PDE4 inhibitor
Phosphodiesterase-4 inhibitor
- ↑ cAMP in inflammatory cells
- Anti-inflammatory in psoriasis, atopic dermatitis and COPD
- Nausea/emesis are central (PDE4D, area postrema); diarrhea and weight loss are GI
- Anti-inflammatory in COPD, psoriasis and atopic dermatitis
- Nausea, diarrhea, weight loss
- Psychiatric effects including depression
Drugs with this mechanism (7)
- Aminophylline — Soluble theophylline; a bronchodilator with a narrow therapeutic index.
- Apremilast — Oral PDE4 inhibitor for psoriasis; no lab monitoring required.
- Crisaborole — Boron-based topical PDE4 inhibitor for mild-to-moderate atopic dermatitis.
- Ensifentrine — Inhaled dual PDE3/PDE4 inhibitor adding bronchodilation and anti-inflammatory activity in COPD.
- Nerandomilast — Oral PDE4 inhibitor for idiopathic and progressive pulmonary fibrosis; diarrhea limits use.
- Roflumilast — Oral PDE4 inhibitor reducing COPD exacerbations.
- Theophylline — Old methylxanthine bronchodilator; narrow index, largely supplanted.
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