Identification
NameApremilast
Accession NumberDB05676
TypeSmall Molecule
GroupsApproved, Investigational
Description

Apremilast is a novel, orally available small molecule inhibitor of type-4 cyclic nucleotide phosphodiesterase (PDE-4). It is indicated in the treatment of active psoriatic arthritis in adults (approved by the FDA in March 2014) and moderate to severe plaque psoriasis (approved by the FDA in September 2014). 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 PDE-4, TNF-alpha, interleukin-2 (IL-2), interferon-gamma, leukotrienes, and nitric oxide synthase. By targeting a central component of the inflammatory signaling cascade rather than a single inflammatory marker, PDE-4 inhibition may restore the homeostatic balance between pro- and anti-inflammatory signalling.

Structure
Thumb
Synonyms
Apremilast
Aprémilast
Apremilastum
N-{2-[(1S)-1-(3-Ethoxy-4-methoxyphenyl)-2-(methylsulfonyl)ethyl]-1,3-dioxo-2,3-dihydro-1H-isoindol-4-yl}acetamide
External IDs CC 10004 / CC-10004 / CC10004
Product Ingredients Not Available
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
OtezlaTablet30 mgOralCelgene2014-12-01Not applicableCanada
OtezlaKitOralCelgene2014-03-25Not applicableUs
OtezlaTablet, film coated30 mgOralCelgene Europe Limited2015-01-15Not applicableEu
OtezlaTablet, film coated30 mg/1OralCelgene2014-04-03Not applicableUs
OtezlaTablet, film coated30 mgOralCelgene Europe Limited2015-01-15Not applicableEu
OtezlaKitOralCelgene2015-02-01Not applicableUs
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixtures
NameLabellerIngredients
OtezlaCelgene
Categories
UNIIUP7QBP99PN
CAS number608141-41-9
WeightAverage: 460.5
Monoisotopic: 460.130422295
Chemical FormulaC22H24N2O7S
InChI KeyIMOZEMNVLZVGJZ-QGZVFWFLSA-N
InChI
InChI=1S/C22H24N2O7S/c1-5-31-19-11-14(9-10-18(19)30-3)17(12-32(4,28)29)24-21(26)15-7-6-8-16(23-13(2)25)20(15)22(24)27/h6-11,17H,5,12H2,1-4H3,(H,23,25)/t17-/m1/s1
IUPAC Name
N-{2-[(1S)-1-(3-ethoxy-4-methoxyphenyl)-2-methanesulfonylethyl]-1,3-dioxo-2,3-dihydro-1H-isoindol-4-yl}ethanimidic acid
SMILES
[H][C@](CS(C)(=O)=O)(N1C(=O)C2=C(C1=O)C(=CC=C2)N=C(C)O)C1=CC(OCC)=C(OC)C=C1
Pharmacology
Indication

Investigated for use/treatment in psoriasis and psoriatic disorders.

Structured Indications
PharmacodynamicsNot Available
Mechanism of action

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 PDE-4, TNF-alpha, interleukin-2 (IL-2), interferon-gamma, leukotrienes, and nitric oxide synthase. By targeting a central component of the inflammatory signaling cascade rather than a single inflammatory marker, PDE-4 inhibition may restore the homeostatic balance between pro- and anti-inflammatory signalling.

TargetKindPharmacological actionActionsOrganismUniProt ID
cAMP-specific 3',5'-cyclic phosphodiesterase 4DProteinyes
antagonist
HumanQ08499 details
cAMP-specific 3',5'-cyclic phosphodiesterase 4AProteinyes
antagonist
HumanP27815 details
cAMP-specific 3',5'-cyclic phosphodiesterase 4BProteinyes
antagonist
HumanQ07343 details
Tumor necrosis factorProteinunknownNot AvailableHumanP01375 details
Interleukin-2ProteinunknownNot AvailableHumanP60568 details
Interferon gammaProteinunknownNot AvailableHumanP01579 details
Nitric oxide synthase, endothelialProteinunknownNot AvailableHumanP29474 details
Related Articles
Absorption

When taken orally, apremilast is absorbed with an absolute bioavailability of ~73%. Co-administration with food does not alter the extent of absorption.

Volume of distribution

Peak plasma concentrations (Cmax) occur at a median time (tmax) of ~2.5 hours.

Protein binding

68%.

Metabolism

Apremilast is metabolized via multiple pathways, including cytochrome (CYP) 3A4-mediated oxidative metabolism with subsequent glucuronidation, non-enzymatic hydrolysis, and non-CYP3A4-mediated metabolism. The unchanged drug accounts for 45% of circulating radioactivity and <7 % of excreted radioactivity. The main metabolite of apremilast is O-desmethyl apremilast glucuronide (M12), with nine other minor metabolites all with at least 50-fold less potency than apremilast in inhibiting PDE-4 and TNF-a.

SubstrateEnzymesProduct
Apremilast
M3Details
M3
M12Details
Route of elimination

58% urine; 39% feces.

Half life

6-9 hours.

Clearance

10 L/hr.

Toxicity

DEPRESSION AND SUICIDE: Apremilast has been associated with increased depression and suicidal behaviour in patients. WEIGHT LOSS: Apremilast has been associated with weight decrease in patients.

