Daxas

Daxas is the brand name for roflumilast, a selective phosphodiesterase-4 (PDE-4) inhibitor used in adults to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in those with severe COPD associated with chronic bronchitis. It is not a bronchodilator and is intended to be used in addition to inhaled therapies such as long-acting bronchodilators and inhaled corticosteroids.

Mechanism of action and use: Roflumilast works by inhibiting PDE-4, which increases cyclic adenosine monophosphate (cAMP) levels in inflammatory and structural cells of the airways. This leads to a reduction in the release of inflammatory mediators and can help decrease COPD exacerbations in the appropriate patient population.

Administration and dosing: Daxas is taken orally once daily. The usual dose is 500 micrograms per day, taken with or without food. The drug is contraindicated in hepatic impairment and should be used with caution in patients with liver disease. It is not intended for relief of acute COPD symptoms and should be used as part of a broader COPD management plan.

Side effects and safety: Common adverse effects include nausea, diarrhea, weight loss, headache, and insomnia. Psychiatric events, such as depression and, in rare cases, suicidality, have been reported; patients should be monitored for mood changes and therapy discontinued if severe or persistent. Weight loss and reduced appetite can occur, requiring monitoring of nutritional status.

Interactions: Roflumilast is metabolized by CYP3A4 and CYP1A2. Concomitant use with strong inhibitors or inducers of these enzymes can alter roflumilast exposure, necessitating monitoring, dose adjustments, or avoidance of certain drug combinations. In some regions, Daxas is marketed alongside roflumilast under other brand names, such as Daliresp in the United States.