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{{Short description|Medication}} |
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{{Drugbox |
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{{Use dmy dates|date=July 2024}} |
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{{cs1 config |name-list-style=vanc |display-authors=6}} |
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{{Infobox drug |
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| Verifiedfields = changed |
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| Verifiedfields = changed |
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| Watchedfields = changed |
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| Watchedfields = changed |
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| verifiedrevid = 401043706 |
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| verifiedrevid = 464383196 |
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| image = Roflumilast structure.svg |
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| IUPAC_name = 3-(cyclopropylmethoxy)-N-(3,5-dichloropyridin-4-yl)-4-(difluoromethoxy)benzamide |
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| image = Roflumilast.png |
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| width = 240 |
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| width = 240 |
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| alt = |
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| image2 = Roflumilast ball-and-stick model.png |
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| width2 = 240 |
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| alt2 = |
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| caption = |
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<!--Clinical data--> |
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<!-- Clinical data --> |
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| tradename = |
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| pronounce = |
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| tradename = Daxas, Daliresp, Zoryve, others |
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| Drugs.com = {{drugs.com|CDI|roflumilast}} |
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| Drugs.com = {{drugs.com|monograph|roflumilast}} |
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| MedlinePlus = a611034 |
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| MedlinePlus = a611034 |
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| DailyMedID = Roflumilast |
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| licence_EU = Daxas |
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| pregnancy_AU = B3 |
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| licence_US = Roflumilast |
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| pregnancy_AU_comment = |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_US = C |
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| pregnancy_category = |
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| routes_of_administration = ], ] |
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| pregnancy_category = |
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| class = ] |
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| legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 --> |
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| ATC_prefix = R03 |
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| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| ATC_suffix = DX07 |
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| ATC_supplemental = {{ATC|D05|AX06}} |
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<!-- Legal status --> |
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| legal_AU = S4 |
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| legal_AU_comment = |
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| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F --> |
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| legal_BR_comment = |
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| legal_CA = Rx-only |
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| legal_CA_comment = <ref name="Daxas CA PI" /><ref>{{cite web | title=Zoryve Product information | website=] | date=7 November 2023 | url=https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=102624 | access-date=13 July 2024}}</ref> |
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| legal_DE = <!-- Anlage I, II, III or Unscheduled --> |
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| legal_DE_comment = |
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| legal_NZ = <!-- Class A, B, C --> |
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| legal_NZ_comment = |
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| legal_UK = POM |
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| legal_UK = POM |
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| legal_UK_comment = <ref name="Daxas SmPC" /> |
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| legal_US = Rx-only |
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| legal_US = Rx-only |
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| legal_US_comment = <ref name="Daliresp FDA label" /><ref name="Zoryve cream FDA label" /><ref name="Zoryve foam FDA label" /> |
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| legal_status = |
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| legal_EU = Rx-only |
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| routes_of_administration = Oral |
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| legal_EU_comment = <ref name="Daxas EPAR" /> |
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| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV --> |
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| legal_UN_comment = |
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| legal_status = <!-- For countries not listed above --> |
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<!--Pharmacokinetic data--> |
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<!-- Pharmacokinetic data --> |
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| bioavailability = 79%<ref name="Daliresp FDA label"/><ref name="Daxas SmPC"/><ref name=EMA/><ref name=MSR/> |
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| bioavailability = |
