Aprilast is a phosphodiesterase 4 (PDE4) inhibitor mainly used to treat psoriatic arthritis and plaque psoriasis. When using it, attention should be paid to adverse reactions such as diarrhea and depression, as well as medication adjustments for special populations.

1. Indications

(1) Psoriatic arthritis

Suitable for adult patients with active psoriatic arthritis, it can improve physical symptoms and inhibit the progression of structural damage.

(2) Plaque psoriasis

Suitable for adult patients with moderate to severe plaque psoriasis and candidates for phototherapy or systemic therapy.

2. Medication precautions

(1) General precautions

The dosage needs to be gradually titrated to reduce gastrointestinal adverse reactions, starting at 10mg once daily and reaching a maintenance dose of 30mg twice daily on the 6th day.

(2) Adverse reaction management

Common gastrointestinal reactions such as diarrhea and nausea usually occur in the early stages of treatment. If persistent diarrhea occurs, assess the risk of dehydration and consider reducing the dosage.

(3) Mental health monitoring

May exacerbate depression or trigger suicidal ideation, it is necessary to evaluate the history of mental illness before medication and closely monitor emotional changes during treatment.

(4) Medication for special populations

Due to limited data during pregnancy, women of childbearing age need contraception; Not recommended for use during lactation; Severe renal insufficiency requires a reduction to 30mg once daily.