II. Mechanism
- Phosphodiesterase-4 Inhibitor increases lung, intracellular cAMP
- Bronchodilates and reduces inflammation
III. Indications
- Severe, refractory COPD with Chronic Bronchitis and frequent exacerbations
IV. Medications
- Roflumilast Tablets: 250 mcg 500 mcg
V. Dosing
- Roflumilast 500 mcg orally daily
VI. Adverse Effects
- Gastrointestinal (common, intolerable in 5%)
- Other common symptoms
- Psychiatric (3%)
- Suicidality
- Depression
- Anxiety
VII. Safety
- Unknown safety in pregnancy
- Unknown safety in Lactation
- Avoid in Lactation (is excreted in Breast Milk)
VIII. Drug Interactions
- Cytochrome P450 3A4 Inhibitors
- Cytochrome P450 3A4 and Cytochrome P450 1A2 Inducers
IX. Efficacy
- NNT: 24 severe COPD patients to prevent 1 hospitalization per year
- Does not reduce mortality
X. Resources
XI. References
- (2015) Presc Lett 22(5): 27
- Field (2011) Circ Respir Pulm Med 5: 57–70 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| roflumilast (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ROFLUMILAST 250 MCG TABLET | Generic | $11.66 each |
| ROFLUMILAST 500 MCG TABLET | Generic | $2.31 each |
| daliresp (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DALIRESP 250 MCG TABLET | $13.35 each | |
| DALIRESP 500 MCG TABLET | Generic | $2.31 each |