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| protein_bound = 99%<ref name="Daliresp FDA label"/><ref name="Daxas SmPC"/><ref name=EMA/><ref name=MSR/> |
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| protein_bound = |
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| metabolism = ] via ] & ]<ref name="Daliresp FDA label"/><ref name="Daxas SmPC"/><ref name=EMA/><ref name=MSR/> |
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| metabolism = |
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| metabolites = |
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| elimination_half-life = |
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| excretion = |
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| onset = |
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| elimination_half-life = 17 hours (30 hours )<ref name="Daliresp FDA label"/><ref name="Daxas SmPC"/><ref name=EMA/><ref name=MSR/> |
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| duration_of_action = |
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| excretion = Urine (70%)<ref name="Daliresp FDA label"/><ref name="Daxas SmPC"/><ref name=EMA/><ref name=MSR/> |
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<!--Identifiers--> |
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<!-- Identifiers --> |
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| CAS_number_Ref = {{cascite|correct|??}} |
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| CAS_number_Ref = {{cascite|changed|??}} |
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| CAS_number = <!-- blanked - oldvalue: 162401-32-3 --> |
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| CAS_number = 162401-32-3 |
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| ATC_prefix = R03 |
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| CAS_supplemental = |
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| ATC_suffix = DX07 |
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| PubChem = 449193 |
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| PubChem = 158787 |
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| IUPHAR_ligand = 6962 |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| DrugBank = |
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| DrugBank = DB01656 |
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| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} |
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| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} |
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| ChemSpiderID = 139677 |
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| ChemSpiderID = 395793 |
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| UNII_Ref = {{fdacite|changed|FDA}} |
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| UNII_Ref = {{fdacite|correct|FDA}} |
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| UNII = 0P6C6ZOP5U |
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| UNII = 0P6C6ZOP5U |
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| KEGG_Ref = |
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| KEGG = D05744 |
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| ChEBI_Ref = {{ebicite|changed|EBI}} |
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| ChEBI = 47657 |
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| ChEMBL_Ref = {{ebicite|changed|EBI}} |
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| ChEMBL_Ref = {{ebicite|changed|EBI}} |
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| ChEMBL = <!-- blanked - oldvalue: 193240 --> |
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| ChEMBL = 193240 |
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| NIAID_ChemDB = |
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| PDB_ligand = ROF |
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| synonyms = |
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<!-- Chemical and physical data --> |
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| IUPAC_name = 3-(Cyclopropylmethoxy)-''N''-(3,5-dichloropyridin-4-yl)-4-(difluoromethoxy)benzamide |
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| C=17 | H=14 | Cl=2 | F=2 | N=2 | O=3 |
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| C=17 | H=14 | Cl=2 | F=2 | N=2 | O=3 |
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| SMILES = C1CC1COC2=C(C=CC(=C2)C(=O)NC3=C(C=NC=C3Cl)Cl)OC(F)F |
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| molecular_weight = 403.207 g/mol |
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| StdInChI_Ref = {{stdinchicite|changed|chemspider}} |
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| smiles = Clc3c(N(OCC1CC1)C(=O)c2ccc(OC(F)F)cc2)c(Cl)cnc3 |
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| InChI = 1/C17H14Cl2F2N2O3/c18-13-7-22-8-14(19)15(13)23(25-9-10-1-2-10)16(24)11-3-5-12(6-4-11)26-17(20)21/h3-8,10,17H,1-2,9H2 |
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| StdInChI = 1S/C17H14Cl2F2N2O3/c18-11-6-22-7-12(19)15(11)23-16(24)10-3-4-13(26-17(20)21)14(5-10)25-8-9-1-2-9/h3-7,9,17H,1-2,8H2,(H,22,23,24) |
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| StdInChI_comment = |
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| InChIKey = IWONQDOIPBAXGV-UHFFFAOYAH |
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| StdInChI_Ref = {{stdinchicite|correct|chemspider}} |
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| StdInChIKey_Ref = {{stdinchicite|changed|chemspider}} |
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| StdInChIKey = MNDBXUUTURYVHR-UHFFFAOYSA-N |
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| StdInChI = 1S/C17H14Cl2F2N2O3/c18-13-7-22-8-14(19)15(13)23(25-9-10-1-2-10)16(24)11-3-5-12(6-4-11)26-17(20)21/h3-8,10,17H,1-2,9H2 |
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| density = |
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| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} |
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| density_notes = |
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| StdInChIKey = IWONQDOIPBAXGV-UHFFFAOYSA-N |
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| melting_point = |
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| melting_high = |
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| melting_notes = |
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| boiling_point = |
