Mechanism
How Roflumilast works
Selectively inhibits phosphodiesterase-4, increasing intracellular cAMP in inflammatory cells and reducing airway inflammation.
← Respiratory Pharmacology
PDE4NBRC High Yield5/5 Importance
Roflumilast Respiratory Pharmacology Guide
The complete learning guide for class, mechanism, indications, adverse effects, kinetics, exam traps, and NBRC-style respiratory pharmacology.
Roflumilast is an oral PDE-4 inhibitor used to reduce COPD exacerbations, especially in patients with severe COPD and chronic bronchitis. It is not a bronchodilator and should not be used for acute symptom relief. Important adverse effects include diarrhea, weight loss, insomnia, and mood changes.
Clinical Pharmacology
Understand the medication before memorizing it
Start with mechanism, clinical pearls, onset, peak, duration, and deeper pharmacology explanations so the rest of the page has context.
Clinical Pearl
What to remember
The NBRC trap is selecting roflumilast for acute bronchospasm; it reduces exacerbations over time.
Kinetics
Onset, peak, and duration
1
Onset
Days to weeks
2
Peak
Variable
3
Duration
Maintenance therapy
Clinical Practice
How this medication is used at the bedside
Review common indications, expected adverse effects, contraindications, cautions, and safety issues in a clinically useful order.
Quick facts
- Subclass
- PDE-4 inhibitor
- NBRC importance
- 5/5
- Difficulty
- 4/5
- Brands
- Daliresp
5/5
NBRC importance
17
Study facts
0
Practice questions
2026
Updated
Common indications
- Severe COPD associated with chronic bronchitis
- Reduction of COPD exacerbation risk
- Add-on therapy for patients with frequent COPD exacerbations
Adverse effects
- Diarrhea
- Weight loss
- Nausea
- Headache
- Insomnia
- Anxiety
- Depression
Contraindications
- Moderate to severe hepatic impairment
- Hypersensitivity to roflumilast or formulation components
Cautions and safety issues
- Not a bronchodilator
- Not for acute bronchospasm
- Monitor weight loss
- Monitor mood changes or depression
- Use caution with psychiatric history
RT & NBRC Mastery
Respiratory therapy exam and bedside mastery
Move from reference knowledge into board-style reasoning, adaptive practice, common distractors, and high-yield clinical scenarios.
NBRC-style question
NBRC-style pharmacology review
A patient scenario involves severe copd with chronic bronchitis and frequent exacerbations. Which medication concept should the respiratory therapy student recognize?
High-yield answer
Roflumilast = COPD exacerbation reducer
Interactive practice
The Adaptive Exam Simulator
Use the complete guide on this page to learn the medication, then switch into the adaptive simulator to test yourself with scored practice, missed-concept review, and NBRC-style clinical reasoning.
ClassPractice
MechanismPractice
Clinical usePractice
Adverse effectsPractice
ScenarioPractice
Common Exam Traps
These are the answer choices, mechanisms, or medication classes most commonly confused with this medication on RT school and NBRC-style exams.
- Short-acting beta agonist
- Long-acting muscarinic antagonist
- Mucolytic
- Pulmonary vasodilator
- Rescue bronchodilator
High-Yield Clinical Scenarios
- Severe COPD with chronic bronchitis and frequent exacerbations
- Question distinguishing anti-inflammatory maintenance therapy from bronchodilator rescue therapy
- COPD patient with weight loss after medication initiation
Guidelines
Guideline-based clinical context
Connect medication facts to the larger respiratory care guidelines, disease-state recommendations, and clinical decision frameworks.
Study Tools
Practice, recall, and retention
Use mini cases, flashcards, FAQs, and related concepts to turn the medication page into a high-retention study experience.
Practice Questions
Complete question bank
Work through 0 board-style and clinical reasoning questions for this medication, organized by concept area.
Related study paths
Continue building pharmacology mastery
Use this medication page as a reference, then reinforce it with interactive practice and related PulmTools study resources.