Roflumilast (Daliresp) for Chronic Obstructive Pulmonary Disease

Underweight patients on roflumilast should be weighed regularly (about every four weeks) and treatment discontinued if clinically significant weight loss occurs.1,2,5 Blood levels of roflumilast may decrease when it is combined with strong cytochrome P450 (CYP450) inducers such as phenytoin (Dilantin) and carbamazepine (Tegretol), so these medications should not be used concomitantly. Roflumilast will decrease the number of exacerbations requiring oral corticosteroids in patients with severe COPD, a history of exacerbation, and bronchitic symptoms.1,4 In premarketing studies, adding roflumilast to long-acting beta2 agonists or short-acting anticholinergics decreased the average number of moderate or severe episodes requiring corticosteroid treatment by 0.23 per patient per year.2 It did not decrease the number of exacerbations requiring hospitalization. Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials.