Pharm

Roflumilast

search

Roflumilast, Daliresp, Phosphodiesterase-4 Inhibitor, PDE4 Inhibitor

  • See Also
  1. COPD Management
  • Mechanism
  1. Phosphodiesterase-4 Inhibitor increases lung, intracellular cAMP
  2. Bronchodilates and reduces inflammation
  • Indications
  1. Severe, refractory COPD with Chronic Bronchitis and frequent exacerbations
  • Medications
  1. Roflumilast Tablets: 250 mcg 500 mcg
  • Dosing
  1. Roflumilast 500 mcg orally daily
  • Adverse Effects
  1. Gastrointestinal (common, intolerable in 5%)
    1. Diarrhea
    2. Nausea
    3. Weight loss (may be >10%)
  2. Other common symptoms
    1. Headache
    2. Insomnia
  3. Psychiatric (3%)
    1. Suicidality
    2. Depression
    3. Anxiety
  • Safety
  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation
    1. Avoid in Lactation (is excreted in Breast Milk)
  • Drug Interactions
  1. Cytochrome P450 3A4 Inhibitors
  2. Cytochrome P450 3A4 and Cytochrome P450 1A2 Inducers
  • Efficacy
  1. NNT: 24 severe COPD patients to prevent 1 hospitalization per year
  2. Does not reduce mortality
  • Resources
  1. Roflumilast (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4d25f69c-58b7-4e2a-b835-4d0c76a83c7c
  • References
  1. (2015) Presc Lett 22(5): 27
  2. Field (2011) Circ Respir Pulm Med 5: 57–70 [PubMed]