Phosphodiesterase-4 (PDE4) Inhibitors for Chronic Obstructive Pulmonary Disease (COPD)

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Phosphodiesterase-4 (PDE4) Inhibitors for Chronic Obstructive Pulmonary Disease (COPD)


Generic NameBrand Name
roflumilast Daliresp

Roflumilast is a pill you take every day to prevent COPD exacerbations.

How It Works

Roflumilast helps reduce the inflammation that can make breathing difficult for people who have COPD.

Why It Is Used

Roflumilast is used to prevent COPD flare-ups for people with COPD who have had problems with flare-ups in the past.

How Well It Works

Roflumilast improved lung function and reduced the number of COPD flare-ups in people with severe COPD.1, 2

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

In some people, the use of roflumilast results in mental health problems or makes mental health problems worse.

Call your doctor right away if you have:

  • Thoughts of suicide.
  • New or worse depression.
  • New or worse anxiety.
  • Trouble sleeping.

Common side effects of this medicine include:

  • Nausea and diarrhea.
  • Weight loss.
  • Headache.
  • Back pain.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

People who have certain liver problems should not use roflumilast.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.



  1. Roflumilast (Daliresp) for COPD (2011). Medical Letter on Drugs and Therapeutics, 53(1369): 59–60.
  2. Calverley PM, et al. (2009). Roflumilast in symptomatic chronic obstructive pulmonary disease: Two randomised clinical trials. Lancet, 374(9691): 685–694.


ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerKen Y. Yoneda, MD - Pulmonology
Last RevisedNovember 29, 2011

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