Affected organisms
  • Humans and other mammals
PathwaysNot Available
Pharmacogenomic Effects/ADRs Not Available
Interactions
Drug Interactions
DrugInteractionDrug group
16-BromoepiandrosteroneThe risk or severity of adverse effects can be increased when Apremilast is combined with 16-Bromoepiandrosterone.Investigational
19-norandrostenedioneThe risk or severity of adverse effects can be increased when Apremilast is combined with 19-norandrostenedione.Experimental, Illicit
5-androstenedioneThe risk or severity of adverse effects can be increased when Apremilast is combined with 5-androstenedione.Experimental, Illicit
AbciximabApremilast may increase the anticoagulant activities of Abciximab.Approved
AcebutololApremilast may decrease the antihypertensive activities of Acebutolol.Approved
AceclofenacThe risk or severity of adverse effects can be increased when Apremilast is combined with Aceclofenac.Approved
AcenocoumarolApremilast may increase the anticoagulant activities of Acenocoumarol.Approved
Acetylsalicylic acidThe risk or severity of adverse effects can be increased when Acetylsalicylic acid is combined with Apremilast.Approved, Vet Approved
AclarubicinApremilast may decrease the excretion rate of Aclarubicin which could result in a higher serum level.Investigational
AdapaleneThe risk or severity of adverse effects can be increased when Adapalene is combined with Apremilast.Approved
AlclometasoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Alclometasone.Approved
AldosteroneThe risk or severity of adverse effects can be increased when Apremilast is combined with Aldosterone.Experimental
Alendronic acidThe risk or severity of adverse effects can be increased when Apremilast is combined with Alendronic acid.Approved
AliskirenApremilast may decrease the antihypertensive activities of Aliskiren.Approved, Investigational
AlprenololApremilast may decrease the antihypertensive activities of Alprenolol.Approved, Withdrawn
AlprostadilThe therapeutic efficacy of Alprostadil can be decreased when used in combination with Apremilast.Approved, Investigational
AmcinonideThe risk or severity of adverse effects can be increased when Apremilast is combined with Amcinonide.Approved
AmikacinApremilast may decrease the excretion rate of Amikacin which could result in a higher serum level.Approved, Vet Approved
AmilorideApremilast may decrease the antihypertensive activities of Amiloride.Approved
AmiodaroneThe metabolism of Apremilast can be decreased when combined with Amiodarone.Approved, Investigational
AmrubicinApremilast may decrease the excretion rate of Amrubicin which could result in a higher serum level.Approved, Investigational
AncrodApremilast may increase the anticoagulant activities of Ancrod.Investigational
AndrographolideThe risk or severity of adverse effects can be increased when Apremilast is combined with HMPL-004.Investigational
AndrostenedioneThe risk or severity of adverse effects can be increased when Apremilast is combined with 4-Androstenedione.Experimental, Illicit
AntipyrineThe risk or severity of adverse effects can be increased when Antipyrine is combined with Apremilast.Approved
Antithrombin III humanApremilast may increase the anticoagulant activities of Antithrombin III human.Approved
ApixabanApremilast may increase the anticoagulant activities of Apixaban.Approved
ApramycinApremilast may decrease the excretion rate of Apramycin which could result in a higher serum level.Experimental, Vet Approved
AprepitantThe serum concentration of Apremilast can be increased when it is combined with Aprepitant.Approved, Investigational
ArbekacinApremilast may decrease the excretion rate of Arbekacin which could result in a higher serum level.Approved
ArdeparinApremilast may increase the anticoagulant activities of Ardeparin.Approved, Withdrawn
ArgatrobanApremilast may increase the anticoagulant activities of Argatroban.Approved, Investigational
ArotinololApremilast may decrease the antihypertensive activities of Arotinolol.Approved
AtazanavirThe metabolism of Apremilast can be decreased when combined with Atazanavir.Approved, Investigational
AtenololApremilast may decrease the antihypertensive activities of Atenolol.Approved
AtomoxetineThe metabolism of Apremilast can be decreased when combined with Atomoxetine.Approved
AzapropazoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Azapropazone.Withdrawn
AzelastineThe risk or severity of adverse effects can be increased when Azelastine is combined with Apremilast.Approved
Azilsartan medoxomilThe risk or severity of adverse effects can be increased when Azilsartan medoxomil is combined with Apremilast.Approved
BalsalazideApremilast may increase the nephrotoxic activities of Balsalazide.Approved, Investigational
BecaplerminApremilast may increase the anticoagulant activities of Becaplermin.Approved, Investigational
Beclomethasone dipropionateThe risk or severity of adverse effects can be increased when Apremilast is combined with Beclomethasone dipropionate.Approved, Investigational
BefunololApremilast may decrease the antihypertensive activities of Befunolol.Experimental
BenazeprilThe risk or severity of adverse effects can be increased when Benazepril is combined with Apremilast.Approved, Investigational
BendroflumethiazideThe therapeutic efficacy of Bendroflumethiazide can be decreased when used in combination with Apremilast.Approved
BenoxaprofenThe risk or severity of adverse effects can be increased when Benoxaprofen is combined with Apremilast.Withdrawn
BeraprostThe therapeutic efficacy of Beraprost can be decreased when used in combination with Apremilast.Investigational
BetamethasoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Betamethasone.Approved, Vet Approved
BetaxololApremilast may decrease the antihypertensive activities of Betaxolol.Approved
Betulinic AcidThe risk or severity of adverse effects can be increased when Apremilast is combined with Betulinic Acid.Investigational
BevantololApremilast may decrease the antihypertensive activities of Bevantolol.Approved
BexaroteneThe serum concentration of Apremilast can be decreased when it is combined with Bexarotene.Approved, Investigational
BimatoprostThe therapeutic efficacy of Bimatoprost can be decreased when used in combination with Apremilast.Approved, Investigational
BisoprololApremilast may decrease the antihypertensive activities of Bisoprolol.Approved
BivalirudinApremilast may increase the anticoagulant activities of Bivalirudin.Approved, Investigational
BoceprevirThe metabolism of Apremilast can be decreased when combined with Boceprevir.Approved, Investigational
BopindololApremilast may decrease the antihypertensive activities of Bopindolol.Approved
BortezomibThe metabolism of Apremilast can be decreased when combined with Bortezomib.Approved, Investigational
BosentanThe serum concentration of Apremilast can be decreased when it is combined with Bosentan.Approved, Investigational
BromfenacThe risk or severity of adverse effects can be increased when Bromfenac is combined with Apremilast.Approved
BudesonideThe risk or severity of adverse effects can be increased when Apremilast is combined with Budesonide.Approved
BufuralolApremilast may decrease the antihypertensive activities of Bufuralol.Experimental, Investigational
BumetanideApremilast may decrease the diuretic activities of Bumetanide.Approved
BupranololApremilast may decrease the antihypertensive activities of Bupranolol.Approved
CandesartanThe risk or severity of adverse effects can be increased when Candesartan is combined with Apremilast.Approved
CandoxatrilThe risk or severity of adverse effects can be increased when Candoxatril is combined with Apremilast.Experimental
CaptoprilThe risk or severity of adverse effects can be increased when Captopril is combined with Apremilast.Approved
CarbamazepineThe serum concentration of Apremilast can be decreased when it is combined with Carbamazepine.Approved, Investigational
Carboprost TromethamineThe therapeutic efficacy of Carboprost Tromethamine can be decreased when used in combination with Apremilast.Approved
CarprofenThe risk or severity of adverse effects can be increased when Carprofen is combined with Apremilast.Approved, Vet Approved, Withdrawn
CarteololApremilast may decrease the antihypertensive activities of Carteolol.Approved
CarvedilolApremilast may decrease the antihypertensive activities of Carvedilol.Approved, Investigational
CastanospermineThe risk or severity of adverse effects can be increased when Castanospermine is combined with Apremilast.Experimental
CelecoxibThe risk or severity of adverse effects can be increased when Apremilast is combined with Celecoxib.Approved, Investigational
CeliprololApremilast may decrease the antihypertensive activities of Celiprolol.Approved, Investigational
CeritinibThe serum concentration of Apremilast can be increased when it is combined with Ceritinib.Approved
CertoparinApremilast may increase the anticoagulant activities of Certoparin.Approved
ChloroquineThe risk or severity of adverse effects can be increased when Chloroquine is combined with Apremilast.Approved, Vet Approved
ChlorothiazideThe therapeutic efficacy of Chlorothiazide can be decreased when used in combination with Apremilast.Approved, Vet Approved
ChlorthalidoneThe therapeutic efficacy of Chlorthalidone can be decreased when used in combination with Apremilast.Approved
CholestyramineCholestyramine can cause a decrease in the absorption of Apremilast resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
Choline magnesium trisalicylateThe risk or severity of adverse effects can be increased when Trisalicylate-choline is combined with Apremilast.Approved
