Oral treatments for psoriasis: Varieties, applications, and potential adverse reactions
Psoriasis, an autoimmune disease that causes red, itchy, scaly, or sore skin, affects an estimated 25 percent of all people with the condition. For those with moderate or severe psoriasis, oral medications may be prescribed as a systemic treatment that works throughout the body. Here is a summary of common side effects and precautions for four oral medications used to treat psoriasis: methotrexate, cyclosporine, fumaric acid esters, and apremilast.
**1. Methotrexate**
Common side effects of methotrexate include gastrointestinal discomfort such as nausea, stomach upset, and mouth ulcers, as well as drowsiness, tiredness, dizziness, and muscle pain. Severe skin reactions, including toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, and photosensitivity leading to exaggerated sunburn reactions, are rare but serious. Methotrexate may also cause kidney problems and nerve problems such as seizures, confusion, tingling, or numbness.
Pregnant or breastfeeding individuals should avoid taking methotrexate due to a lack of research, and patients with blood disorders, kidney, lung, or brain disease, diabetes, or alcohol consumption should exercise caution.
**2. Cyclosporine**
Common side effects of cyclosporine include kidney toxicity, high blood pressure, increased risk of infections, tremors, headache, and gum hyperplasia. Regular monitoring of kidney function and blood pressure is essential, and the use of cyclosporine should be avoided in people with uncontrolled hypertension or infections.
**3. Fumaric Acid Esters (e.g., dimethyl fumarate)**
Common side effects of fumaric acid esters include flushing and redness, gastrointestinal symptoms such as diarrhea, nausea, and abdominal pain, lymphopenia (decreased white blood cells), and rarely, kidney issues. Regular blood tests to monitor lymphocyte counts are necessary, and patients should be advised about flushing and GI symptoms, which usually improve with time.
**4. Apremilast**
Common side effects of apremilast include diarrhea, nausea, headache, upper respiratory tract infections, and weight loss in some patients. Monitoring for depression or mood changes is necessary, as apremilast may cause or worsen depression. No routine lab monitoring is required, but weight and mood should be considered.
The information provided combines explicit details found regarding methotrexate side effects and precautions with established clinical knowledge for the other drugs. It is essential to consult detailed prescribing information or a healthcare provider for drug-specific monitoring protocols or interactions.
[1] National Psoriasis Foundation. (2021). Methotrexate. Retrieved from
- Some treatment seekers might find themselves naive about the potential side effects of methotrexate, a common treatment for psoriasis, which includes gastrointestinal discomfort, drowsiness, and muscle pain.
- Health-and-wellness personas, especially switchers, must be aware that using cyclosporine for psoriasis treatment comes with potential kidney toxicity and high blood pressure risks, necessitating regular monitoring of kidney function and blood pressure.
- Established psoriasis therapies and treatments, such as fumaric acid esters, may lead to common side effects like flushing, gastrointestinal symptoms, and decreased white blood cells, highlighting the importance of regular blood tests.
- Apremilast, another therapy for psoriasis, may induce side effects such as diarrhea, nausea, and headache, while also requiring mood monitoring due to the risk of depression or mood changes.
- Science-supported treatments for skin conditions like psoriasis and other medical conditions come with their own set of precautions and side effects; for instance, methotrexate should be avoided by pregnant or breastfeeding individuals and those with specific health issues.
- Patients with moderate or severe psoriasis, seeking treatment, must be thoroughly informed about the various therapies and treatments available, their associated side effects, and necessary precautions.
- Healthcare providers play a crucial role in explaining the potential risks and benefits of each treatment option to the treatment seekers, ensuring they make an informed decision when managing their health and wellness.
- The field of science is constantly evolving, and new therapies and treatments for medical conditions like psoriasis might emerge, providing improved options for those currently seeking solutions to manage their skin conditions more effectively in the future.
