Key takeaways

There is no direct interaction between Otezla (apremilast) and alcohol, but combining them is not recommended due to potential worsening of side effects.
Otezla treats psoriasis by calming the immune system to reduce pain and inflammation, but alcohol consumption can increase inflammation and worsen psoriasis symptoms.
Heavy alcohol use is linked to more severe psoriasis symptoms, particularly in women, and can affect psoriasis on a cellular level by impairing skin barrier function and increasing cytokine production.
While moderate to severe liver disease does not affect Otezla’s absorption, alcohol can increase the risk of liver disease, which is a concern for those on Otezla due to its metabolism in the liver.

Psoriasis can cause minor discomfort for some people, but for others, it’s a heavy burden that affects their overall quality of life. If you’re living with psoriasis, you might be prescribed a drug called Otezla (apremilast). This drug helps calm the immune system to decrease pain and inflammation. That way you can worry less about a flare-up and focus more on the things that matter, such as your work, family, and social life.

One concern you may have, however, is whether you can mix Otezla and alcohol. While there is no known interaction between alcohol and Otezla, there are some things you should consider before drinking alcohol while on Otezla. Read on to find out more about what could happen when you mix Otezla and alcohol.

What are the side effects of Otezla?

Otezla is a brand-name drug used to treat plaque psoriasis, among other conditions. It contains the active ingredient apremilast, which works as a phosphodiesterase-4 (PDE4) inhibitor. PDE4 is an enzyme that plays a role in the inflammatory processes in the body. Blocking this enzyme can help relieve inflammation associated with psoriasis.

The use of Otezla may cause some side effects. The most common side effects of Otezla include:

Diarrhea
Nausea
Headache
Upper respiratory tract infections

Otezla can also cause other side effects like fatigue, vomiting, indigestion, and stomach pain. In some cases, Otezla can cause severe nausea and diarrhea. It may also cause significant weight loss and depression in some people.

Can you mix Otezla and alcohol?

While there is no direct interaction between Otezla and alcohol, it is not recommended to drink alcohol while taking Otezla. Otezla and alcohol consumption could lead to worsened side effects.

Many people are aware that drinking alcohol alone can lead to nausea, vomiting, diarrhea, and indigestion. Mixing alcohol with Otezla could cause you to experience these effects on a more severe level.

Talk to your doctor or healthcare provider if you have concerns about Otezla and alcohol use. Your doctor may tell you that drinking in moderation with Otezla carries a lower risk of side effects than if you were to drink heavily with Otezla. But, you should still use caution when combining alcohol and Otezla if your physician says it’s okay to do so.

If you have psoriasis, you should already be watching your alcohol intake whether or not you’re taking Otezla. Alcohol is known to increase inflammation in the body, increase the risk of infections, and stimulate skin-cell turnover. These effects can cause worsened psoriasis symptoms.

Psoriasis and alcohol

If you have psoriasis, you may be living with symptoms like redness, irritation, and silver-like scales on the skin. Psoriasis flare-ups can be mildly annoying at best and extremely debilitating at worst. You might already know what causes these flare-ups. For most people with psoriasis, different factors like stress, smoking, and alcohol can be triggers.

A multicenter study of over 1,203 participants found a link between the severity of psoriasis symptoms and alcohol consumption. However, a stronger link was found in women; overconsumption of alcohol in women was associated with an increased psoriasis area severity index (PASI) score. A high PASI score indicates more severe symptoms than a low PASI score.

People who over-consume alcohol also tend to have psoriasis symptoms across more than one area of their body. Alcohol overconsumption is associated with severe psoriasis symptoms that can spread across the face, groin, and joint areas.

Other effects of alcohol on psoriasis

Alcohol can affect you on a cellular level in the skin and immune system. Animal studies have shown that alcohol use can impair the barrier function of the skin, which may increase the risk of infections. Alcohol can also increase the production of inflammatory chemicals called cytokines and stimulate the activity of certain skin cells called keratinocytes. These effects could lead to worsened symptoms of psoriasis, including inflammation.

Psoriasis not only affects physical health, but it can also affect your mental health. You might be struggling with anxiety or depression in addition to psoriasis. Without proper treatment, mental health problems can increase the likelihood of using alcohol as a coping mechanism. Around 10% of people with psoriasis may also be dealing with an ongoing alcohol use disorder.

Otezla, alcohol, and the liver

Alcohol consumption can increase the risk of liver disease over time. People who are heavy drinkers have a high risk of experiencing cirrhosis, or late-stage liver damage and scarring. In addition, studies have shown that there is a high prevalence of psoriasis in people with alcoholic and nonalcoholic liver disease.

Otezla is processed, or metabolized, in the liver. Because alcohol can also affect the liver over time, you should watch your alcohol intake while on treatment with Otezla. However, the FDA label indicates that moderate to severe liver disease doesn’t necessarily affect the absorption of Otezla.

Certain drugs can alter certain processes in the liver and should be avoided while taking Otezla. Drugs like rifampin and phenobarbital can increase the processing and elimination of Otezla from the body, leading to reduced effectiveness. Your doctor may recommend increasing or decreasing the dosage of your medications to ensure they work as they should and without causing problems.

Looking out for your health

It’s always best to get medical advice if you have concerns about medication side effects and alcohol. Talk to your doctor or healthcare provider before combining alcohol with your psoriasis medication.