Key takeaways:
There are several oral medications that help manage psoriatic arthritis (PsA). But injectable biologics are the first-choice treatment option for most people. Sotyktu (deucravacitinib), the newest oral PsA medication, may also be considered.
Oral conventional DMARDs are effective for mild-to-moderate PsA symptoms. NSAIDs and oral corticosteroids are helpful options for short-term relief from PsA flares.
Janus kinase (JAK) inhibitors are typically prescribed if injectable biologics aren’t effective or well tolerated. If biologics and JAK inhibitors aren’t an option, Otezla (apremilast) is an oral alternative.
Save on related medications
Psoriatic arthritis (PsA) is a type of arthritis that can affect people with psoriasis. It can cause long-term damage to joints. There’s no cure for PsA. But medications can help reduce pain and prevent joint damage.
The medications you take will typically depend on the severity of your symptoms. Some of these medications are injections, and others are pills. You may need to try a few different medications before finding one that works for you. Below we highlight some common oral medications prescribed for PsA and how they differ.
1. NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often recommended to help with mild PsA symptoms. Many NSAIDs are available over-the-counter (OTC) and are affordable. Stronger NSAIDs are also available with a prescription. Common NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve).
NSAIDs aren’t FDA-approved for PsA, so they won’t prevent or slow joint damage. But they can help reduce pain and swelling. This can make movement easier for people living with PsA, especially in the morning.
NSAIDs can cause stomach irritation, heart problems, and kidney problems, especially with long-term use. And they won’t treat moderate-to-severe PsA symptoms on their own.
2. Oral corticosteroids
Oral corticosteroids, or “steroids” for short, are typically prescribed for PsA flares. Prednisone is a common example.
Oral steroids can provide fast relief from pain and inflammation. But they have significant side effects if you take them long term. So steroids are typically prescribed as a short-term treatment when PsA symptoms flare up. They’re also sometimes used to help manage symptoms while you’re waiting for a disease-modifying antirheumatic drug (DMARD) to start working.
You’ll often follow a tapering schedule when taking a short course of steroids. This means you’ll slowly lower your dosage over time to help prevent withdrawal symptoms.
A delayed-release form of prednisone (formerly under the band name Rayos) is also commonly prescribed for inflammatory conditions such as PsA. It releases the medication 4 hours after you take it. The cells involved in inflammation are most active between 2 AM and 8 AM. So taking the delayed-release version at bedtime allows it to work its best during this key window.
3. Conventional DMARDs
Disease-modifying antirheumatic drugs (DMARDs) are medications that can help calm PsA symptoms by quieting down your immune system. They may also help slow disease progression and prevent joint damage. Most DMARDs aren’t FDA approved for PsA. So they’re prescribed off-label for this use.
Conventional DMARDs are often the first type of medication prescribed for mild-to-moderate PsA. Examples include:
Methotrexate (Trexall, Otrexup)
Sulfasalazine (Azulfidine)
Leflunomide (Arava)
Cyclosporine (Neoral)
Each DMARD has its own side effects and drug interactions to consider. Your prescriber will help you choose the best for your needs and lifestyle.
Methotrexate is the most commonly prescribed DMARD. You’ll typically take it once a week for PsA. You’ll also need to take folic acid along with it, since methotrexate can lower folic acid levels in your body. Common side effects include nausea, diarrhea, and mouth sores. More serious side effects, such as liver and lung problems, are also possible.
4. Xeljanz
Xeljanz (tofacitinib) belongs to a class of medications called janus kinase (JAK) inhibitors. JAK inhibitors block a set of enzymes (proteins) that contribute to inflammation in the body. They’re effective for PsA and other types of autoimmune conditions. But JAK inhibitors aren’t considered a first-choice treatment option for PsA in most cases.
Xeljanz is FDA approved to treat adults and children ages 2 and older for PsA. You’ll typically take it along with a conventional DMARD, such as leflunomide or methotrexate. The typical Xeljanz dosage for adults is 5 mg twice a day, while the dosage for children is based on body weight. It also comes in an extended-release form (Xeljanz XR) that’s a once-daily 11 mg dose. Your dose will be lower if you have liver or kidney problems, or if you’re taking certain other medications.
