apremilast 30 mg tablet — an immunomodulator that represented a genuine advance in psoriasis treatment when approved by the FDA in 2014. Apremilast is a phosphodiesterase 4 (PDE4) inhibitor that works entirely intracellularly on immune-cell signalling, without the immunosuppression, lab-monitoring burden, or injection requirements of methotrexate or biologic agents.
Aprezo contains the same active ingredient at the same strength as Amgen’s branded Otezla® and is one of the most-prescribed oral systemic psoriasis drugs in the world. It has a favourable safety profile suitable for long-term outpatient use.
What Is Aprezo?
Aprezo is a prescription oral immunomodulator that selectively inhibits PDE4 in immune and inflammatory cells. This raises intracellular cyclic AMP and shifts the cytokine balance away from pro-inflammatory signals (TNF-α, IL-23, IL-17, IFN-γ) and toward anti-inflammatory ones (IL-10).
Aprezo is indicated for:
- Moderate-to-severe plaque psoriasis — in adults for whom phototherapy or other systemic therapy is appropriate
- Active psoriatic arthritis — alone or combined with DMARDs like methotrexate
- Oral ulcers associated with Behçet’s disease — FDA-approved indication since 2019
- Scalp and nail psoriasis — often particularly responsive to apremilast
- Palmoplantar and genital psoriasis — where topical therapy is insufficient
How Does Aprezo Work?
Apremilast’s mechanism is distinct from other psoriasis systemics:
- Inhibits PDE4 inside immune cells — PDE4 is the enzyme that normally breaks down intracellular cAMP
- Higher cAMP activates protein kinase A and suppresses transcription factor NF-κB
- Downstream effect: reduced production of TNF-α, IL-23, IL-17, IL-8, and IFN-γ, with increased IL-10
- No direct immunosuppression — patients are not immunocompromised and do not need routine infection screening like on biologics
- Clinical effect is gradual — most patients see meaningful psoriasis improvement by 16 weeks; some earlier
Because the drug does not target a single cytokine but modulates the whole signalling milieu upstream, efficacy is more moderate than TNF or IL-17 biologics but the safety margin is broader — particularly attractive for patients who cannot tolerate biologics or want to avoid injections.
Aprezo Dosage and Administration
Apremilast uses a 5-day titration to reduce initial GI side effects.
| Day | Morning | Evening |
|---|---|---|
| 1 | 10 mg | — |
| 2 | 10 mg | 10 mg |
| 3 | 10 mg | 20 mg |
| 4 | 20 mg | 20 mg |
| 5 | 20 mg | 30 mg |
| 6 onward | 30 mg | 30 mg |
Note: the titration pack typically contains 10 mg and 20 mg tablets for days 1–5. The 30 mg tablet (Aprezo) is the maintenance strength from day 6 onward.
| Scenario | Dose | Notes |
|---|---|---|
| Plaque psoriasis / psoriatic arthritis (maintenance) | 30 mg twice daily | Continue indefinitely while effective |
| Behçet’s oral ulcers | 30 mg twice daily | Similar titration |
| Severe renal impairment (CrCl <30 mL/min) | 30 mg once daily (morning only) | Halve the maintenance dose; titration uses morning doses only |
| Hepatic impairment | Standard dose | No adjustment needed |
| Pregnancy | Avoid | Contraindicated |
How to Take Aprezo Properly
- Swallow the tablet whole with water; can be taken with or without food
- Take at roughly the same times each day (morning and evening, about 12 hours apart)
- Complete the full 5-day titration, even if you tolerate early doses well — the titration schedule reduces GI side effects meaningfully
- If nausea or diarrhoea is troublesome at maintenance dose, take with food rather than stopping
- Allow at least 16 weeks before judging efficacy — most patients who will respond do so by then
- Monitor weight monthly — unintentional weight loss occurs in a minority of patients
- Monitor mood actively — new or worsening depression has been reported
- Do not stop abruptly without medical discussion — psoriasis may flare
Side Effects of Aprezo
| Severity | Side Effect |
|---|---|
| Common (≥1 in 10) | Diarrhoea, nausea, headache (especially weeks 1–4) |
| Common (≥1 in 100) | Abdominal pain, vomiting, upper respiratory tract infection, fatigue, weight loss (≥5% of body weight in ~10% of users) |
| Uncommon | Mood changes / depression, migraine, insomnia, hypersensitivity reactions |
| Rare | Severe diarrhoea requiring hospitalisation, severe weight loss, suicidal ideation, angioedema |
GI side effects are usually self-limited — most resolve within the first 2–4 weeks as the body adapts. Persistent severe diarrhoea should prompt review.
