Otezla weight loss is a documented side effect. In US trials, about 10 to 12 in 100 adults lost 5 to 10% of their body weight on Otezla (apremilast), compared with 3 to 5 in 100 on placebo. The label tells prescribers to monitor weight regularly and to consider stopping if the loss is unexplained or clinically significant. Never stop or change your dose without speaking to your prescriber.
Otezla is a prescription medicine, not a weight-loss product. It treats active psoriatic arthritis, plaque psoriasis and oral ulcers linked to Behçet’s disease. This page explains what the official label reports, so you can spot a problem early.
Otezla weight loss: what the label reports
The US prescribing information lists “weight decrease” as a warning. Weight loss of 5 to 10% was more common on Otezla than on placebo in both main adult trials.
| Condition in trial | 5 to 10% weight loss on Otezla | 5 to 10% weight loss on placebo |
|---|---|---|
| Psoriatic arthritis | 10% | 3.3% |
| Plaque psoriasis | 12% | 5% |
The label says patients “should have their weight monitored regularly.” If the loss is unexplained or significant, the prescriber should evaluate it and consider stopping. For children, the current label adds that height and weight growth should be closely monitored.
Why Otezla weight loss numbers differ by condition
You will see different percentages quoted online. They are not contradictions. Each comes from a different trial, population and time window.
First, the label reports 5 to 10% weight loss, not average loss. Second, plaque psoriasis trials counted 12% of patients and psoriatic arthritis trials counted 10%. Third, the Behçet’s trial ran only 12 weeks, so its figures are not comparable.
The label does not explain why weight falls. Digestive effects are one likely contributor, because diarrhoea and nausea are the most common reactions. That is an inference, not a proven mechanism. Treat any single “normal range” or “danger threshold” you read elsewhere with caution unless it cites the label.
Common Otezla side effects by condition
| Side effect | Psoriatic arthritis (Otezla vs placebo) | Plaque psoriasis (Otezla vs placebo) | Behçet’s (Otezla vs placebo) |
|---|---|---|---|
| Diarrhoea | 7.7% vs 1.6% | 17% vs 6% | 41.3% vs 20.4% |
| Nausea | 8.9% vs 3.1% | 17% vs 7% | 19.2% vs 10.7% |
| Headache | 5.9% vs 2.2% | 8% vs 4% (tension headache) | 14.4% vs 10.7% |
Most digestive effects appear in the first weeks. The label suggests a dose reduction or pause if diarrhoea, nausea or vomiting become severe. People aged 65 or older, and people taking medicines that cause fluid loss, face a higher risk of complications.
Otezla weight loss: what to do if you notice it
- Weigh yourself at the same time each week and note the trend.
- Tell your prescriber if you lose weight without trying to.
- Report severe or lasting diarrhoea, blood in stools, black stools, fever or severe stomach pain.
- Keep taking the medicine as prescribed until you have spoken to your doctor.
Do not use Otezla to lose weight. It is not approved for that purpose, and the weight change is a side effect to monitor.
Who needs extra care on Otezla
- Mood and mental health: Depression was reported in 1.3% of plaque psoriasis patients on Otezla versus 0.4% on placebo, and 1.0% versus 0.8% in psoriatic arthritis. Suicidal thoughts or behaviour occurred in 0.2% of psoriatic arthritis patients on Otezla and none on placebo. Tell your doctor about any history of depression, and ask family to watch for mood changes. If you have thoughts of suicide, call or text 988 in the US or Canada, call Samaritans on 116 123 in the UK, or call Lifeline on 13 11 14 in Australia.
- Kidney disease: In adults with severe kidney impairment (creatinine clearance below 30 mL/min), the maintenance dose drops to 30 mg once daily. Mild or moderate impairment needs no change.
- Other medicines: Strong enzyme inducers such as rifampin, phenobarbital, carbamazepine and phenytoin are not recommended with Otezla. Rifampin cut apremilast exposure by 72%.
- Pregnancy and breastfeeding: Human data are very limited and animal studies suggest a possible risk of fetal loss. No human milk data exist. Discuss both with your prescriber before use.
- Children: The current label covers children aged 6 and over who weigh at least 20 kg, for psoriatic arthritis and moderate-to-severe plaque psoriasis. Dosing depends on weight.
What is supported, overstated or not supported
| Claim you may see | Where it stands |
|---|---|
| Otezla can cause weight loss | Supported. It is a labelled warning. |
| Otezla is a weight-loss treatment | Not supported. It is not approved for weight loss. |
| Losing more than 14% is fatal | Not supported. The label gives no such threshold. Any significant loss needs medical review. |
| Otezla cures arthritis or psoriasis | Overstated. It treats symptoms while you take it and is not a cure. |
| Otezla is never used in children | Overstated. It is approved for children aged 6 and over at 20 kg or more for two conditions. |
| The daily maximum is 60 mg | Roughly right for adults at 30 mg twice daily. Doses differ with kidney function and weight in children. |
Frequently asked questions
In US trials, 10% of adults with psoriatic arthritis and 12% with plaque psoriasis lost 5 to 10% of body weight on Otezla. Individual results vary, and your prescriber should monitor your weight.
It can be if it is unexplained or significant. The label advises evaluating the loss and considering stopping the medicine. Contact your prescriber instead of stopping on your own.
The label does not state a cause. Diarrhoea and nausea are common and may contribute, but that is an inference, not a proven mechanism.
No. It is approved for psoriatic arthritis, plaque psoriasis and Behcet disease oral ulcers. Weight loss is a side effect, not a benefit.
In plaque psoriasis trials, diarrhoea affected 17% on Otezla versus 6% on placebo, and nausea 17% versus 7%. Most cases appear in the first weeks.
Yes. Depression was reported in 1.3% of plaque psoriasis patients on Otezla versus 0.4% on placebo. Tell your doctor about low mood or suicidal thoughts straight away.
Children aged 6 and over who weigh at least 20 kg can be prescribed it for psoriatic arthritis or moderate-to-severe plaque psoriasis. Growth is monitored closely.
Human data are very limited and animal studies suggest a possible risk of fetal loss. Speak to your prescriber before using it if you are pregnant or planning pregnancy.
Related reading
- How to maintain weight loss after reaching your goal
- Can you lose a pound a day?
- Does skipping meals help weight loss?
- Sustainable weight loss: habits that hold
Sources
This article is general information, not medical advice. Talk to your doctor, pharmacist or prescriber before starting, changing or stopping any medicine. Last reviewed and rewritten October 2026.
