Generic Name and Formulations:
Roflumilast 500mcg; tabs.
Indications for DALIRESP:
To reduce risk of COPD exacerbations in severe COPD patients with chronic bronchitis and a history of exacerbations.
Limitations Of use:
Not for the relief of acute bronchospasm.
500mcg once daily.
Moderate-to-severe liver impairment (Child-Pugh Class B or C).
Depression. Suicidal ideation. Monitor for new or worsening insomnia, anxiety, depression, suicidal thoughts, other mood changes; reevaluate if occur. Mild liver impairment (Child-Pugh Class A). Monitor weight regularly; consider discontinuing if unexplained or significant weight loss occurs. Pregnancy. Labor & delivery, nursing mothers: not recommended.
Concomitant strong CYP450 inducers (eg, rifampicin, phenobarbital, carbamazepine, phenytoin): not recommended. Potentiated by CYP3A4 and CYP1A2 inhibitors (eg, erythromycin, ketoconazole, fluvoxamine, enoxacin, cimetidine), and by oral contraceptives containing gestodene + ethinyl estradiol (possible increased adverse effects).
Selective phosphodiesterase 4 (PDE4) inhibitor.
Diarrhea, weight loss, nausea, headache, back pain, influenza, dizziness, decreased appetite; psychiatric effects (eg, insomnia, anxiety, depression).
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