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Rofaday

✅ Reduces lung inflammation
✅ Improves lung function
✅ Treats chronic bronchitis
✅ Decreases COPD exacerbations
✅ Enhances breathing capacity

Rofaday contains Roflumilast.

Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring  · Laatst beoordeeld: mei 2026

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⚡ Quick Answer — What is Rofaday?

Rofaday bevat roflumilast 500 mcg, an oral selective phosphodiesterase-4 (PDE4) inhibitor taken once daily for severe chronic obstructive pulmonary disease (COPD) with chronic bronchitis phenotype and frequent exacerbations. Roflumilast is anti-inflammatory rather than bronchodilator — it suppresses neutrophil and macrophage activation in airways, reducing exacerbation frequency by ~17% in landmark trials (M2-124, M2-125, REACT). It is added on top of optimal LAMA + LABA (± ICS) in patients with severe disease. Manufactured by Cipla.

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What Is Rofaday?

Rofaday is an oral PDE4 inhibitor for severe COPD. Roflumilast is the only PDE4 inhibitor licensed for COPD — sold internationally as Daxas (AstraZeneca) and Daliresp. It is a niche but well-evidenced add-on for the chronic bronchitis phenotype.

How Does Rofaday Work?

Phosphodiesterase-4 (PDE4) is the dominant cyclic AMP-degrading enzyme in inflammatory cells (neutrophils, macrophages, eosinophils, T-cells). Inhibiting PDE4 raises cyclic AMP in these cells, suppressing:

  • Neutrophil chemotaxis and degranulation in airways
  • Macrophage cytokine release (TNF-α, IL-8)
  • Airway smooth-muscle proliferation and fibroblast activation
  • Mucus hypersecretion and goblet-cell hyperplasia

The clinical result is a 15–17% reduction in COPD exacerbation rate when added to optimal inhaled therapy.

Toepassingen en Indicaties

  • Severe COPD (FEV1 <50% predicted) with chronic bronchitis and a history of exacerbations, on top of optimal LAMA + LABA (± ICS)
  • Frequent exacerbator phenotype with persistent productive cough

Rofaday Dosage

PatientDoseringFrequentie
Adults — start250 mcg for first 4 weeksEénmaal daags
Adults — maintenance500 mcgOnce daily, with or without food
LeverfunctiestoornisAvoid (Child-Pugh B/C)

Side Effects of Rofaday

  • Weight loss (averages 2–3 kg in trials — monitor; reverse if >5%)
  • Diarrhoea, nausea (commonest reason for discontinuation; usually settles after first 2–4 weeks)
  • Hoofdpijn
  • Insomnia, anxiety
  • Dyspepsia, abdominal pain
  • Mood changes — depression, anxiety; rarely suicidal ideation (warning)

Serious — stop and seek help:

  • Severe weight loss (>5% body weight)
  • New or worsening depression, suicidal thoughts
  • Severe persistent diarrhoea
  • Ernstige allergische reactie

Waarschuwingen en voorzorgsmaatregelen

  • Mood and behaviour: screen for depression before starting; warn patients/families to report new mood symptoms.
  • Weight loss: baseline and 3-monthly weight monitoring; if loss exceeds 5%, review or stop.
  • Leverfunctiestoornis: avoid in Child-Pugh B and C.
  • 4-week dose titration (250 mcg) reduces GI side effects and diarrhoea — most patients can then tolerate 500 mcg.
  • Not a bronchodilator — does not replace LAMA, LABA, or ICS.
  • Zwangerschap en borstvoeding: contraindicated.
  • Drug interactions: CYP3A4 inducers (rifampicin) reduce levels — avoid. Strong CYP1A2 inhibitors (fluvoxamine, ciprofloxacin) raise levels — caution.

Contra-indicaties

  • Hypersensitivity to roflumilast
  • Moderate-to-severe hepatic impairment (Child-Pugh B/C)
  • Zwangerschap

Geneesmiddelinteracties

Interacting drugEffectWat te doen
CYP3A4 inducers (rifampicin, phenobarbital, phenytoin, carbamazepine)Reduce roflumilast levels by 50%Vermijden
Strong CYP1A2 inhibitors (fluvoxamine, ciprofloxacin, enoxacin)Raise roflumilast levels — increase side effect riskCaution; consider lower dose
Oral contraceptives containing gestodeneModest increase in roflumilast levelsNo dose adjustment usually needed

Opslag

  • Store below 25°C in a cool, dry place away from direct sunlight.
  • Keep in original packaging until use to protect from moisture and light.
  • Do not use after the expiry date printed on the strip.
  • Keep out of reach of children.

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Veelgestelde vragen

When is Rofaday added?

For severe COPD (FEV1 <50% predicted) with chronic bronchitis phenotype and a history of frequent exacerbations on top of optimal LAMA + LABA (± ICS). Not for mild COPD or asthma.

Why must I start at 250 mcg?

A 4-week titration at 250 mcg dramatically reduces GI side effects (diarrhoea, nausea) — most patients can then move to the maintenance 500 mcg without intolerance.

How much does Rofaday reduce exacerbations?

About 15–17% reduction in moderate-to-severe COPD exacerbations in landmark trials (M2-124, M2-125, REACT). Most benefit seen in the chronic bronchitis with frequent exacerbator phenotype.

Will Rofaday make me lose weight?

Yes — average 2–3 kg in trials. Monitor weight at baseline and every 3 months. If loss exceeds 5%, review indication or stop.

What about mood changes?

Rare but reported. Screen for depression at baseline; counsel patient and family to report new mood symptoms, anxiety, or suicidal thoughts. Stop and review.

Is Rofaday a bronchodilator?

No — it is anti-inflammatory only. Continue your LAMA, LABA, and (where indicated) ICS inhalers.

Can I take Rofaday during pregnancy?

Contraindicated.

How does Rofaday compare to triple therapy?

Triple inhaler (Triohale) and Rofaday tackle COPD exacerbations through different mechanisms (bronchodilation + inflammation suppression vs PDE4-mediated anti-inflammation). Some patients benefit from both.

What are the most important drug interactions?

Rifampicin (and other CYP3A4 inducers) reduce Rofaday levels by half — avoid. Strong CYP1A2 inhibitors (fluvoxamine, ciprofloxacin) raise levels — caution.

Medical disclaimer: This page is educational and does not replace professional medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any inhaler or respiratory medication, especially if you have other medical conditions, take other prescriptions, are pregnant or breastfeeding, or are over 65.

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Sterkte

500 mcg

Hoeveelheid

30 Tabletten, 60 Tabletten, 90 Tabletten, 180 Tabletten

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