Otezla Update after Failing First Attempt
Otezla update
This update is a bit long, sorry..
After not being able to get through the side effects of Otezla last July, I decided to give it another try. The following September I researched all the other available disease modifying drugs for someone with MS and PSA and realized my options were limited and it looked like Otezla would be the best for me if I could get through the side effects. So after reading a number of posts on the forums, I saw that others had titrated up slower by using double the starter packs and some we’re only taking one pill a day instead of two. They also took anti nausea medication. So I decided to follow this protocol and it worked with a few exceptions that are avoidable.
The two things that increase side effects for me and will make me sick are; serious interpersonal stress and wine.
We had some major problems with our tenants, scary problems..and that made the otezla side effects really surface big!
The second thing I have discovered is that my daily white wine habit of one to two glasses is affecting the side effects. One glass (8 oz max. approx.) seems fine, any more and I’m sick the next day, literally gagging or throwing up and a headache.
So I learned from my new colleagues on this forum some very helpful lessons; double the starter pack so titration is much slower, take an anti nausea med and something for headaches before they start and one will get through the side effects. I am taking two a day.
I have noticed less pain in my hands, and I’m feeling like it’s starting to work. It’s not affecting my ms, like I thought it was the first time I tried it. Anytime that I’m not well ms will act up a bit, but usually nothing too serious.
I’m very thankful for this forum and all of your help. Now to kick the white wine habit! Who would have thought that would be so hard when one drinks so little.. Anyone have a recommendation for dealcholized Chardonnay?
Thank you everyone for helping me on this journey. I’ll be posting on other topics re PSA.
Thank you so much for this wonderful update. I am delighted that you acquired the knowledge that you needed to move forward and do what is best for you. Good Luck kicking the white wine, even when you do not drink a lot. I think it is the lack of choice that gets to us. I am excited to hear more about how your PSA has been fairing.
- Clair ( Team Member)
Unfortunately, there is no such thing as a good de-alcoholized wine. But you really will be better for it if you give up the alcohol. Cold turkey. One glass of wine every once in awhile is one thing, but a glass (or two) a day is a habit. Make plans for doing something different at whatever time of day is your daily glass of wine. Sometimes it's the process that's harder to give up than the actual thing you want to give up. You can also just try curling up with a cup of herbal tea, something with chamomille for a relaxing sip. thank you Eric, appreciate this a lot
Hi
, I just wanted to chime in and echo Clair. Thanks so much for the update! It is wonderful that you're moving in the right direction. Unfortunately I don't have any recommendations for non-alcoholic chardonnay, but I have heard from some friends that there are some decent alcohol-free drinks that taste like the "real thing." Hopefully you can find an alternative that you can enjoy without the next day side effects! (And, if you do, please let us know!) We really appreciate you being a part of the community, sharing, and updating on how things are going. Sending you gentle hugs. -- Warmly, Christine (Team Member) 
Hi Christine I posted another comment to above about the white wine. I enjoy a glass now and again but it definitely does interact with Otezla and I have discovered over the last while to mix half wine and half sparkling water which doesn't make me feel unwell and 2/3 glasses is plenty. what a great idea! Now that you mention it, I have a very vague memory of my grandma doing this when I was a little girl. (Thanks for the memory!) It's great that you've found a way to enjoy a glass of wine now and then without feeling unwell after. Thanks so much for sharing it with (and all of us) here! -- Warmly, Christine (Team Member)
Out of curiosity, why did you settle on Otezla? I know some rheumatologists don't feel comfortable having patients on two concurrent biologic medications, and maybe you're not on something like Kesimpta for your MS anyway, but biologics for Psoriatic Disease really do appear to be the best way forward for many of us. The main downside of biologics is the body's ability to create antibodies against them over time, so low dose methotrexate is often prescribed in combination to help offset this effect. But, by all means, see how much abstinence from alcohol helps before giving up on the Otezla. I"m sure you will see a difference in this, as even moderate alcohol consumption causes malabsorption of nutrients like B vitamins, D, E, and C, as well as minerals like zinc and calcium. Alcohol metabolizes as acetaldehyde, and this makes it hard for your body to absorb nutrients, as well as altering how the body metabolizes medication. So there's a good chance that the simple act of giving up that daily glass of wine will net you big improvements.
