Roflumilast (brand name Daliresp) is an oral phosphodiesterase-4 (PDE4) inhibitor used to reduce the risk of COPD exacerbations in patients with severe COPD and chronic bronchitis who have frequent flare-ups. It works by decreasing airway inflammation, complementing bronchodilator therapy. Roflumilast is not a bronchodilator itself and is typically used as an add-on to inhaled treatments like LABA or LAMA. Common side effects include weight loss, diarrhea, nausea, and insomnia, and it may not be well-tolerated by all patients. It’s best suited for patients with ongoing exacerbations despite optimized inhaler use.