Roflumilast is a selective phosphodiesterase-4 (PDE-4) inhibitor primarily used for maintenance therapy of chronic obstructive pulmonary disease (COPD). The medication should strictly follow the dosage plan, and special populations should pay attention to risks such as pregnancy contraindications and liver function monitoring.

1. Usage and dosage

(1) Standard dose: Oral administration of 500 μ g once daily, no need to take with meals.

(2) Dose adjustment: The initial treatment should start at 250 μ g once daily and increase to 500 μ g after 2 weeks to alleviate gastrointestinal reactions.

(3) Omission treatment: If one dose is missed, there is no need to supplement it, and the next administration will continue according to the original plan.

2. Medication for special populations

(1) Pregnancy: Animal studies have shown embryotoxicity, and it is contraindicated during pregnancy.

(2) Breastfeeding period: It is not clear whether the medication is secreted into the breast milk. It is recommended to stop breastfeeding during the treatment period.

(3) Children: The safety and efficacy of patients under 18 years old have not been established.

(4) Elderly: Patients aged 65 or older do not need to adjust their dosage, but close monitoring of their mental symptoms is necessary.

(5) Liver dysfunction: Patients with moderate liver injury (Child Pugh B) should reduce their dosage to 250 μ g once daily, while severe liver injury (Child Pugh C) should be avoided.

3. Medication precautions

(1) Psychological symptoms: May trigger depression or suicidal tendencies, and emotional changes should be closely monitored during medication.

(2) Weight monitoring: Common weight loss (≥ 5%), it is recommended to regularly monitor weight changes.

(3) Drug interactions: Combination with strong inducers of CYP3A4 (such as rifampicin) can reduce efficacy and should be avoided.