The time it takes for Xeljanz to work is different for each person. Studies show that some people feel relief from joint pain and swelling 2 weeks after starting Xeljanz. For others, it can take 3 months or longer.
Common Xeljanz side effects include:
Headache
Diarrhea
Increased blood pressure
Xeljanz also has several boxed warnings, the strongest warning the FDA gives to medications.
These include a greater risk of:
Serious infections
Cancer
Heart attack, stroke, or death
Blood clots, including in the lungs
5. Rinvoq
Rinvoq (upadacitinib) is another JAK inhibitor that’s approved to treat PsA among adults and children ages 2 and older. The typical Rinvoq dosage for PsA for adults is 15 mg once daily, while the children’s dosage is based on body weight.
Rinvoq and Xeljanz are considered similarly effective for PsA. But neither medication is a first-choice treatment option. Experts recommend trying biologic medications, such as Humira (adalimumab), first.
Common Rinvoq side effects include:
Upper respiratory infections
Nausea
Acne
Rinvoq also carries the same boxed warnings as Xeljanz.
6. Otezla
Otezla (apremilast) is a phosphodiesterase 4 (PDE4) inhibitor. It stops the production of an enzyme (protein) called PDE4 that’s involved in inflammation. Otezla is approved for adults and children ages 6 and older to treat PsA. But it’s only typically prescribed if DMARDs, biologics, or JAK inhibitors aren’t an option.
The typical Otezla dosage is 30 mg twice daily for adults and 20 mg twice daily for most children. In most cases, you’ll start with a lower dose and increase it over time to minimize side effects. It can take 4 months or longer for your symptoms to improve while taking Otezla.
Common Otezla side effects include:
Diarrhea
Nausea
Headache
Upper respiratory infections
Rare but serious side effects include severe diarrhea, vomiting, and nausea. Significant weight loss is also possible. Otezla may also cause new or worsening depression, including suicidal thoughts, for some people.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
7. Sotyktu
Sotyktu (deucravacitinib) is the newest oral medication and the first of its kind to be approved to treat adults living with PsA. Sotyktu is a tyrosine kinase 2 (TYK2) inhibitor that helps prevent the release of chemicals that contribute to inflammation.
Studies looked at Sotyktu as a treatment for both people with a history of biologic use and those who had never received a biologic. But it isn’t clear yet whether Sotyktu will be considered a first-choice treatment option or reserved for those unable to tolerate biologic therapy.
The typical Sotyktu dosage is 6 mg one daily. In studies, PsA symptoms showed measurable improvement after 16 weeks (4 months) of treatment.
Common Sotyktu side effects include:
Upper respiratory infections
Herpes simplex infections
Mouth ulcers
Acne
Folliculitis (inflamed hair follicles)
Increased blood creatine phosphokinase levels (can be a sign of muscle damage)
Rare but serious side effects include an increased risk of serious infections, increased risk of lymphoma and other cancers, and rhabdomyolysis (muscle breakdown). Sotyktu may also increase triglycerides and liver enzyme levels.
Injectable vs. oral medications for psoriatic arthritis
In most cases, PsA treatment starts with injectable biologic medications called TNF-alpha inhibitors. Examples include Humira, Enbrel (etanercept) and Remicade (infliximab). Current guidelines recommend these biologics as a first-choice treatment.
That being said, your prescriber may decide to start with oral medications, such as NSAIDs and conventional DMARDs. That’s because oral medications tend to be more affordable. NSAIDs and oral steroids are also often prescribed as needed for PsA flares.
Other oral PsA treatments, such as JAK inhibitors and Otezla, are typically prescribed if biologic treatments aren’t effective or you’re unable to tolerate them.
Keep in mind that PsA treatment isn’t one size fits all. You may have to try a few different medications before you find one that works for you. You may also need more than one medication to manage your symptoms.
Frequently asked questions
It depends. In some cases, your prescriber may recommend an oral conventional DMARD, such as methotrexate, along with an injectable biologic treatment. Conventional DMARDs are also often combined with oral JAK inhibitors. And oral medications such as NSAIDs and steroids are often prescribed along with other treatments for short-term relief when PsA flares occur.
But other combinations aren’t recommended. For example, you shouldn’t combine an oral JAK inhibitor with an injectable biologic. Your prescriber will let you know what combinations are safe for you.