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| boiling_notes = |
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| solubility = |
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| sol_units = |
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| specific_rotation = |
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}} |
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}} |
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'''Roflumilast''', sold under the brand name '''Daxas''' among others, is a medication used for the treatment of ],<ref name="Daliresp FDA label" /> ],<ref name="Zoryve cream FDA label" /> ],<ref name="Zoryve foam FDA label" /> and ].<ref name="Zoryve cream FDA label" /> It acts as a selective, long-acting ] (PDE-4).<ref name="pmid18044684" /> It has ] effects.<ref name="pmid18044684">{{cite journal | vauthors = Boswell-Smith V, Spina D | title = PDE4 inhibitors as potential therapeutic agents in the treatment of COPD-focus on roflumilast | journal = International Journal of Chronic Obstructive Pulmonary Disease | volume = 2 | issue = 2 | pages = 121–9 | year = 2007 | pmid = 18044684 | pmc = 2695611 | url = }}</ref><ref name="pmid18307529">{{cite journal | vauthors = Herbert C, Hettiaratchi A, Webb DC, Thomas PS, Foster PS, Kumar RK | title = Suppression of cytokine expression by roflumilast and dexamethasone in a model of chronic asthma | journal = Clinical and Experimental Allergy | volume = 38 | issue = 5 | pages = 847–56 | date = May 2008 | pmid = 18307529 | doi = 10.1111/j.1365-2222.2008.02950.x | s2cid = 19050454 }}</ref><ref name="pmid18447606">{{cite journal | vauthors = Field SK | title = Roflumilast: an oral, once-daily selective PDE-4 inhibitor for the management of COPD and asthma | journal = Expert Opinion on Investigational Drugs | volume = 17 | issue = 5 | pages = 811–8 | date = May 2008 | pmid = 18447606 | doi = 10.1517/13543784.17.5.811 | s2cid = 73241684 }}</ref> |
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'''Roflumilast''' (trade names '''Daxas''', '''Daliresp''') is a drug which acts as a selective, long-acting ]. It has ] effects and is under development as an orally administered drug for the treatment of inflammatory conditions of the lungs such as ], and ] (COPD).<ref name="pmid18044684">{{cite journal |
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| last1 = Boswell-Smith | first1 = V |
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| last2 = Spina | first2 = D |
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| title = PDE4 inhibitors as potential therapeutic agents in the treatment of COPD-focus on roflumilast |
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| journal = ] |
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| volume = 2 |
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| issue = 2 |
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| pages = 121–9 |
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| year = 2007 |
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| pmid = 18044684 |
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| pmc = 2695611 |
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| url = http://www.dovepress.com/getfile.php?fileID=971 |
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| issn = 1178-2005 |
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}}</ref><ref name="pmid18307529">{{cite journal |
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| last1 = Herbert | first1 = C |
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| last2 = Hettiaratchi | first2 = A |
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| last3 = Webb | first3 = DC |
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| last4 = Thomas | first4 = PS |
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| last5 = Foster | first5 = PS |
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| last6 = Kumar | first6 = RK |
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| title = Suppression of cytokine expression by roflumilast and dexamethasone in a model of chronic asthma |
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| journal = ] |
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| volume = 38 |
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| issue = 5 |
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| pages = 847–56 |
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| year = 2008 |
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| month = May |
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| pmid = 18307529 |
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| doi = 10.1111/j.1365-2222.2008.02950.x |
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| issn = 1365-2222 |
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}}</ref><ref name="pmid18374614">{{cite journal |
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| last1 = Hohlfeld | first1 = JM |
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| last2 = Schoenfeld | first2 = K |
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| last3 = Lavae-Mokhtari | first3 = M |
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| last4 = Schaumann | first4 = F |
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| last5 = Mueller | first5 = M |
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| last6 = Bredenbroeker | first6 = D |
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| last7 = Krug | first7 = N |
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| last8 = Hermann | first8 = R |
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| title = Roflumilast attenuates pulmonary inflammation upon segmental endotoxin challenge in healthy subjects: a randomized placebo-controlled trial |
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| journal = ] |
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| volume = 21 |
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| issue = 4 |
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| pages = 616–23 |
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| year = 2008 |
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| month = August |
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| pmid = 18374614 |
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| doi = 10.1016/j.pupt.2008.02.002 |
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| issn = 1094-5539 |
