Daliresp (Roflumilast)
Indication: Reduce risk of COPD exacerbations
Drug Class: Selective Phosphodiesterase-4 (PDE4) Inhibitor
GOLD 2019 Guideline Recommendations:
Initiate if severe COPD with exacerbations while adherent to regimen:
- Triple Therapy (LAMA/LABA/ICS)
- Dual Bronchodilators (LAMA/LABA) & Eosinophils < 100
Dosing: 250 mcg tablet once daily for 4 weeks, then increase to 500 mcg once daily
The 2019 COPD GOLD guidelines were released a few weeks ago and there have been a few changes in recommendations for the treatment of COPD. Roflumilast is a PDE4 inhibitor that is indicated for severe COPD with chronic bronchitis, specifically to reduce the risk of future exacerbations. 2019 GOLD guidelines recommend the use of this medication in 2 instances. First if patient is already on triple therapy inhalation regimen and has an exacerbation. Second if patient is on dual bronchodilators with eosinophils <100 and has an exacerbation. This second group is important since it eosinophils are low, adding an ICS likely won’t have any clinical effect.
Jarred Prudencio, PharmD - https://www.instagram.com/ambcarerx
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