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Compare Xeljanz vs. Otezla

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Xeljanz (tofacitinib) and Otezla (apremilast) are both oral medications used to treat inflammatory conditions, but they belong to different drug classes and have distinct uses and side effects. Xeljanz is a Janus kinase (JAK) inhibitor that treats various types of arthritis and ulcerative colitis by blocking a protein involved in inflammation. In contrast, Otezla is a phosphodiesterase-4 (PDE-4) inhibitor that blocks a different protein to reduce inflammation associated with psoriatic arthritis, plaque psoriasis, and mouth sores from Behçet’s disease. Xeljanz can cause serious side effects like infections, heart problems, and blood clots, while Otezla is more likely to cause nausea, diarrhea, and weight loss. Both medications are not yet available as lower-cost generics. Xeljanz is available in both immediate-release and extended-release forms. And Otezla is only available in one formulation that requires a gradual dose increase to minimize stomach-related side effects.

Xeljanz (tofacitinib)
Otezla (apremilast)
Xeljanz (tofacitinib)
Otezla (apremilast)
Summary of Xeljanz vs. Otezla
Summary for JAK inhibitor
Prescription only
Xeljanz (tofacitinib) is a JAK inhibitor that treats different types of inflammatory problems (like psoriatic arthritis and rheumatoid arthritis) in adults. It's also used for certain kinds of arthritis in children ages 2 years and older. Xeljanz (tofacitinib) is taken by mouth once or twice per day. It's a good option for people who've tried other medications already, but the medication has side effects like a higher risk of infections, headache, and diarrhea. It also has serious risks, including heart problems and blood clots.
Summary for PDE-4 inhibitor
Prescription only
Otezla (apremilast) is a tablet that's taken by mouth. It's used to treat plaque psoriasis, psoriatic arthritis, and mouth sores from Behçet’s disease. This medication belongs to the drug class called phosphodiesterase-4 (PDE-4) inhibitors. You usually start Otezla (apremilast) at a low dose. Then, the dose is slowly raised over 5 days to lower the risk of side effects like nausea and diarrhea. This medication is available as a brand-name medication. Generic versions of apremilast likely won't be available until at least 2028.
Indications of Xeljanz vs. Otezla
Indications for

•Moderate-to-severe rheumatoid arthritis (RA) in adults

•Psoriatic arthritis (PsA) in adults

•Ankylosing spondylitis (AS) in adults

•Moderate-to-severe ulcerative colitis (UC) in adults

•Moderate-to-severe polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older - immediate-release tablets and liquid only

Indications for

•Active psoriatic arthritis in adults

•Moderate-to-severe plaque psoriasis in people age 6 years and older weighing at least 44 lbs

•Mouth sores from Behçet’s disease in adults
Pros and Cons of Xeljanz vs. Otezla
Pros and Const for JAK inhibitor
Pros

•Works well to treat many types of inflammatory problems

•Good option for people who haven't responded well to other treatments

•Available as immediate-release and extended-release tablets

•Liquid form available if you have trouble swallowing

Cons

•Potential to cause many serious side effects (e.g., certain cancers, serious infections, blood clots, stomach problems)

•Can raise cholesterol levels

•Not recommended to breastfeed while taking the medication

•Not completely clear whether it's safe to take during pregnancy

Pros and Const for PDE-4 inhibitor
Pros

•Taken by mouth

•Can take with or without food

•Dose adjustment available for people with severe kidney problems

Cons

•Dosing schedule can be confusing in the beginning

•Common to have nausea or diarrhea in the beginning

•Might not be a good option for people who've had depression or suicidal behavior
Common Side Effects of Xeljanz vs. Otezla
Common Side Effects for
Arthritis:

•Upper respiratory tract infection (4%)

•Nose and throat infection (3-4%)

•Diarrhea (3-4%)

•Headache (3-4%)

Ulcerative colitis:

•Nose and throat infection (10-14%)

•High cholesterol (5-9%)

•Headache (3-9%)

•Upper respiratory tract infection (6-7%)

•Muscle damage (3-7%)

•Rash (3-6%)

•Diarrhea (2-5%)

•Stomach infection (3-4%)

•Anemia (2-4%)

Note: The side effects you have might differ based on your dose and the reason why you're taking Xeljanz (tofacitinib).
Common Side Effects for

•Diarrhea (17%)

•Nausea (17%)

•Upper respiratory tract infection (e.g., common cold; 9%)

•Headache (6%)
Warnings of Xeljanz vs. Otezla
Common Side Effects for

•Serious infections

•Possible higher risk of death for people with rheumatoid arthritis

•Possible risk of cancer

•Risk of heart attack, stroke, and blood clots

•Stomach problems

•Allergic reactions

•Low blood cell counts

•Liver damage

Common Side Effects for

•Allergic reaction

•Diarrhea, nausea, and vomiting

•Depression

•Possible weight loss

•Drug interactions
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Compare Xeljanz vs. Otezla

Key takeaways

Summary of Xeljanz vs. Otezla

Indications of Xeljanz vs. Otezla

Pros and Cons of Xeljanz vs. Otezla

Common Side Effects of Xeljanz vs. Otezla

Warnings of Xeljanz vs. Otezla

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