II. Mechanism
- Phosphodiesterase-4 Inhibitor increases lung, intracellular cAMP
III. Indications
- Severe, refractory COPD with frequent exacerbations
IV. Dosing
- Roflumilast 500 mcg orally daily ($250/month)
V. Adverse Effects
- Gastrointestinal (common, intolerable in 5%)
- Other common symptoms
- Psychiatric (3%)
- Suicidality
- Depression
- Anxiety
VI. Drug Interactions
- Cytochrome P450 3A4 Inhibitors
- Cytochrome P450 3A4 and Cytochrome P450 1A2 Inducers
VII. Efficacy
- NNT: 24 severe COPD patients to prevent 1 hospitalization per year
- Does not reduce mortality
VIII. References
- (2015) Presc Lett 22(5): 27
- Field (2011) Circ Respir Pulm Med 5: 57–70 [PubMed]
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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 |