Athletic Usage of Apremilast: Potential Side Effects, Hazards, and Security Concerns
Apremilast, marketed under the brand name Otezla, is a disease-modifying antirheumatic drug (DMARD) that has been approved by the Food and Drug Administration (FDA) to treat Psoriatic arthritis (PsA) [2]. This oral medication works by inhibiting the production of a particular enzyme called phosphodiesterase 4 (PDE4) [1].
While apremilast has been found to be safe and beneficial for people taking it for up to 5 years to treat PsA [1], there are potential side effects that could impact athletic performance.
Some of the side effects that might affect physical comfort, hydration, and concentration during athletic activities include diarrhea, nausea, and headaches (including tension headaches) [1][3]. Upper respiratory tract infections, another reported side effect, could reduce respiratory efficiency and endurance [1].
These side effects might lead to decreased energy levels, difficulty maintaining hydration, and reduced focus or stamina, all of which can negatively impact athletic performance. Severe allergic reactions, although less common, would require immediate medical attention and preclude athletic exertion [1].
The most relevant apremilast side effects potentially impacting athletic performance are:
- Diarrhea: may cause dehydration and electrolyte imbalance
- Nausea: can reduce appetite and energy availability
- Headaches/tension headaches: affect concentration and comfort
- Upper respiratory tract infections: impair breathing and endurance
No other specific side effects related to muscle function or cardiovascular capacity were identified in the reviewed information [1][2][3].
It's important to note that apremilast may interact with various treatments, including carbamazepine (Tegretol), phenobarbital (Luminal), phenytoin (Dilantin), rifampin (Rimactain), and St. John's wort [1].
Athletes may need to talk with their sports and healthcare teams to discuss how they may manage any potential weight loss, as apremilast may cause unintended weight loss in some people [3]. A 2019 study found that most people taking apremilast kept their weight within a 5% range of their starting weight [4].
Apremilast has been shown to be effective in reducing swollen and tender joints in people with PsA and relieving skin symptoms, including psoriasis on the scalp and nails [1]. Gastrointestinal symptoms usually appear within the first 2 weeks of starting apremilast and resolve within 4 weeks, even with continued use of the drug [1].
People with chronic kidney disease may need a lower dosage of 30 mg apremilast once a day [1].
Further research is necessary to confirm the findings about the potential effects of apremilast on mental health [5]. Apremilast may not be suitable for people who have depression or a history of mental health issues [6].
The FDA has warned of a possible risk of hypersensitivity from apremilast [1]. People should consult their healthcare provider for advice on the use of apremilast, especially if they have a history of mental health issues or are pregnant.
References:
[1] Apremilast (Otezla) [Summary Review]. (2020). Drugs.com. Retrieved from https://www.drugs.com/mtm/apremilast.html
[2] FDA approves first oral treatment for psoriatic arthritis. (2014, June 27). FDA. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-treatment-psoriatic-arthritis
[3] Apremilast (Otezla) Side Effects. (n.d.). Mayo Clinic. Retrieved from https://www.mayoclinic.org/drugs-supplements/apremilast-oral-route/side-effects/drg-20070776
[4] Long-term weight changes in patients with psoriatic arthritis treated with apremilast. (2019). The Journal of Rheumatology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764513/
[5] Apremilast and mental health. (2020, April 21). Psoriasis.org. Retrieved from https://www.psoriasis.org/about-psoriasis/treatment/apremilast-and-mental-health
[6] Apremilast: Important Safety Information. (n.d.). Otezla.com. Retrieved from https://www.otezla.com/important-safety-information
- The oral medication apremilast, brand name Otezla, is a disease-modifying antirheumatic drug (DMARD) approved by the FDA to treat Psoriatic arthritis (PsA).
- Inhibiting the production of phosphodiesterase 4 (PDE4), this medication is beneficial for people taking it to treat PsA for up to 5 years.
- Some potential side effects of apremilast may impact athletic performance, including diarrhea, nausea, headaches (including tension headaches), and upper respiratory tract infections.
- These side effects can lead to decreased energy levels, difficulty maintaining hydration, reduced focus or stamina, and may impair breathing and endurance, all of which can negatively impact athletic performance.
- The most relevant apremilast side effects potentially impacting athletic performance are diarrhea, nausea, headaches/tension headaches, and upper respiratory tract infections.
- While apremilast may cause unintended weight loss in some people, it has been shown to effectively reduce swollen and tender joints in people with PsA and relieve skin symptoms like psoriasis on the scalp and nails.
