Indications for DALIRESP:
To reduce risk of COPD exacerbations in severe COPD patients with chronic bronchitis and a history of exacerbations. Limitations of use: not for the relief of acute bronchospasm.
Adult:
500mcg once daily.
Children:
Not established.
Pharmacological Class:
Selective phosphodiesterase 4 (PDE4) inhibitor.
Contraindications:
Moderate-to-severe liver impairment (Child-Pugh Class B or C).
Warnings/Precautions:
Depression. Suicidal ideation. Mild liver impairment (Child-Pugh Class A). Monitor for insomnia, anxiety, depression, suicidal ideation, other mood changes; reeva luate if occurs. Monitor weight regularly; consider discontinuing if unexplained or significant weight loss occurs. Pregnancy (Cat. C). Labor & delivery, nursing mothers: not recommended.
Interactions:
Concomitant strong CYP450 inducers (eg, rifampicin, phenobarbital, carbamazepine, phenytoin): not recommended. Potentiated by CYP3A4 and CYP1A2 inhibitors (eg, erythromycin, ketoconazole, fluvoxamine, enoxacin, cimetidine), and by oral contraceptives containing gestodene + ethinyl estradiol (possible increased adverse effects).
Adverse Reactions:
Diarrhea, weight decrease, nausea, headache, back pain, influenza, dizziness, decreased appetite; psychiatric effects (eg, insomnia, anxiety, depression).
How Supplied:
Tabs—30, 90
美国食品和药物管理局1日批准一种治疗慢性阻塞性肺病(慢阻肺)的药物上市,这一药物可用于减轻重度慢阻肺患者的咳嗽及呼吸道黏液过多症状。
美国药管局说,这一药物的通用名为罗氟司特(roflumilast),是一种磷酸二酯酶-4抑制剂,其安全性和有效性在两个三期临床试验中得到验证。共有1500多名40岁以上的慢阻肺患者参与试验,他们在接受罗氟司特治疗前12个月内病情均曾恶化。
美国药管局表示,服用罗氟司特的不良反应包括腹泻、恶心、失眠、背疼、食欲不振以及头晕眼花,故不建议18岁以下慢阻肺患者服用这种药物。
慢阻肺是一种不可逆的肺部疾病,常见症状包括呼吸困难或“透不过气来”,痰多以及慢性咳嗽。世界卫生组织指出,吸烟是慢阻肺最重要病因,长时间高强度接触烟尘、特定化学物质和室内外污染物也会增加患慢阻肺的危险。
世卫组织认为,慢阻肺可以预防,但目前无法治愈。治疗有助于减缓病情发展,但这一疾病通常在发病一段时间后逐渐恶化。其恶化期可能持续数周,病程加速,最终导致患者肺功能下降,死亡风险加大。
【产品特点】
★罗氟司特及其活性代谢产物(罗氟司特氮氧化物)均是磷酸二酯酶4(PDE4)的选择性抑制剂;
★ 全球范围内获准用于慢性阻塞性肺病治疗的第一个新型口服药物,较目前应用广泛的吸入剂具有更高的依从性;
★罗氟司特可以显著改善肺功能,减少 COPD急性加重期次数,特别是每日500 μg效果更明显.