Mestla (Apremilast)

Apremilast works by selectively inhibiting the enzyme phosphodiesterase‑4 (PDE4). This inhibition raises intracellular cyclic AMP levels, which in turn down‑regulates the production of pro‑inflammatory cytokines such as tumor necrosis factor‑α, interleukin‑17 and interleukin‑23. By dampening these inflammatory signals, apremilast reduces the immune‑mediated processes that drive skin plaque formation and joint inflammation in psoriasis and psoriatic arthritis.

The dose is individualized by the prescribing healthcare professional. Typically, treatment starts with a titration period to improve tolerability, followed by a maintenance dose, but the exact amount, frequency and duration are determined based on the patient’s condition, response and any comorbidities. Patients should follow the prescriber’s instructions and not adjust the dose on their own.

Safety of apremilast in pregnancy and lactation has not been established. The product is classified with an unknown pregnancy category, and animal studies have shown potential risks. Therefore, it should only be used during pregnancy or while breastfeeding if the potential benefit justifies the possible risk to the fetus or infant, and after a thorough discussion with a healthcare provider.

To order Mestla, submit an enquiry on the product page at gnhindia.com, specifying the required quantity. GNH India works with hospitals, pharmacies and procurement teams worldwide, and will request verification of trade or institutional credentials. Once eligibility is confirmed, the sales team provides pricing, availability, shipping details—including any cold‑chain requirements if applicable—and assists with the necessary import documentation.

Mestla offers an oral, non‑biologic systemic option, whereas many alternatives such as biologic agents (e.g., secukinumab, adalimumab) are administered by injection or infusion. Compared with traditional systemic drugs like methotrexate, apremilast has a different safety profile, with fewer laboratory monitoring requirements but a higher incidence of gastrointestinal side effects. Choice of therapy depends on disease severity, patient preference, comorbidities and physician assessment.

Mestla tablets should be stored at ambient temperature, below 25 °C, in the original blister pack to protect them from moisture and light. Keep the container tightly closed and out of reach of children. Do not store in bathrooms or near heat sources. If a tablet becomes damaged or discolored, discard it according to local regulations.

Mestla is taken orally with a glass of water, preferably with food to reduce gastrointestinal discomfort. The tablets should be swallowed whole and not split, chewed, or crushed unless specifically instructed by a healthcare professional. Dosing schedules, including any titration steps, are determined by the prescriber and should be followed exactly as prescribed.

The most serious risks include the potential for depression, suicidal thoughts or behavior, which require immediate medical evaluation, and severe allergic reactions such as anaphylaxis. Pancreatitis, although rare, is another critical concern that presents with persistent abdominal pain and elevated enzymes. Patients should be educated to report any mood changes, severe rash, breathing difficulty or abdominal symptoms promptly.

Mestla should not be used by individuals with known hypersensitivity to apremilast or any of the tablet excipients. It is also contraindicated in patients with severe hepatic impairment and should be avoided in those with uncontrolled depression or a history of suicidal behavior. Pregnant or breastfeeding women should only use it when clearly needed, after a risk‑benefit discussion with their clinician.