Roflumilast, a selective phosphodiesterase 4 inhibitor, is used to prevent chronic obstructive pulmonary disease (COPD) exacerbations.
It is usually prescribed to individuals who have severe COPD-related chronic bronchitis and a history of flare-ups. However, this medication is not used to relieve bronchospasm.
Roflumilast can only be purchased with a doctor’s prescription. It is usually sold in tablet form.
2 What to Know Before Using
Before you start treatment with roflumilast, you and your treating physician need to consider the associated pros and cons.
If you’ve had allergic reactions to roflumilast and similar drugs, your doctor may opt not to use it. You also need to tell him/her if you have allergies to food, drugs, preservatives, and other medications.
The effects of roflumilast in pediatric patients have not been adequately studied. However, studies in geriatric patients have shown that roflumilast works as indicated without being affected by age-related factors.
This medicine has a pregnancy category of C, which means that not enough research has been done on pregnant women. The same is true for breastfeeding mothers.
The risks and benefits should be weighed carefully. Roflumilast also interacts with other medications. That’s why you should give your physician a list of your current medications.
Concomitant use of riociguat is not recommended. Your doctor might choose not to use roflumilast or stop riociguat.
The following medications should not be taken concomitantly with roflumilast but might be necessary for certain situations:
In such cases, your healthcare provider may adjustment the dose and timing of either or both medications.
Simultaneous use of cimetidine, enoxacin, erythromycin, Ethinyl estradiol, fluvoxamine, gestodene, and ketoconazole can increase the risk of side effects.
Follow your doctor’s instructions regarding dietary restrictions if any. Certain medical conditions can also influence the efficacy of roflumilast.
It should be used with caution in individuals with a history of depression and mental illness because it can make these conditions worse.
Roflumilast should not be given to patients with moderate to severe liver disease.
Take roflumilast as directed by your physician. Take it within the prescribed treatment duration and at the indicated time. Do not change your dose without consulting your physician.
You can take roflumilast with or without food. Be informed and read the medication guide. If you need further clarifications, check with your doctor.
The dosage of roflumilast, treatment duration, and frequency will depend on your condition, so it’s different for everyone. That’s why you should stick to the instructions.
For COPD prevention in adult patients, the recommended dose is 500 mcg daily with or without food. For children, the dose, timing, and treatment duration will be determined by the treating physician.
If you forget a dose, take it immediately. However, you should skip it if it’s almost time to take the next dose. You should never double dose. Keep roflumilast in a safe place where children cannot reach.
Make sure the container is sealed. Do not expose roflumilast to extreme temperature. Do not take expired medications. You can ask for advice on how to dispose of outdated medicines.
4 Precautions to Take
You need to go to your follow-up appointments so that your doctor can assess your progress. He/she needs to make sure roflumilast is working well. If not, he/she will have to consider other medications.
As mentioned earlier, roflumilast is used to prevent COPD exacerbations. However, it should not be used to treat ongoing exacerbations and acute bronchospasm. You should use an inhaled medication for such cases.
If you do not have one, consult your healthcare provider. Roflumilast can also psychiatric reactions. If you have a history of depression or mental illness, you and your caregiver should watch out for mood changes, depression, insomnia and suicidal tendencies.
Consult your treating physician right away if you notice an increase in those symptoms. Roflumilast can also cause weight loss. You and your healthcare provider will have to monitor your weight.
If sudden or unusual weight loss is noticed, further evaluation may be warranted. In such cases, roflumilast may be stopped. Check with your doctor first before you take other prescription or non-prescription medicines and supplements.
5 Potential Side Effects
There are several side effects and adverse reactions associated with roflumilast treatment.
Common adverse reactions include diarrhea, nausea, headache, insomnia, decreased appetite, abdominal pain, rhinitis, urinary tract infection, sinusitis, and depression. A commonly reported side effect that needs medical attention includes unexplained weight loss.
Less common ones that need to be reported to your doctor right away include chills, cough, fear, nervousness, fever, irritability, joint pain, muscle pain, runny nose, shivering, sore throat, sweating, unusual tiredness or weakness, and vomiting.
There are also side effects that do not need treatment. These can include the following: back pain, bladder pain, burning sensation in the chest/stomach, painful urination, dizziness, indigestion, muscle spasm, shortness of breath, sneezing, stomach upset, wheezing, and trembling of the hands or feet.
If you experience other unusual effects of roflumilast, get in touch with your doctor right away.
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