Nonmedication options such as regular exercise, physical and occupational therapy, and an anti-inflammatory diet can help you manage PsA symptoms. But if your symptoms become more severe or widespread, these changes probably won’t be enough on their own.
Leaving PsA untreated can lead to permanent joint damage and other complications. So it’s best to see a specialist for guidance, rather than trying to manage PsA on your own without medication.
It depends. In some cases, your prescriber may recommend an oral conventional DMARD, such as methotrexate, along with an injectable biologic treatment. Conventional DMARDs are also often combined with oral JAK inhibitors. And oral medications such as NSAIDs and steroids are often prescribed along with other treatments for short-term relief when PsA flares occur.
But other combinations aren’t recommended. For example, you shouldn’t combine an oral JAK inhibitor with an injectable biologic. Your prescriber will let you know what combinations are safe for you.
Nonmedication options such as regular exercise, physical and occupational therapy, and an anti-inflammatory diet can help you manage PsA symptoms. But if your symptoms become more severe or widespread, these changes probably won’t be enough on their own.
Leaving PsA untreated can lead to permanent joint damage and other complications. So it’s best to see a specialist for guidance, rather than trying to manage PsA on your own without medication.
The bottom line
There are several oral medications that help manage psoriatic arthritis (PsA). But injectable biologics are the first-choice treatment option for most people.
Conventional DMARDs, such as methotrexate, are oral medications that are effective for mild to moderate PsA symptoms. They tend to be more affordable than other treatment options. Nonsteroidal anti-inflammatory drugs and oral corticosteroids are helpful options for short-term relief from PsA flares.
Janus kinase (JAK) inhibitors, such as Xeljanz (tofacitinib) and Rinvoq (upadacitinib), are typically prescribed if injectable biologics aren’t effective or well tolerated. Otezla (apremilast) is reserved for those who are unable to take or tolerate biologics or JAK inhibitors. Sotyktu (deucravacitinib) is the newest oral PsA medication. Your prescriber will help determine the best PsA treatment for your needs.
Why trust our experts?
References
Amgen, Inc. (2025). Otezla- apremilast tablet, film coated [package insert].
Arthritis Foundation. (n.d.). The first medications for PsA.
Bristol Myers Squibb. (2026). Sotyktu (deucravacitinib) tablets, for oral use [package insert].
Gossec, L., et al. (2024). EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 update. Annals of the Rheumatic Diseases.
INA Pharmaceuticals Inc. (2025). Prednisone delayed release- prednisone tablet, delayed release [package insert].
Kang, E. J., et al. (2015). Psoriatic arthritis: Latest treatments and their place in therapy. Therapeutic Advances in Chronic Disease.
Martin, G. (2023). Novel therapies in plaque psoriasis: A review of tyrosine kinase 2 inhibitors. Dermatology and Therapy.
McCormick, B. (2026). FDA approves first TYK2 inhibitor for adults with active psoriatic arthritis. AJMC.
MedlinePlus. (n.d.). Creatine kinase.
National Psoriasis Foundation. (2025). NSAIDS.
Onorati, H. (2025). Using a steroid to treat PsA? National Psoriasis Foundation.
Pfizer. (n.d.). Clinical trials | Xeljanz (tofacitinib) for PsA.
Paik, J., et al. (2019). Tofacitinib: A review in psoriatic arthritis. Drugs.
Schlosser, S. (2026). New oral TYK2 inhibitor approved for PsA. National Psoriasis Foundation.
Singh, J. A., et al. (2018). 2018 American College of Rheumatology / National Psoriasis Foundation guideline for the treatment of psoriatic arthritis. Arthritis & Rheumatology.
Steinzor, P. (2025). Deucravacitinib shows superiority in psoriatic arthritis phase 3 trial. AJMC.
U.S. Pharmaceuticals. (2026). Xeljanz [package insert].
Wilsdon, T. D., et al. (2019). Methotrexate for psoriatic arthritis. Cochrane Database of Systematic Reviews.
Zerilli, T., et al. (2015). Apremilast (Otezla): A new oral treatment for adults with psoriasis and psoriatic arthritis. Pharmacy and Therapeutics.
