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3.3.3 Phosphodiesterase type-4 inhibitors

Prescribing Notes

  • Roflumilast is recommended as an add-on to bronchodilator therapy for treating severe chronic obstructive pulmonary disease in adults with chronic bronchitis providing certain criteria are met. Roflumilast should only be started by a specialist in respiratory medicine. See NICE TA 461 for further details.
  • The MHRA Drug Safety Update January 2013 detailed that there is a risk of suicidal behaviour associated with the use of roflumilast and should be avoided in patients with previous or existing psychiatric symptoms and treatment should be discontinued if new or worsening symptoms are identified. Full details of the bulletin are available here.