Pulmonology Book


Phosphodiesterase-4 Inhibitor

Aka: Phosphodiesterase-4 Inhibitor, Roflumilast, Daliresp
  1. See Also
    1. COPD Management
  2. Mechanism
    1. Phosphodiesterase-4 Inhibitor increases lung, intracellular cAMP
  3. Indications
    1. Severe, refractory COPD with frequent exacerbations
  4. Dosing
    1. Roflumilast 500 mcg orally daily ($250/month)
  5. 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
  6. Drug Interactions
    1. Cytochrome P450 3A4 Inhibitors
    2. Cytochrome P450 3A4 and Cytochrome P450 1A2 Inducers
  7. Efficacy
    1. NNT: 24 severe COPD patients to prevent 1 hospitalization per year
    2. Does not reduce mortality
  8. References
    1. (2015) Presc Lett 22(5): 27
    2. Field (2011) Circ Respir Pulm Med 5: 57–70 [PubMed]
Medication Costs
daliresp (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
DALIRESP 500 MCG TABLET $10.29 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

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