Ambassador Program | Otezla® (apremilast)
Indications
Approved Uses Otezla® (apremilast) is a prescription medicine used for the treatment of:
  • Adult patients with plaque psoriasis for whom phototherapy or systemic therapy is appropriate. Read more >
Approved Uses Otezla® (apremilast) is a prescription medicine used for the treatment of:
  • Adult patients with plaque psoriasis for whom phototherapy or systemic therapy is appropriate.
  • Pediatric patients 6 years of age and older and weighing at least 20 kg with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy.
  • Adult patients with active psoriatic arthritis.
  • Adult patients with oral ulcers associated with Behçet’s Disease. Read less >

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Please continue with the form below if you:
  • Are currently taking Otezla
  • Are a US citizen
  • Began taking Otezla at 18 years of age or older

Once you complete the form below, a member of our team will reach out within 2 business days to get more details about you and your experience with Otezla. Or, you can give us a call at 1-855-697-3968.
We’re available from 8:30 AM – 6:00 PM ET, Monday – Friday.

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You can reach our team at 1-855-697-3968.
We’re available also to call 8:30 AM – 6:00 PM ET, Monday – Friday.

Patient Authorization

Step 1 Of 2
*Please make a selection
Consent to Health Data Collection & Processing for Marketing Purposes

I consent to Amgen collecting and processing my Health Data for the following purposes:

  • To conduct marketing activities, including market research activities, and to communicate with me regarding products and services that may be of interest to me.

Amgen uses the following for marketing purposes:

  • Health Data – my name, gender, date of birth, contact information and information relating to my health condition or treatment.

I understand that Amgen is seeking my consent to collect and process my Health Data to market products and services to me and that I do not have to give consent to the collection and processing of my Health Data for marketing purposes. I also understand that Amgen will not sell my Health Data to third parties. If I consent to the collection and processing of my Health Data for marketing purposes, I agree that Amgen may contact me for marketing purposes. Finally, I understand that I may withdraw my consent to the collection and processing of my Health Data for marketing purposes at any time using the method listed in the Additional Disclosures section below.

If you do not consent to the collection and processing of your health data for marketing purposes, you will not be able to receive marketing communications from Amgen. If you want to receive marketing communications from Amgen, select “I consent to the collection and processing of my Health Data for marketing purposes” If you do not consent to the collection and processing of your health data for marketing purposes, you will not be able to receive marketing communications from Amgen. If you want to receive marketing communications from Amgen, select “I consent to the collection and processing of my Health Data for marketing purposes”
Step 2 Of 2
*Please make a selection
Consent to Health Data Disclosure for Marketing Purposes

I consent to Amgen disclosing my Health Data to its data processors, contractors, and business partners for the following purposes:

  • To conduct marketing activities, including market research activities, and to communicate with me regarding products and services that may be of interest to me.

If I provide my consent, Amgen will disclose the following for such purposes:

  • Health Data – my name, gender, date of birth, contact information and information relating to my health condition or treatment.

I understand that Amgen is seeking my consent to disclose my Health Data to its data processors, contractors, and business partners to market products and services to me and that I do not have to give consent to disclosure of my Health Data for marketing purposes. I also understand that Amgen will not sell my Health Data to third parties. Finally, I understand that I may withdraw my consent to the disclosure of my Health Data for marketing purposes at any time using the method listed in the Additional Disclosures section below.

If you do not consent to the disclosure of your health data for marketing purposes, you will not be able to receive marketing communications from Amgen. If you want to receive marketing communications from Amgen, select “I consent to the disclosure of my Health Data for marketing purposes” If you do not consent to the disclosure of your health data for marketing purposes, you will not be able to receive marketing communications from Amgen. If you want to receive marketing communications from Amgen, select “I consent to the disclosure of my Health Data for marketing purposes”

IMPORTANT SAFETY INFORMATION

You must not take Otezla if you are allergic to apremilast or to any of the ingredients in Otezla.

Otezla can cause allergic reactions, sometimes severe. Stop using Otezla and call your healthcare provider or seek emergency help right away if you develop any of the following symptoms of a serious allergic reaction: trouble breathing or swallowing, raised bumps (hives), rash or itching, swelling of the face, lips, tongue, throat or arms.

Otezla can cause severe diarrhea, nausea, and vomiting, especially within the first few weeks of treatment. Use in elderly patients and the use of certain medications with Otezla appears to increase the risk of complications from having severe diarrhea, nausea, or vomiting. Tell your doctor if any of these conditions occur.

Otezla is associated with an increase in depression. In clinical studies, some patients reported depression, or suicidal behavior while taking Otezla. Some patients stopped taking Otezla due to depression. Before starting Otezla, tell your doctor if you have had feelings of depression, or suicidal thoughts or behavior. Be sure to tell your doctor if any of these symptoms or other mood changes develop or worsen during treatment with Otezla.

Some patients taking Otezla lost body weight. Your doctor should monitor your weight regularly. If unexplained or significant weight loss occurs, your doctor will decide if you should continue taking Otezla. For children 6 years of age or older, their doctor should monitor their growth (height and weight). If they are not growing or gaining weight as expected, their doctor will decide if they should continue taking Otezla.

Some medicines may make Otezla less effective and should not be taken with Otezla. Tell your doctor about all the medicines you take, including prescription and nonprescription medicines.

The most common side effects of Otezla include diarrhea, nausea, upper respiratory tract infection, tension headache, and headache. These are not all the possible side effects with Otezla. Ask your doctor about other potential side effects. Tell your doctor about any side effect that bothers you or does not go away.

Tell your doctor if you are pregnant, planning to become pregnant or planning to breastfeed.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-332-1088.

Please click here for the Full Prescribing Information for Otezla.

APPROVED USES

Otezla® (apremilast) is a prescription medicine used for the treatment of:

  • Adult patients with plaque psoriasis for whom phototherapy or systemic therapy is appropriate.
  • Pediatric patients 6 years of age and older and weighing at least 20 kg with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy.
  • Adult patients with active psoriatic arthritis.
  • Adult patients with oral ulcers associated with Behçet’s Disease.

IMPORTANT SAFETY INFORMATION

You must not take Otezla if you are allergic to apremilast or to any of the ingredients in Otezla.

Otezla can cause allergic reactions, sometimes severe. Stop using Otezla and call your healthcare provider or seek emergency help right away if you develop any of the following symptoms of a serious allergic reaction: trouble breathing or swallowing,