Roflumilast

DEA Class; Rx

Common Brand Names; Daliresp, Zoryve

  • Phosphodiesterase-4 Enzyme Inhibitors

Phosphodiesterase-4 (PDE4) inhibitor that reduces inflammation via an intracellular action
Used orally to reduce COPD exacerbations in adults with severe COPD, chronic bronchitis, and history of COPD exacerbations; topically to treat plaque psoriasis, including intertriginous areas, in adults and children 12 years of age and older
GOLD guidelines recommend use with a long-acting bronchodilator

Indicated to reduce the risk of COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations

Indicated for plaque psoriasis, including intertriginous areas

Hypersensitivity

Moderate-to-severe liver impairment (Child-Pugh class B or C)

  • Diarrhea (9.5%)
  • Weight loss (7.5%)
  • Nausea (4.7%)
  • Headache (4.4%)
  • Back pain (3.2%)
  • Insomnia (2.4%)
  • Decreased appetite (2.1%)
  • Dizziness (2.1%)
  • Abdominal pain (1-2%)
  • Anxiety (1-2%)
  • Depression (1-2%)
  • Dyspepsia (1-2%)
  • Gastritis (1-2%)
  • Muscle spasms (1-2%)
  • Rhinitis (1-2%)
  • Sinusitis (1-2%)
  • Tremor (1-2%)
  • Urinary tract infection (1-2%)
  • Vomiting (1-2%)

Not indicated for relief of acute bronchospasm; drug is not bronchodilator

Psychiatric events, including suicidality, reported (monitor for emergence or worsening of insomnia, mood disturbance, or anxiety)

Monitor for clinically significant weight loss; this may be reversible upon discontinuance

Data are insufficient regarding drug-associated risk during pregnancy

Unknown if distributed in human breast milk; however, human IgG is known to be present in human milk

Adults

500 mcg/day PO; 1 application per day topically.

Geriatric

500 mcg/day PO; 1 application per day topically.

Adolescents

1 application per day topically; safety and efficacy have not been established for the oral tablet.

Children

12 years: 1 application per day topically; safety and efficacy have not been established for the oral tablet.
1 to 11 years: Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Roflumilast

tablet

  • 250mcg
  • 500mcg

topical cream

  • 0.3%

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