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}}</ref><ref name="pmid18447606">{{cite journal |
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| last1 = Field | first1 = SK |
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| title = Roflumilast: an oral, once-daily selective PDE-4 inhibitor for the management of COPD and asthma |
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| journal = ] |
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| volume = 17 |
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| issue = 5 |
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| pages = 811–8 |
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| year = 2008 |
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| month = May |
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| pmid = 18447606 |
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| doi = 10.1517/13543784.17.5.811 |
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| issn = 1354-3784 |
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}}</ref> While roflumilast was found to be effective in clinical trials, it produced several dose-limiting side effects including ], ] and ], and development is continuing in an attempt to minimise the incidence of side effects while retaining clinical efficacy.<ref name="pmid18660825">{{cite journal |
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| last1 = Spina | first1 = D |
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| title = PDE4 inhibitors: current status |
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| journal = ] |
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| volume = 155 |
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| issue = 3 |
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| pages = 308–15 |
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| year = 2008 |
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| month = October |
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| pmid = 18660825 |
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| pmc = 2567892 |
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| doi = 10.1038/bjp.2008.307 |
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| issn = 1476-5381 |
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}}</ref> |
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It was approved for medical use in the European Union in 2010,<ref name="Daxas EPAR">{{cite web | title=Daxas EPAR | website=] | date=17 September 2018 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/daxas | access-date=28 September 2020 | archive-date=12 August 2020 | archive-url=https://web.archive.org/web/20200812193907/https://www.ema.europa.eu/en/medicines/human/EPAR/daxas | url-status=live }}</ref> in the United States in 2011,<ref name="Daliresp FDA label">{{cite web | title=Daliresp- roflumilast tablet | website=DailyMed | date=12 March 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c9a1d0a8-581f-4f91-a2b8-f419192d0ebf | access-date=28 September 2020 | archive-date=25 March 2021 | archive-url=https://web.archive.org/web/20210325081719/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c9a1d0a8-581f-4f91-a2b8-f419192d0ebf | url-status=live }}</ref> and in Canada in 2017.<ref name="Daxas CA PI">{{cite web | title=Daxas Product information | website=] | date=20 July 2017 | url=https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=84447 | access-date=13 July 2024}}</ref> It is available as a ].<ref>{{cite web | title=2022 First Generic Drug Approvals | website=U.S. ] (FDA) | date=3 March 2023 | url=https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/2022-first-generic-drug-approvals | archive-url=https://web.archive.org/web/20230630003602/https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/2022-first-generic-drug-approvals | archive-date=30 June 2023 | url-status=live | access-date=30 June 2023}}</ref> |
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In June 2010, Daxas was approved in the ] for severe ] associated with chronic bronchitis.<ref></ref> In March 2011, Daliresp gained FDA approval in the ] for reducing COPD exacerbations.<ref>{{cite press release |
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| url = http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm244989.htm |
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| title = FDA approves new drug to treat chronic obstructive pulmonary disease |
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| date = March 1, 2011 |
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| publisher = ] (FDA) |
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}}</ref> |
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==Chemical synthesis== |
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==Medical uses== |
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Roflumilast is ] for the treatment of severe chronic obstructive pulmonary disease (COPD),<ref name="Daliresp FDA label" /> plaque ],<ref name="Zoryve cream FDA label">{{cite web | title=Zoryve- roflumilast cream | website=DailyMed | date=16 August 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ec1bb0d1-f38a-4080-831a-68791d1d1fdb | access-date=21 January 2023 | archive-date=21 January 2023 | archive-url=https://web.archive.org/web/20230121062229/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ec1bb0d1-f38a-4080-831a-68791d1d1fdb | url-status=live }}</ref><ref>{{cite press release | title=FDA Approves Arcutis' Zoryve (Roflumilast) Cream 0.3% For the Treatment of Plaque Psoriasis in Individuals Age 12 and Older | publisher=Arcutis Biotherapeutics | via=GlobeNewswire | date=29 July 2022 | url=https://www.globenewswire.com/news-release/2022/07/29/2488966/0/en/FDA-Approves-Arcutis-ZORYVE-Roflumilast-Cream-0-3-For-the-Treatment-of-Plaque-Psoriasis-in-Individuals-Age-12-and-Older.html | access-date=1 August 2022 | archive-date=1 August 2022 | archive-url=https://web.archive.org/web/20220801114445/https://www.globenewswire.com/news-release/2022/07/29/2488966/0/en/FDA-Approves-Arcutis-ZORYVE-Roflumilast-Cream-0-3-For-the-Treatment-of-Plaque-Psoriasis-in-Individuals-Age-12-and-Older.html | url-status=live }}</ref> seborrheic dermatitis,<ref name="Zoryve foam FDA label">{{cite web | title=Zoryve- roflumilast aerosol, foam | website=DailyMed | date=20 December 2023 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f9e0b4a9-a227-4947-b00c-41fb18d16589 | access-date=13 July 2024}}</ref> and atopic dermatitis,<ref name="Zoryve cream FDA label" /><ref>{{cite web |title=FDA Approves Atopic Dermatitis Label Expansion for Arcutis' Zoryve Cream |url=https://www.biospace.com/article/fda-approves-atopic-dermatitis-label-expansion-for-arcutis-zoryve-topical-cream-/ |access-date=13 July 2024 |website=BioSpace }}</ref> |