CiclesonideThe risk or severity of adverse effects can be increased when Apremilast is combined with Ciclesonide.Approved, Investigational
CilazaprilThe risk or severity of adverse effects can be increased when Cilazapril is combined with Apremilast.Approved
CinoxacinApremilast may increase the neuroexcitatory activities of Cinoxacin.Approved, Withdrawn
CiprofloxacinApremilast may increase the neuroexcitatory activities of Ciprofloxacin.Approved, Investigational
Citric AcidApremilast may increase the anticoagulant activities of Citric Acid.Nutraceutical, Vet Approved
ClarithromycinThe metabolism of Apremilast can be decreased when combined with Clarithromycin.Approved
ClemastineThe metabolism of Apremilast can be decreased when combined with Clemastine.Approved
Clobetasol propionateThe risk or severity of adverse effects can be increased when Apremilast is combined with Clobetasol propionate.Approved
ClocortoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Clocortolone.Approved
Clodronic AcidThe risk or severity of adverse effects can be increased when Apremilast is combined with Clodronate.Approved, Investigational, Vet Approved
ClonixinThe risk or severity of adverse effects can be increased when Apremilast is combined with Clonixin.Approved
ClotrimazoleThe metabolism of Apremilast can be decreased when combined with Clotrimazole.Approved, Vet Approved
CobicistatThe metabolism of Apremilast can be decreased when combined with Cobicistat.Approved
ColesevelamColesevelam can cause a decrease in the absorption of Apremilast resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
ColestipolColestipol can cause a decrease in the absorption of Apremilast resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
ConivaptanThe serum concentration of Apremilast can be increased when it is combined with Conivaptan.Approved, Investigational
Cortisone acetateThe risk or severity of adverse effects can be increased when Apremilast is combined with Cortisone acetate.Approved
CrizotinibThe metabolism of Apremilast can be decreased when combined with Crizotinib.Approved
CyclosporineApremilast may increase the nephrotoxic activities of Cyclosporine.Approved, Investigational, Vet Approved
CyclosporineThe metabolism of Apremilast can be decreased when combined with Cyclosporine.Approved, Investigational, Vet Approved
Dabigatran etexilateApremilast may increase the anticoagulant activities of Dabigatran etexilate.Approved
DabrafenibThe serum concentration of Apremilast can be decreased when it is combined with Dabrafenib.Approved
DalteparinApremilast may increase the anticoagulant activities of Dalteparin.Approved
DarunavirThe metabolism of Apremilast can be decreased when combined with Darunavir.Approved
DasatinibThe serum concentration of Apremilast can be increased when it is combined with Dasatinib.Approved, Investigational
DaunorubicinApremilast may decrease the excretion rate of Daunorubicin which could result in a higher serum level.Approved
DeferasiroxThe serum concentration of Apremilast can be decreased when it is combined with Deferasirox.Approved, Investigational
DelavirdineThe metabolism of Apremilast can be decreased when combined with Delavirdine.Approved
DenosumabThe risk or severity of adverse effects can be increased when Denosumab is combined with Apremilast.Approved
DesirudinApremilast may increase the anticoagulant activities of Desirudin.Approved
DesmopressinThe risk or severity of adverse effects can be increased when Apremilast is combined with Desmopressin.Approved
DesoximetasoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Desoximetasone.Approved
Desoxycorticosterone PivalateThe risk or severity of adverse effects can be increased when Apremilast is combined with Desoxycorticosterone Pivalate.Experimental, Vet Approved
DexamethasoneThe serum concentration of Apremilast can be decreased when it is combined with Dexamethasone.Approved, Investigational, Vet Approved
DexketoprofenThe risk or severity of adverse effects can be increased when Dexketoprofen is combined with Apremilast.Approved
DextranApremilast may increase the anticoagulant activities of Dextran.Approved, Vet Approved
Dextran 40Apremilast may increase the anticoagulant activities of Dextran 40.Approved
DiclofenacThe risk or severity of adverse effects can be increased when Diclofenac is combined with Apremilast.Approved, Vet Approved
DicoumarolApremilast may increase the anticoagulant activities of Dicoumarol.Approved
DiflorasoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Diflorasone.Approved
DiflunisalThe risk or severity of adverse effects can be increased when Diflunisal is combined with Apremilast.Approved
DifluocortoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Difluocortolone.Approved
DifluprednateThe risk or severity of adverse effects can be increased when Apremilast is combined with Difluprednate.Approved
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Apremilast.Approved
DihydroergotamineThe metabolism of Apremilast can be decreased when combined with Dihydroergotamine.Approved
DiltiazemThe metabolism of Apremilast can be decreased when combined with Diltiazem.Approved
Dinoprost TromethamineThe therapeutic efficacy of Dinoprost Tromethamine can be decreased when used in combination with Apremilast.Approved, Vet Approved
DinoprostoneThe therapeutic efficacy of Dinoprostone can be decreased when used in combination with Apremilast.Approved
DoxorubicinApremilast may decrease the excretion rate of Doxorubicin which could result in a higher serum level.Approved, Investigational
DoxycyclineThe metabolism of Apremilast can be decreased when combined with Doxycycline.Approved, Investigational, Vet Approved
DronedaroneThe metabolism of Apremilast can be decreased when combined with Dronedarone.Approved
DrospirenoneApremilast may increase the hyperkalemic activities of Drospirenone.Approved
DroxicamThe risk or severity of adverse effects can be increased when Apremilast is combined with Droxicam.Approved
Edetic AcidApremilast may increase the anticoagulant activities of Edetic Acid.Approved, Vet Approved
EdoxabanApremilast may increase the anticoagulant activities of Edoxaban.Approved
EfavirenzThe serum concentration of Apremilast can be decreased when it is combined with Efavirenz.Approved, Investigational
EnalaprilThe risk or severity of adverse effects can be increased when Enalapril is combined with Apremilast.Approved, Vet Approved
EnalaprilatThe risk or severity of adverse effects can be increased when Enalaprilat is combined with Apremilast.Approved
EnoxacinApremilast may increase the neuroexcitatory activities of Enoxacin.Approved
EnoxaparinApremilast may increase the anticoagulant activities of Enoxaparin.Approved
EnzalutamideThe serum concentration of Apremilast can be decreased when it is combined with Enzalutamide.Approved
EpirizoleThe risk or severity of adverse effects can be increased when Apremilast is combined with Epirizole.Approved
EpirubicinApremilast may decrease the excretion rate of Epirubicin which could result in a higher serum level.Approved
EplerenoneApremilast may decrease the antihypertensive activities of Eplerenone.Approved
EpoprostenolThe therapeutic efficacy of Epoprostenol can be decreased when used in combination with Apremilast.Approved
EprosartanThe risk or severity of adverse effects can be increased when Eprosartan is combined with Apremilast.Approved
EquileninThe risk or severity of adverse effects can be increased when Apremilast is combined with Equilenin.Experimental
EquilinThe risk or severity of adverse effects can be increased when Apremilast is combined with Equilin.Approved
ErythromycinThe metabolism of Apremilast can be decreased when combined with Erythromycin.Approved, Vet Approved
Eslicarbazepine acetateThe serum concentration of Apremilast can be decreased when it is combined with Eslicarbazepine acetate.Approved
EsmololApremilast may decrease the antihypertensive activities of Esmolol.Approved
EstroneThe risk or severity of adverse effects can be increased when Apremilast is combined with Estrone.Approved
Estrone sulfateThe risk or severity of adverse effects can be increased when Apremilast is combined with Estrone sulfate.Approved
Etacrynic acidApremilast may decrease the diuretic activities of Etacrynic acid.Approved
EtanerceptThe risk or severity of adverse effects can be increased when Etanercept is combined with Apremilast.Approved, Investigational
Ethyl biscoumacetateApremilast may increase the anticoagulant activities of Ethyl biscoumacetate.Withdrawn
Etidronic acidThe risk or severity of adverse effects can be increased when Apremilast is combined with Etidronic acid.Approved
EtodolacThe risk or severity of adverse effects can be increased when Apremilast is combined with Etodolac.Approved, Investigational, Vet Approved
EtofenamateThe risk or severity of adverse effects can be increased when Apremilast is combined with Etofenamate.Approved
EtoricoxibThe risk or severity of adverse effects can be increased when Apremilast is combined with Etoricoxib.Approved, Investigational
EtravirineThe serum concentration of Apremilast can be decreased when it is combined with Etravirine.Approved
FenbufenThe risk or severity of adverse effects can be increased when Apremilast is combined with Fenbufen.Approved
FenoprofenThe risk or severity of adverse effects can be increased when Fenoprofen is combined with Apremilast.Approved
FingolimodApremilast may increase the immunosuppressive activities of Fingolimod.Approved, Investigational
FleroxacinApremilast may increase the neuroexcitatory activities of Fleroxacin.Approved
FloctafenineThe risk or severity of adverse effects can be increased when Floctafenine is combined with Apremilast.Approved, Withdrawn