Warnings and Precautions
- Depression risk. New or worsening depression, suicidal thoughts, or suicide have been reported in some patients. Monitor mood; report mood changes promptly
- Weight loss. 10% of patients lose ≥5% body weight. Monitor weight monthly — if significant unintentional loss occurs, consider dose reduction or discontinuation
- Diarrhoea and nausea. Most common in the first 2–4 weeks — the 5-day titration schedule substantially reduces severity
- Pregnancy. Teratogenic in animal studies — avoid. Use reliable contraception during and for 30 days after stopping
- Breastfeeding. Not recommended
- Alcohol. No direct interaction but worsens GI side effects in early weeks
- Vaccinations. Live vaccines are OK on apremilast (unlike on biologics) because apremilast is not immunosuppressive
Contraindications — Who Should NOT Take Aprezo
- Pregnancy
- Known hypersensitivity to apremilast or any excipient
- Active severe depression with suicidality (consider carefully)
Drug Interactions
| Drug / Class | Interaction |
|---|---|
| Strong CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, phenobarbital, St John’s wort) | Avoid combination — may reduce apremilast levels by 72% and lose efficacy |
| CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) | Modest rise in apremilast levels — usually clinically manageable |
| Methotrexate | Commonly co-prescribed in psoriatic arthritis — no adverse pharmacokinetic interaction |
| Biologic agents (TNF, IL-17, IL-23 inhibitors) | Usually used in sequence rather than combination — data for co-prescription limited |
| Alcohol | Worsens GI side effects early; moderate later |
Storage Instructions
- Store below 25 °C in a dry place, away from direct sunlight
- Keep in the original blister packaging
- Keep out of reach of children
- Do not use after the expiry date
Related Alternatives on MedsBase
- Dapsone — alternative oral immunomodulator for selected inflammatory skin disease
- Browse all Eczema & Psoriasis Treatments →
Frequently Asked Questions
What is Aprezo used for?
Aprezo (apremilast) treats moderate-to-severe plaque psoriasis, active psoriatic arthritis, and oral ulcers of Behçet’s disease. It is often prescribed for patients who cannot or prefer not to use biologic injections or methotrexate.
How fast does Aprezo work?
Early improvement at 4–6 weeks; meaningful response typically by 16 weeks. Joint symptoms in psoriatic arthritis can respond faster than skin lesions.
Why is there a titration pack?
The 5-day step-up from 10 mg to the 30 mg twice-daily maintenance dose significantly reduces initial nausea, diarrhoea, and headache. Never skip the titration — starting directly at 30 mg twice daily is much less tolerable.
Is Aprezo a biologic?
No — apremilast is a small-molecule oral medication, not a biologic. It does not require injections, infusions, cold-chain storage, or pre-treatment tuberculosis / hepatitis screening. This is one of its major practical advantages.
Will I lose weight on Aprezo?
About 10% of users lose ≥5% of body weight. In overweight patients this can be welcome, but any significant unintentional loss should be discussed with your doctor. Monitor weight monthly.
Can I drink alcohol on Aprezo?
Moderate intake is acceptable. Heavy drinking can worsen GI side effects, particularly in the first weeks.
Can I get pregnant on Aprezo?
No — apremilast is contraindicated in pregnancy. Use reliable contraception during treatment and for at least 30 days after stopping.
Can I combine Aprezo with methotrexate?
Yes — this combination is common in psoriatic arthritis and is well tolerated. No adverse pharmacokinetic interaction.
Does Aprezo affect the immune system?
Unlike biologics, apremilast does not cause immunosuppression. Routine tuberculosis or hepatitis screening is not required, and live vaccines are permitted.
What if Aprezo doesn’t work after 16 weeks?
Efficacy is more moderate than biologics. If response is insufficient, your dermatologist or rheumatologist may switch to a biologic (adalimumab, secukinumab, ixekizumab, guselkumab) or to traditional systemics (methotrexate, ciclosporin).
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| Strength | 30 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
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