PDE4 inhibitors
- Increase intracellular cAMP by blocking PDE4
- Roflumilast: COPD exacerbation reduction
- Apremilast: psoriasis/PsA/Behçet
- Topical roflumilast: psoriasis/seb derm
- Diarrhea + weight loss are common systemic AEs
- Neuropsychiatric effects require awareness
- Uses differ markedly by formulation
Class at a glance
- Increase intracellular cAMP by blocking PDE4
Members / distinctions
- Roflumilast: COPD exacerbation reduction
- Apremilast: psoriasis/PsA/Behçet
Clinical role
- Topical roflumilast: psoriasis/seb derm
- Neuropsychiatric effects require awareness
- Uses differ markedly by formulation
Practical pearls
- Diarrhea + weight loss are common systemic AEs
Pearls
- Topical crisaborole and roflumilast cream also treat atopic dermatitis
- Crisaborole: application-site stinging and burning
- Roflumilast cream while breastfeeding: smallest area, avoid infant contact
Self-check
- Key risk with PDE4 inhibitors?
Diarrhea + weight loss are common systemic AEs. - Which systemic PDE4 inhibitor reduces COPD exacerbations?
Roflumilast.
Drugs in this class (3)
All drug classes · Open PDE4 inhibitors in the interactive console ↗