FluconazoleThe metabolism of Apremilast can be decreased when combined with Fluconazole.Approved
FludrocortisoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Fludrocortisone.Approved
FlumequineApremilast may increase the neuroexcitatory activities of Flumequine.Withdrawn
FlumethasoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Flumethasone.Approved, Vet Approved
FlunisolideThe risk or severity of adverse effects can be increased when Apremilast is combined with Flunisolide.Approved, Investigational
Fluocinolone AcetonideThe risk or severity of adverse effects can be increased when Apremilast is combined with Fluocinolone Acetonide.Approved, Investigational, Vet Approved
FluocinonideThe risk or severity of adverse effects can be increased when Apremilast is combined with Fluocinonide.Approved, Investigational
FluocortoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Fluocortolone.Approved, Withdrawn
FluorometholoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Fluorometholone.Approved
FluprednideneThe risk or severity of adverse effects can be increased when Apremilast is combined with Fluprednidene.Approved, Withdrawn
FlurandrenolideThe risk or severity of adverse effects can be increased when Apremilast is combined with Flurandrenolide.Approved
FlurbiprofenThe risk or severity of adverse effects can be increased when Flurbiprofen is combined with Apremilast.Approved, Investigational
Fluticasone furoateThe risk or severity of adverse effects can be increased when Apremilast is combined with Fluticasone furoate.Approved
Fluticasone PropionateThe risk or severity of adverse effects can be increased when Apremilast is combined with Fluticasone Propionate.Approved
FluvoxamineThe metabolism of Apremilast can be decreased when combined with Fluvoxamine.Approved, Investigational
Folic AcidThe therapeutic efficacy of Folic Acid can be decreased when used in combination with Apremilast.Approved, Nutraceutical, Vet Approved
Fondaparinux sodiumApremilast may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
ForasartanThe risk or severity of adverse effects can be increased when Forasartan is combined with Apremilast.Experimental
FormestaneThe risk or severity of adverse effects can be increased when Apremilast is combined with Formestane.Approved, Investigational, Withdrawn
FosamprenavirThe metabolism of Apremilast can be decreased when combined with Fosamprenavir.Approved
FosaprepitantThe serum concentration of Apremilast can be increased when it is combined with Fosaprepitant.Approved
FosinoprilThe risk or severity of adverse effects can be increased when Fosinopril is combined with Apremilast.Approved
FosphenytoinThe serum concentration of Apremilast can be decreased when it is combined with Fosphenytoin.Approved
FramycetinApremilast may decrease the excretion rate of Framycetin which could result in a higher serum level.Approved
FurosemideApremilast may decrease the diuretic activities of Furosemide.Approved, Vet Approved
Fusidic AcidThe serum concentration of Apremilast can be increased when it is combined with Fusidic Acid.Approved
G17DTThe risk or severity of adverse effects can be increased when Apremilast is combined with G17DT.Investigational
GabexateApremilast may increase the anticoagulant activities of Gabexate.Investigational
GatifloxacinApremilast may increase the neuroexcitatory activities of Gatifloxacin.Approved, Investigational
GemeprostThe therapeutic efficacy of Gemeprost can be decreased when used in combination with Apremilast.Approved, Withdrawn
GemifloxacinApremilast may increase the neuroexcitatory activities of Gemifloxacin.Approved, Investigational
GeneticinApremilast may decrease the excretion rate of Geneticin which could result in a higher serum level.Experimental
GentamicinApremilast may decrease the excretion rate of Gentamicin which could result in a higher serum level.Approved, Vet Approved
GENTAMICIN C1AApremilast may decrease the excretion rate of GENTAMICIN C1A which could result in a higher serum level.Experimental
GrepafloxacinApremilast may increase the neuroexcitatory activities of Grepafloxacin.Withdrawn
HaloperidolThe risk or severity of adverse effects can be increased when Apremilast is combined with Haloperidol.Approved
HE3286The risk or severity of adverse effects can be increased when Apremilast is combined with HE3286.Investigational
HeparinApremilast may increase the anticoagulant activities of Heparin.Approved, Investigational
HydralazineApremilast may decrease the antihypertensive activities of Hydralazine.Approved
HydrochlorothiazideThe therapeutic efficacy of Hydrochlorothiazide can be decreased when used in combination with Apremilast.Approved, Vet Approved
HydrocortisoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Hydrocortisone.Approved, Vet Approved
HydroflumethiazideThe therapeutic efficacy of Hydroflumethiazide can be decreased when used in combination with Apremilast.Approved
IbandronateThe risk or severity of adverse effects can be increased when Apremilast is combined with Ibandronate.Approved, Investigational
IbuprofenThe risk or severity of adverse effects can be increased when Ibuprofen is combined with Apremilast.Approved
IbuproxamThe risk or severity of adverse effects can be increased when Apremilast is combined with Ibuproxam.Withdrawn
IcatibantThe risk or severity of adverse effects can be increased when Apremilast is combined with Icatibant.Approved
IdarubicinApremilast may decrease the excretion rate of Idarubicin which could result in a higher serum level.Approved
IdelalisibThe serum concentration of Apremilast can be increased when it is combined with Idelalisib.Approved
IloprostThe therapeutic efficacy of Iloprost can be decreased when used in combination with Apremilast.Approved, Investigational
ImatinibThe metabolism of Apremilast can be decreased when combined with Imatinib.Approved
IndapamideThe therapeutic efficacy of Indapamide can be decreased when used in combination with Apremilast.Approved
IndenololApremilast may decrease the antihypertensive activities of Indenolol.Withdrawn
IndinavirThe metabolism of Apremilast can be decreased when combined with Indinavir.Approved
IndomethacinThe risk or severity of adverse effects can be increased when Indomethacin is combined with Apremilast.Approved, Investigational
IndoprofenThe risk or severity of adverse effects can be increased when Apremilast is combined with Indoprofen.Withdrawn
INGN 201The risk or severity of adverse effects can be increased when Apremilast is combined with INGN 201.Investigational
INGN 225The risk or severity of adverse effects can be increased when Apremilast is combined with INGN 225.Investigational
IrbesartanThe risk or severity of adverse effects can be increased when Irbesartan is combined with Apremilast.Approved, Investigational
IsavuconazoniumThe metabolism of Apremilast can be decreased when combined with Isavuconazonium.Approved, Investigational
IsoxicamThe risk or severity of adverse effects can be increased when Apremilast is combined with Isoxicam.Withdrawn
IsradipineThe metabolism of Apremilast can be decreased when combined with Isradipine.Approved
ItraconazoleThe metabolism of Apremilast can be decreased when combined with Itraconazole.Approved, Investigational
IvacaftorThe serum concentration of Apremilast can be increased when it is combined with Ivacaftor.Approved
KanamycinApremilast may decrease the excretion rate of Kanamycin which could result in a higher serum level.Approved, Vet Approved
KebuzoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Kebuzone.Experimental
KetoconazoleThe metabolism of Apremilast can be decreased when combined with Ketoconazole.Approved, Investigational
KetoprofenThe risk or severity of adverse effects can be increased when Ketoprofen is combined with Apremilast.Approved, Vet Approved
KetorolacThe risk or severity of adverse effects can be increased when Ketorolac is combined with Apremilast.Approved
LabetalolApremilast may decrease the antihypertensive activities of Labetalol.Approved
LatanoprostThe therapeutic efficacy of Latanoprost can be decreased when used in combination with Apremilast.Approved, Investigational
LeflunomideThe risk or severity of adverse effects can be increased when Apremilast is combined with Leflunomide.Approved, Investigational
LepirudinApremilast may increase the anticoagulant activities of Lepirudin.Approved
LevobunololApremilast may decrease the antihypertensive activities of Levobunolol.Approved
LevofloxacinApremilast may increase the neuroexcitatory activities of Levofloxacin.Approved, Investigational
LimaprostThe therapeutic efficacy of Limaprost can be decreased when used in combination with Apremilast.Approved
LisinoprilThe risk or severity of adverse effects can be increased when Lisinopril is combined with Apremilast.Approved, Investigational
LithiumThe serum concentration of Lithium can be increased when it is combined with Apremilast.Approved
LomefloxacinApremilast may increase the neuroexcitatory activities of Lomefloxacin.Approved
LopinavirThe metabolism of Apremilast can be decreased when combined with Lopinavir.Approved
LornoxicamThe risk or severity of adverse effects can be increased when Apremilast is combined with Lornoxicam.Approved
LosartanThe risk or severity of adverse effects can be increased when Losartan is combined with Apremilast.Approved
LovastatinThe metabolism of Apremilast can be decreased when combined with Lovastatin.Approved, Investigational
LoxoprofenThe risk or severity of adverse effects can be increased when Apremilast is combined with Loxoprofen.Approved