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Chemical synthesis:<ref>Amschler, H.; 1998, {{US Patent|5712298}}.</ref> |
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It is used in the prevention of exacerbations (lung attacks) in severe chronic obstructive pulmonary disease (COPD).<ref name="Daxas SmPC">{{cite web | title=Daxas 250 micrograms tablets - Summary of Product Characteristics (SmPC) | website=(emc) | date=11 June 2020 | url=https://www.medicines.org.uk/emc/product/9162/smpc | access-date=28 September 2020 | archive-date=19 September 2020 | archive-url=https://web.archive.org/web/20200919164902/https://www.medicines.org.uk/emc/product/9162/smpc | url-status=live }}</ref><ref name="Daliresp FDA label" /><ref name="Daxas EPAR" /><ref name=EMA>{{cite web|title=Daliresp : EPAR - Product Information|work=European Medicines Agency|publisher=Takeda GmbH|date=26 September 2013|access-date=18 November 2013|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002398/WC500103078.pdf|archive-date=26 June 2016|archive-url=https://web.archive.org/web/20160626155812/http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002398/WC500103078.pdf|url-status=live}}</ref><ref name=MSR>{{cite web|title=roflumilast (Rx) - Daliresp|work=Medscape Reference|publisher=WebMD|access-date=18 November 2013|url=http://reference.medscape.com/drug/daliresp-roflumilast-999626|archive-date=12 September 2017|archive-url=https://web.archive.org/web/20170912145935/http://reference.medscape.com/drug/daliresp-roflumilast-999626|url-status=live}}</ref> |
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==See also== |
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==Adverse effects== |
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*] |
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Common (1–10% incidence) adverse effects include diarrhea, weight loss, nausea, headache, insomnia, decreased appetite, abdominal pain, rhinitis, sinusitis, urinary tract infection, and depression.<ref name="Daliresp FDA label"/><ref name="Daxas SmPC"/><ref name=EMA/><ref name=MSR/><ref name="pmid18660825">{{cite journal | vauthors = Spina D | title = PDE4 inhibitors: current status | journal = British Journal of Pharmacology | volume = 155 | issue = 3 | pages = 308–15 | date = October 2008 | pmid = 18660825 | pmc = 2567892 | doi = 10.1038/bjp.2008.307 }}</ref> |
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==References== |
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== Society and culture == |
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=== Legal status === |
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In June 2010, it was approved in the European Union for severe COPD associated with chronic bronchitis.<ref name="Daxas EPAR" /><ref>{{Cite web |url=http://www.genengnews.com/gen-news-highlights/nycomed-s-anti-inflammatory-gains-approval-in-eu-for-copd/81243622/ |title="Nycomed's Anti-Inflammatory Gains Approval in EU for COPD" |access-date=10 July 2010 |archive-date=24 August 2017 |archive-url=https://web.archive.org/web/20170824222207/http://www.genengnews.com/gen-news-highlights/nycomed-s-anti-inflammatory-gains-approval-in-eu-for-copd/81243622 |url-status=live }}</ref> In February 2011, it gained FDA approval in the United States for reducing COPD exacerbations.<ref>{{cite web | title=Drug Approval Package: Daliresp Tablets (roflumilast) NDA #022522 | website=U.S. ] (FDA) | date=24 December 1999 | url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022522Orig1s000TOC.cfm | access-date=28 September 2020 | archive-date=27 October 2020 | archive-url=https://web.archive.org/web/20201027013611/https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022522Orig1s000TOC.cfm | url-status=live }}</ref><ref>{{cite press release | url = https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm244989.htm | title = FDA approves new drug to treat chronic obstructive pulmonary disease | date = 1 March 2011 | publisher = U.S. ] (FDA) | access-date = 16 December 2019 | archive-date = 18 January 2017 | archive-url = https://web.archive.org/web/20170118091136/http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm244989.htm | url-status = dead }}</ref> |
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== References == |
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{{Reflist}} |
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== Further reading == |
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{{Phosphodiesterase inhibitors}} |
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* {{cite journal | vauthors = Hohlfeld JM, Schoenfeld K, Lavae-Mokhtari M, Schaumann F, Mueller M, Bredenbroeker D, Krug N, Hermann R | title = Roflumilast attenuates pulmonary inflammation upon segmental endotoxin challenge in healthy subjects: a randomized placebo-controlled trial | journal = Pulmonary Pharmacology & Therapeutics | volume = 21 | issue = 4 | pages = 616–23 | date = August 2008 | pmid = 18374614 | doi = 10.1016/j.pupt.2008.02.002 | url = https://hal.archives-ouvertes.fr/hal-00499153/file/PEER_stage2_10.1016%252Fj.pupt.2008.02.002.pdf | access-date = 24 June 2019 | archive-date = 28 August 2019 | archive-url = https://web.archive.org/web/20190828080728/https://hal.archives-ouvertes.fr/hal-00499153/file/PEER_stage2_10.1016%25252Fj.pupt.2008.02.002.pdf | url-status = live }} |
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{{Drugs for obstructive airway diseases}} |
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{{Phosphodiesterase inhibitors}} |
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{{AstraZeneca}} |
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{{Portal bar | Medicine}} |
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{{Authority control}} |
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==External links== |
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* {{Official website|http://www.daliresp.com/}} |
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* European Public Assessment Report (EPAR) |
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