LubiprostoneThe therapeutic efficacy of Lubiprostone can be decreased when used in combination with Apremilast.Approved, Investigational
LuliconazoleThe serum concentration of Apremilast can be increased when it is combined with Luliconazole.Approved
LumacaftorThe serum concentration of Apremilast can be decreased when it is combined with Lumacaftor.Approved
LumiracoxibThe risk or severity of adverse effects can be increased when Apremilast is combined with Lumiracoxib.Approved, Investigational
Magnesium salicylateThe risk or severity of adverse effects can be increased when Magnesium salicylate is combined with Apremilast.Approved
MasoprocolThe risk or severity of adverse effects can be increased when Masoprocol is combined with Apremilast.Approved
ME-609The risk or severity of adverse effects can be increased when Apremilast is combined with ME-609.Investigational
Meclofenamic acidThe risk or severity of adverse effects can be increased when Meclofenamic acid is combined with Apremilast.Approved, Vet Approved
MedrysoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Medrysone.Approved
Mefenamic acidThe risk or severity of adverse effects can be increased when Mefenamic acid is combined with Apremilast.Approved
MeloxicamThe risk or severity of adverse effects can be increased when Meloxicam is combined with Apremilast.Approved, Vet Approved
MesalazineApremilast may increase the nephrotoxic activities of Mesalazine.Approved
MetamizoleThe risk or severity of adverse effects can be increased when Metamizole is combined with Apremilast.Withdrawn
MethotrexateThe serum concentration of Methotrexate can be increased when it is combined with Apremilast.Approved
MethyclothiazideThe therapeutic efficacy of Methyclothiazide can be decreased when used in combination with Apremilast.Approved
MethylprednisoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Methylprednisolone.Approved, Vet Approved
MetipranololApremilast may decrease the antihypertensive activities of Metipranolol.Approved
MetolazoneThe therapeutic efficacy of Metolazone can be decreased when used in combination with Apremilast.Approved
MetoprololApremilast may decrease the antihypertensive activities of Metoprolol.Approved, Investigational
MetrizamideApremilast may decrease the excretion rate of Metrizamide which could result in a higher serum level.Approved
MifepristoneThe serum concentration of Apremilast can be increased when it is combined with Mifepristone.Approved, Investigational
MisoprostolThe therapeutic efficacy of Misoprostol can be decreased when used in combination with Apremilast.Approved
MitotaneThe serum concentration of Apremilast can be decreased when it is combined with Mitotane.Approved
ModafinilThe serum concentration of Apremilast can be decreased when it is combined with Modafinil.Approved, Investigational
MoexiprilThe risk or severity of adverse effects can be increased when Moexipril is combined with Apremilast.Approved
MometasoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Mometasone.Approved, Vet Approved
MorniflumateThe risk or severity of adverse effects can be increased when Morniflumate is combined with Apremilast.Approved
MoxifloxacinApremilast may increase the neuroexcitatory activities of Moxifloxacin.Approved, Investigational
Mycophenolate mofetilThe risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Apremilast.Approved, Investigational
Mycophenolic acidThe risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Apremilast.Approved
NabumetoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Nabumetone.Approved
NadololApremilast may decrease the antihypertensive activities of Nadolol.Approved
NadroparinApremilast may increase the anticoagulant activities of Nadroparin.Approved
NafamostatApremilast may increase the anticoagulant activities of Nafamostat.Approved, Investigational
NafcillinThe serum concentration of Apremilast can be decreased when it is combined with Nafcillin.Approved
NaftifineThe risk or severity of adverse effects can be increased when Naftifine is combined with Apremilast.Approved
Nalidixic AcidApremilast may increase the neuroexcitatory activities of Nalidixic Acid.Approved
NaproxenThe risk or severity of adverse effects can be increased when Naproxen is combined with Apremilast.Approved, Vet Approved
NatalizumabThe risk or severity of adverse effects can be increased when Apremilast is combined with Natalizumab.Approved, Investigational
NCX 1022The risk or severity of adverse effects can be increased when Apremilast is combined with NCX 1022.Investigational
NCX 4016The risk or severity of adverse effects can be increased when Apremilast is combined with NCX 4016.Investigational
NeamineApremilast may decrease the excretion rate of Neamine which could result in a higher serum level.Experimental
NefazodoneThe metabolism of Apremilast can be decreased when combined with Nefazodone.Approved, Withdrawn
NelfinavirThe metabolism of Apremilast can be decreased when combined with Nelfinavir.Approved
NeomycinApremilast may decrease the excretion rate of Neomycin which could result in a higher serum level.Approved, Vet Approved
NepafenacThe risk or severity of adverse effects can be increased when Apremilast is combined with Nepafenac.Approved
NetilmicinApremilast may decrease the excretion rate of Netilmicin which could result in a higher serum level.Approved
NetupitantThe serum concentration of Apremilast can be increased when it is combined with Netupitant.Approved
NevirapineThe serum concentration of Apremilast can be decreased when it is combined with Nevirapine.Approved
Niflumic AcidThe risk or severity of adverse effects can be increased when Niflumic Acid is combined with Apremilast.Approved
NilotinibThe metabolism of Apremilast can be decreased when combined with Nilotinib.Approved, Investigational
NimesulideThe risk or severity of adverse effects can be increased when Nimesulide is combined with Apremilast.Approved, Withdrawn
NorfloxacinApremilast may increase the neuroexcitatory activities of Norfloxacin.Approved
OfloxacinApremilast may increase the neuroexcitatory activities of Ofloxacin.Approved
OlaparibThe metabolism of Apremilast can be decreased when combined with Olaparib.Approved
Oleoyl estroneThe risk or severity of adverse effects can be increased when Apremilast is combined with Oleoyl estrone.Investigational
OlmesartanThe risk or severity of adverse effects can be increased when Olmesartan is combined with Apremilast.Approved, Investigational
OlopatadineThe risk or severity of adverse effects can be increased when Olopatadine is combined with Apremilast.Approved
OlsalazineApremilast may increase the nephrotoxic activities of Olsalazine.Approved
Omacetaxine mepesuccinateThe risk or severity of adverse effects can be increased when Apremilast is combined with Omacetaxine mepesuccinate.Approved
OmapatrilatThe risk or severity of adverse effects can be increased when Omapatrilat is combined with Apremilast.Investigational
OsimertinibThe serum concentration of Apremilast can be increased when it is combined with Osimertinib.Approved
OxaprozinThe risk or severity of adverse effects can be increased when Oxaprozin is combined with Apremilast.Approved
OxprenololApremilast may decrease the antihypertensive activities of Oxprenolol.Approved
OxyphenbutazoneThe risk or severity of adverse effects can be increased when Oxyphenbutazone is combined with Apremilast.Withdrawn
PalbociclibThe serum concentration of Apremilast can be increased when it is combined with Palbociclib.Approved
PamidronateThe risk or severity of adverse effects can be increased when Apremilast is combined with Pamidronate.Approved
ParamethasoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Paramethasone.Approved
ParecoxibThe risk or severity of adverse effects can be increased when Apremilast is combined with Parecoxib.Approved
ParomomycinApremilast may decrease the excretion rate of Paromomycin which could result in a higher serum level.Approved, Investigational
PefloxacinApremilast may increase the neuroexcitatory activities of Pefloxacin.Approved
PenbutololApremilast may decrease the antihypertensive activities of Penbutolol.Approved, Investigational
PentobarbitalThe serum concentration of Apremilast can be decreased when it is combined with Pentobarbital.Approved, Vet Approved
Pentosan PolysulfateApremilast may increase the anticoagulant activities of Pentosan Polysulfate.Approved
PerindoprilThe risk or severity of adverse effects can be increased when Perindopril is combined with Apremilast.Approved
PhenindioneApremilast may increase the anticoagulant activities of Phenindione.Approved
PhenobarbitalThe serum concentration of Apremilast can be decreased when it is combined with Phenobarbital.Approved
PhenprocoumonApremilast may increase the anticoagulant activities of Phenprocoumon.Approved
PhenylbutazoneThe risk or severity of adverse effects can be increased when Phenylbutazone is combined with Apremilast.Approved, Vet Approved
PhenytoinThe serum concentration of Apremilast can be decreased when it is combined with Phenytoin.Approved, Vet Approved
PimecrolimusThe risk or severity of adverse effects can be increased when Pimecrolimus is combined with Apremilast.Approved, Investigational
PindololApremilast may decrease the antihypertensive activities of Pindolol.Approved
PirarubicinApremilast may decrease the excretion rate of Pirarubicin which could result in a higher serum level.Investigational
PiretanideApremilast may decrease the diuretic activities of Piretanide.Experimental
PirfenidoneThe risk or severity of adverse effects can be increased when Pirfenidone is combined with Apremilast.Investigational
PiroxicamThe risk or severity of adverse effects can be increased when Piroxicam is combined with Apremilast.Approved, Investigational
PlicamycinApremilast may decrease the excretion rate of Plicamycin which could result in a higher serum level.Approved, Withdrawn
PolythiazideThe therapeutic efficacy of Polythiazide can be decreased when used in combination with Apremilast.Approved
PosaconazoleThe metabolism of Apremilast can be decreased when combined with Posaconazole.Approved, Investigational, Vet Approved
PractololApremilast may decrease the antihypertensive activities of Practolol.Approved
PralatrexateThe serum concentration of Pralatrexate can be increased when it is combined with Apremilast.Approved
PrasteroneThe risk or severity of adverse effects can be increased when Apremilast is combined with Prasterone.Approved, Nutraceutical
Prasterone sulfateThe risk or severity of adverse effects can be increased when Apremilast is combined with dehydroepiandrosterone sulfate.Investigational
PrednicarbateThe risk or severity of adverse effects can be increased when Apremilast is combined with Prednicarbate.Approved
PrednisoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Prednisolone.Approved, Vet Approved
PrednisoneThe risk or severity of adverse effects can be increased when Apremilast is combined with Prednisone.Approved, Vet Approved
PregnenoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Pregnenolone.Experimental
PrimidoneThe serum concentration of Apremilast can be decreased when it is combined with Primidone.Approved, Vet Approved
ProbenecidThe serum concentration of Apremilast can be increased when it is combined with Probenecid.Approved
PropacetamolThe risk or severity of adverse effects can be increased when Apremilast is combined with Propacetamol.Approved
PropranololApremilast may decrease the antihypertensive activities of Propranolol.Approved, Investigational
Prostaglandin B2The therapeutic efficacy of Prostaglandin B2 can be decreased when used in combination with Apremilast.Experimental
Prostaglandin G2The therapeutic efficacy of Prostaglandin G2 can be decreased when used in combination with Apremilast.Experimental
Protein S humanApremilast may increase the anticoagulant activities of Protein S human.Approved
PTC299The risk or severity of adverse effects can be increased when PTC299 is combined with Apremilast.Investigational
PuromycinApremilast may decrease the excretion rate of Puromycin which could result in a higher serum level.Experimental
QuinaprilThe risk or severity of adverse effects can be increased when Quinapril is combined with Apremilast.Approved, Investigational
QuinethazoneThe therapeutic efficacy of Quinethazone can be decreased when used in combination with Apremilast.Approved
RamiprilThe risk or severity of adverse effects can be increased when Ramipril is combined with Apremilast.Approved
RanolazineThe metabolism of Apremilast can be decreased when combined with Ranolazine.Approved, Investigational
RescinnamineThe risk or severity of adverse effects can be increased when Rescinnamine is combined with Apremilast.Approved
ResveratrolThe risk or severity of adverse effects can be increased when Resveratrol is combined with Apremilast.Experimental, Investigational
ReviparinApremilast may increase the anticoagulant activities of Reviparin.Approved
RibostamycinApremilast may decrease the excretion rate of Ribostamycin which could result in a higher serum level.Approved
RifabutinThe serum concentration of Apremilast can be decreased when it is combined with Rifabutin.Approved
RifampicinThe serum concentration of Apremilast can be decreased when it is combined with Rifampicin.Approved
RifapentineThe serum concentration of Apremilast can be decreased when it is combined with Rifapentine.Approved
RimexoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Rimexolone.Approved
RindopepimutThe risk or severity of adverse effects can be increased when Apremilast is combined with CDX-110.Investigational
RiociguatApremilast may increase the hypotensive activities of Riociguat.Approved
RisedronateThe risk or severity of adverse effects can be increased when Apremilast is combined with Risedronate.Approved, Investigational
RitonavirThe metabolism of Apremilast can be decreased when combined with Ritonavir.Approved, Investigational
RivaroxabanApremilast may increase the anticoagulant activities of Rivaroxaban.Approved
RofecoxibThe risk or severity of adverse effects can be increased when Apremilast is combined with Rofecoxib.Investigational, Withdrawn
RoflumilastRoflumilast may increase the immunosuppressive activities of Apremilast.Approved
RosoxacinApremilast may increase the neuroexcitatory activities of Rosoxacin.Approved
SacubitrilThe risk or severity of adverse effects can be increased when Sacubitril is combined with Apremilast.Approved
SalicylamideThe risk or severity of adverse effects can be increased when Apremilast is combined with Salicylamide.Approved
Salicylic acidThe risk or severity of adverse effects can be increased when Salicylic acid is combined with Apremilast.Approved, Vet Approved
SalsalateThe risk or severity of adverse effects can be increased when Salsalate is combined with Apremilast.Approved
SaprisartanThe risk or severity of adverse effects can be increased when Saprisartan is combined with Apremilast.Experimental
SaquinavirThe metabolism of Apremilast can be decreased when combined with Saquinavir.Approved, Investigational
SildenafilThe metabolism of Apremilast can be decreased when combined with Sildenafil.Approved, Investigational
SiltuximabThe serum concentration of Apremilast can be decreased when it is combined with Siltuximab.Approved
SimeprevirThe serum concentration of Apremilast can be increased when it is combined with Simeprevir.Approved
Sipuleucel-TThe therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Apremilast.Approved
SotalolApremilast may decrease the antihypertensive activities of Sotalol.Approved
SP1049CApremilast may decrease the excretion rate of SP1049C which could result in a higher serum level.Investigational
SparfloxacinApremilast may increase the neuroexcitatory activities of Sparfloxacin.Approved
SpectinomycinApremilast may decrease the excretion rate of Spectinomycin which could result in a higher serum level.Approved, Vet Approved
SpiraprilThe risk or severity of adverse effects can be increased when Spirapril is combined with Apremilast.Approved
SpironolactoneApremilast may decrease the antihypertensive activities of Spironolactone.Approved
SRP 299The risk or severity of adverse effects can be increased when Apremilast is combined with SRP 299.Investigational
SRT501The risk or severity of adverse effects can be increased when SRT501 is combined with Apremilast.Investigational
St. John's WortThe serum concentration of Apremilast can be decreased when it is combined with St. John&#39;s Wort.Nutraceutical
StiripentolThe serum concentration of Apremilast can be increased when it is combined with Stiripentol.Approved
StreptomycinApremilast may decrease the excretion rate of Streptomycin which could result in a higher serum level.Approved, Vet Approved
StreptozocinApremilast may decrease the excretion rate of Streptozocin which could result in a higher serum level.Approved
SulfasalazineApremilast may increase the nephrotoxic activities of Sulfasalazine.Approved
SulfisoxazoleThe metabolism of Apremilast can be decreased when combined with Sulfisoxazole.Approved, Vet Approved
SulindacThe risk or severity of adverse effects can be increased when Sulindac is combined with Apremilast.Approved
SulodexideApremilast may increase the anticoagulant activities of Sulodexide.Approved, Investigational
SuprofenThe risk or severity of adverse effects can be increased when Suprofen is combined with Apremilast.Approved, Withdrawn
TacrolimusThe risk or severity of adverse effects can be increased when Tacrolimus is combined with Apremilast.Approved, Investigational
TacrolimusApremilast may increase the nephrotoxic activities of Tacrolimus.Approved, Investigational
TafluprostThe therapeutic efficacy of Tafluprost can be decreased when used in combination with Apremilast.Approved
TalniflumateThe risk or severity of adverse effects can be increased when Talniflumate is combined with Apremilast.Approved
TasosartanThe risk or severity of adverse effects can be increased when Tasosartan is combined with Apremilast.Approved
Technetium Tc-99m medronateThe risk or severity of adverse effects can be increased when Apremilast is combined with Technetium Tc-99m Medronate.Approved
TelaprevirThe metabolism of Apremilast can be decreased when combined with Telaprevir.Withdrawn
TelithromycinThe metabolism of Apremilast can be decreased when combined with Telithromycin.Approved
TelmisartanThe risk or severity of adverse effects can be increased when Telmisartan is combined with Apremilast.Approved, Investigational
TemafloxacinApremilast may increase the neuroexcitatory activities of Temafloxacin.Withdrawn
TemocaprilThe risk or severity of adverse effects can be increased when Temocapril is combined with Apremilast.Experimental, Investigational
TenofovirThe risk or severity of adverse effects can be increased when Apremilast is combined with Tenofovir.Approved, Investigational
TenoxicamThe risk or severity of adverse effects can be increased when Tenoxicam is combined with Apremilast.Approved
TeriflunomideThe risk or severity of adverse effects can be increased when Apremilast is combined with Teriflunomide.Approved
Tiaprofenic acidThe risk or severity of adverse effects can be increased when Tiaprofenic acid is combined with Apremilast.Approved
TiclopidineThe metabolism of Apremilast can be decreased when combined with Ticlopidine.Approved
Tiludronic acidThe risk or severity of adverse effects can be increased when Apremilast is combined with Tiludronate.Approved, Vet Approved
TimololApremilast may decrease the antihypertensive activities of Timolol.Approved
TixocortolThe risk or severity of adverse effects can be increased when Apremilast is combined with Tixocortol.Approved
TobramycinApremilast may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
TocilizumabThe serum concentration of Apremilast can be decreased when it is combined with Tocilizumab.Approved
TofacitinibApremilast may increase the immunosuppressive activities of Tofacitinib.Approved, Investigational
Tolfenamic AcidThe risk or severity of adverse effects can be increased when Apremilast is combined with Tolfenamic Acid.Approved
TolmetinThe risk or severity of adverse effects can be increased when Tolmetin is combined with Apremilast.Approved
TorasemideApremilast may decrease the diuretic activities of Torasemide.Approved
TrandolaprilThe risk or severity of adverse effects can be increased when Trandolapril is combined with Apremilast.Approved
TranilastThe risk or severity of adverse effects can be increased when Apremilast is combined with Tranilast.Approved, Investigational
TrastuzumabTrastuzumab may increase the neutropenic activities of Apremilast.Approved, Investigational
TravoprostThe therapeutic efficacy of Travoprost can be decreased when used in combination with Apremilast.Approved
TreprostinilThe risk or severity of adverse effects can be increased when Treprostinil is combined with Apremilast.Approved, Investigational
TriamcinoloneThe risk or severity of adverse effects can be increased when Apremilast is combined with Triamcinolone.Approved, Vet Approved
TriamtereneApremilast may decrease the antihypertensive activities of Triamterene.Approved
TrichlormethiazideThe therapeutic efficacy of Trichlormethiazide can be decreased when used in combination with Apremilast.Approved, Vet Approved
TrovafloxacinApremilast may increase the neuroexcitatory activities of Trovafloxacin.Approved, Withdrawn
UnoprostoneThe therapeutic efficacy of Unoprostone can be decreased when used in combination with Apremilast.Approved
ValdecoxibThe risk or severity of adverse effects can be increased when Apremilast is combined with Valdecoxib.Investigational, Withdrawn
ValrubicinApremilast may decrease the excretion rate of Valrubicin which could result in a higher serum level.Approved
ValsartanThe risk or severity of adverse effects can be increased when Valsartan is combined with Apremilast.Approved, Investigational
VancomycinThe serum concentration of Vancomycin can be increased when it is combined with Apremilast.Approved
VenlafaxineThe metabolism of Apremilast can be decreased when combined with Venlafaxine.Approved
VerapamilThe metabolism of Apremilast can be decreased when combined with Verapamil.Approved
VoriconazoleThe metabolism of Apremilast can be decreased when combined with Voriconazole.Approved, Investigational
WarfarinApremilast may increase the anticoagulant activities of Warfarin.Approved
XimelagatranApremilast may increase the anticoagulant activities of Ximelagatran.Approved, Investigational, Withdrawn
ZaltoprofenThe risk or severity of adverse effects can be increased when Apremilast is combined with Zaltoprofen.Approved
ZileutonThe risk or severity of adverse effects can be increased when Zileuton is combined with Apremilast.Approved, Investigational, Withdrawn
ZiprasidoneThe metabolism of Apremilast can be decreased when combined with Ziprasidone.Approved
Zoledronic acidThe risk or severity of adverse effects can be increased when Apremilast is combined with Zoledronic acid.Approved
ZomepiracThe risk or severity of adverse effects can be increased when Zomepirac is combined with Apremilast.Withdrawn
ZorubicinApremilast may decrease the excretion rate of Zorubicin which could result in a higher serum level.Experimental
Food InteractionsNot Available
References
Synthesis ReferenceNot Available
General References
  1. Khobzaoui M, Gutke HJ, Burnet M: CC-10004 . Curr Opin Investig Drugs. 2005 May;6(5):518-25. [PubMed:15912967 ]
  2. Molostvov G, Morris A, Rose P, Basu S, Muller G: The effects of selective cytokine inhibitory drugs (CC-10004 and CC-1088) on VEGF and IL-6 expression and apoptosis in myeloma and endothelial cell co-cultures. Br J Haematol. 2004 Feb;124(3):366-75. [PubMed:14717786 ]
  3. Abdulrahim H, Thistleton S, Adebajo AO, Shaw T, Edwards C, Wells A: Apremilast: a PDE4 inhibitor for the treatment of psoriatic arthritis. Expert Opin Pharmacother. 2015 May;16(7):1099-108. doi: 10.1517/14656566.2015.1034107. Epub 2015 Apr 11. [PubMed:25864487 ]
  4. Hoffmann M, Kumar G, Schafer P, Cedzik D, Capone L, Fong KL, Gu Z, Heller D, Feng H, Surapaneni S, Laskin O, Wu A: Disposition, metabolism and mass balance of [(14)C]apremilast following oral administration. Xenobiotica. 2011 Dec;41(12):1063-75. doi: 10.3109/00498254.2011.604745. Epub 2011 Aug 23. [PubMed:21859393 ]
External Links
ATC CodesL04AA32
AHFS CodesNot Available
PDB EntriesNot Available
FDA labelDownload (179 KB)
MSDSDownload (104 KB)
Clinical Trials
Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedNot AvailableHealthy Volunteers5
1CompletedTreatmentHealthy Volunteers1
1CompletedTreatmentPharmacokinetics1
1RecruitingBasic ScienceHealthy Volunteers1
1, 2CompletedTreatmentDiscoid Lupus Erythematosus (DLE)1
1, 2TerminatedTreatmentUveitis1
2CompletedTreatmentAnkylosing Spondylitis (AS)1
2CompletedTreatmentBehcet's Syndrome1
2CompletedTreatmentChronic Prostatitis With Chronic Pelvic Pain Syndrome / Prostatitis1
2CompletedTreatmentDermatitis, Allergic Contact / Moderate, refractory Atopic dermatitis1
2CompletedTreatmentDermatitis, Atopic Dermatitis1
2CompletedTreatmentErosive Osteoarthritis of the Hand1
2CompletedTreatmentErythematotelangiectatic Rosacea / Papulopustular Rosacea1
2CompletedTreatmentPlaque-Type Psoriasis / Psoriasis1
2CompletedTreatmentPlaque-Type Psoriasis / Psoriasis-Type Psoriasis1
2CompletedTreatmentPrurigo Nodularis1
2CompletedTreatmentPsoriasis2
2CompletedTreatmentPsoriasis / Psoriasis Arthropatica / Psoriatic Arthritis1
2CompletedTreatmentPsoriatic Arthritis1
2CompletedTreatmentRheumatoid Arthritis1
2CompletedTreatmentVulvodynia1
2Not Yet RecruitingTreatmentDermatitis Eczema / Dermatitis, Eczematous / Nummular Dermatitis / Nummular Eczema1
2RecruitingNot AvailableHidradenitis Suppurativa (HS)1
2RecruitingTreatmentHidradenitis Suppurativa (HS)1
2RecruitingTreatmentPsoriasis1
2RecruitingTreatmentUlcerative Colitis (UC)1
2RecruitingTreatmentVitiligo2
2TerminatedTreatmentAcne1
2TerminatedTreatmentRheumatoid Arthritis1
2Unknown StatusTreatmentLichen Planus (LP)1
2WithdrawnTreatmentChronic Plaque Psoriasis1
2WithdrawnTreatmentGout Acute1
2WithdrawnTreatmentRheumatoid Arthritis1
3Active Not RecruitingTreatmentAnkylosing Spondyloarthritis1
3Active Not RecruitingTreatmentBehcet's Syndrome1
3Active Not RecruitingTreatmentPlaque Psoriasis2
3Active Not RecruitingTreatmentPsoriatic Arthritis3
3CompletedTreatmentPsoriasis / Psoriatic Arthritis1
3CompletedTreatmentPsoriatic Arthritis2
3Not Yet RecruitingTreatmentPsoriasis1
4Active Not RecruitingTreatmentParapsoriasis1
4CompletedTreatmentPalmo-plantar Psoriasis1
4CompletedTreatmentPlaque Psoriasis1
4Not Yet RecruitingTreatmentPsoriasis / Psoriasis Vulgaris / Psoriatic Nail1
4RecruitingTreatmentCardiovascular Disease (CVD) / Psoriasis1
4RecruitingTreatmentPlaque Psoriasis1
4RecruitingTreatmentPsoriasis1
4WithdrawnTreatmentPsoriatic Arthritis1
Not AvailableActive Not RecruitingTreatmentAlopecia Areata (AA)1
Not AvailableCompletedNot AvailableModerate, refractory Atopic dermatitis1
Not AvailableRecruitingNot AvailablePsoriasis1
Not AvailableRecruitingNot AvailablePsoriasis / Psoriatic Arthritis1
Not AvailableTerminatedTreatmentDermatomyositis1
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
KitOral
Kit; tabletOral
TabletOral30 mg
Tablet, film coatedOral30 mg/1
Tablet, film coatedOral30 mg
PricesNot Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US6020358 No1998-10-302018-10-30Us
US6962940 No2003-03-192023-03-19Us
US7208516 No2003-03-192023-03-19Us
US7427638 No2004-11-172024-11-17Us
US7659302 No2003-03-192023-03-19Us
US7893101 No2003-12-092023-12-09Us
US8455536 No2003-03-192023-03-19Us
US8802717 No2003-03-192023-03-19Us
US9018243 No2003-03-192023-03-19Us
Properties
StateSolid
Experimental PropertiesNot Available
Predicted Properties
PropertyValueSource
Water Solubility0.0503 mg/mLALOGPS
logP1.79ALOGPS
logP1.39ChemAxon
logS-4ALOGPS
pKa (Strongest Acidic)4.83ChemAxon
pKa (Strongest Basic)-0.25ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count8ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area122.57 Å2ChemAxon
Rotatable Bond Count8ChemAxon
Refractivity119.85 m3·mol-1ChemAxon
Polarizability46.71 Å3ChemAxon
Number of Rings3ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET featuresNot Available
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as isoindolones. These are aromatic polycyclic compounds that an isoindole bearing a ketone.
KingdomOrganic compounds
Super ClassOrganoheterocyclic compounds
ClassIsoindoles and derivatives
Sub ClassIsoindolines
Direct ParentIsoindolones
Alternative ParentsIsoindoles / N-arylamides / Methoxybenzenes / Anisoles / Dicarboximides / Alkyl aryl ethers / Vinylogous amides / Sulfones / Acetamides / Tertiary amines
SubstituentsIsoindolone / Isoindole / Methoxybenzene / N-arylamide / Phenol ether / Anisole / Dicarboximide / Alkyl aryl ether / Benzenoid / Monocyclic benzene moiety
Molecular FrameworkAromatic heteropolycyclic compounds
External Descriptorsaromatic ether, sulfone, phthalimides, N-acetylarylamine (CHEBI:78540 )

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Ubiquitin protein ligase binding
Specific Function:
Hydrolyzes the second messenger cAMP, which is a key regulator of many important physiological processes.
Gene Name:
PDE4D
Uniprot ID:
Q08499
Molecular Weight:
91114.1 Da
References
  1. Baumer W, Hoppmann J, Rundfeldt C, Kietzmann M: Highly selective phosphodiesterase 4 inhibitors for the treatment of allergic skin diseases and psoriasis. Inflamm Allergy Drug Targets. 2007 Mar;6(1):17-26. [PubMed:17352685 ]
  2. Abdulrahim H, Thistleton S, Adebajo AO, Shaw T, Edwards C, Wells A: Apremilast: a PDE4 inhibitor for the treatment of psoriatic arthritis. Expert Opin Pharmacother. 2015 May;16(7):1099-108. doi: 10.1517/14656566.2015.1034107. Epub 2015 Apr 11. [PubMed:25864487 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Metal ion binding
Specific Function:
Hydrolyzes the second messenger cAMP, which is a key regulator of many important physiological processes.
Gene Name:
PDE4A
Uniprot ID:
P27815
Molecular Weight:
98142.155 Da
References
  1. Baumer W, Hoppmann J, Rundfeldt C, Kietzmann M: Highly selective phosphodiesterase 4 inhibitors for the treatment of allergic skin diseases and psoriasis. Inflamm Allergy Drug Targets. 2007 Mar;6(1):17-26. [PubMed:17352685 ]
  2. Abdulrahim H, Thistleton S, Adebajo AO, Shaw T, Edwards C, Wells A: Apremilast: a PDE4 inhibitor for the treatment of psoriatic arthritis. Expert Opin Pharmacother. 2015 May;16(7):1099-108. doi: 10.1517/14656566.2015.1034107. Epub 2015 Apr 11. [PubMed:25864487 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Metal ion binding
Specific Function:
Hydrolyzes the second messenger cAMP, which is a key regulator of many important physiological processes. May be involved in mediating central nervous system effects of therapeutic agents ranging from antidepressants to antiasthmatic and anti-inflammatory agents.
Gene Name:
PDE4B
Uniprot ID:
Q07343
Molecular Weight:
83342.695 Da
References
  1. Baumer W, Hoppmann J, Rundfeldt C, Kietzmann M: Highly selective phosphodiesterase 4 inhibitors for the treatment of allergic skin diseases and psoriasis. Inflamm Allergy Drug Targets. 2007 Mar;6(1):17-26. [PubMed:17352685 ]
  2. Abdulrahim H, Thistleton S, Adebajo AO, Shaw T, Edwards C, Wells A: Apremilast: a PDE4 inhibitor for the treatment of psoriatic arthritis. Expert Opin Pharmacother. 2015 May;16(7):1099-108. doi: 10.1517/14656566.2015.1034107. Epub 2015 Apr 11. [PubMed:25864487 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
General Function:
Tumor necrosis factor receptor binding
Specific Function:
Cytokine that binds to TNFRSF1A/TNFR1 and TNFRSF1B/TNFBR. It is mainly secreted by macrophages and can induce cell death of certain tumor cell lines. It is potent pyrogen causing fever by direct action or by stimulation of interleukin-1 secretion and is implicated in the induction of cachexia, Under certain conditions it can stimulate cell proliferation and induce cell differentiation. Impairs ...
Gene Name:
TNF
Uniprot ID:
P01375
Molecular Weight:
25644.15 Da
Kind
Protein
Organism
Human
Pharmacological action
unknown
General Function:
Kinase activator activity
Specific Function:
Produced by T-cells in response to antigenic or mitogenic stimulation, this protein is required for T-cell proliferation and other activities crucial to regulation of the immune response. Can stimulate B-cells, monocytes, lymphokine-activated killer cells, natural killer cells, and glioma cells.
Gene Name:
IL2
Uniprot ID:
P60568
Molecular Weight:
17627.52 Da
Kind
Protein
Organism
Human
Pharmacological action
unknown
General Function:
Interferon-gamma receptor binding
Specific Function:
Produced by lymphocytes activated by specific antigens or mitogens. IFN-gamma, in addition to having antiviral activity, has important immunoregulatory functions. It is a potent activator of macrophages, it has antiproliferative effects on transformed cells and it can potentiate the antiviral and antitumor effects of the type I interferons.
Gene Name:
IFNG
Uniprot ID:
P01579
Molecular Weight:
19348.165 Da
Kind
Protein
Organism
Human
Pharmacological action
unknown
General Function:
Tetrahydrobiopterin binding
Specific Function:
Produces nitric oxide (NO) which is implicated in vascular smooth muscle relaxation through a cGMP-mediated signal transduction pathway. NO mediates vascular endothelial growth factor (VEGF)-induced angiogenesis in coronary vessels and promotes blood clotting through the activation of platelets.Isoform eNOS13C: Lacks eNOS activity, dominant-negative form that may down-regulate eNOS activity by ...
Gene Name:
NOS3
Uniprot ID:
P29474
Molecular Weight:
133287.62 Da

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
no
Actions
substrate
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
References
  1. Hoffmann M, Kumar G, Schafer P, Cedzik D, Capone L, Fong KL, Gu Z, Heller D, Feng H, Surapaneni S, Laskin O, Wu A: Disposition, metabolism and mass balance of [(14)C]apremilast following oral administration. Xenobiotica. 2011 Dec;41(12):1063-75. doi: 10.3109/00498254.2011.604745. Epub 2011 Aug 23. [PubMed:21859393 ]
Drug created on November 18, 2007 11:26 / Updated on June 24, 2017 13:24