Roflumilast (Daliresp) and Ketamine Therapy | Tovani Health
Daliresp (Roflumilast) — PDE4 inhibitor (COPD exacerbation reduction)
Verdict at Tovani Health
Compatible; the FDA suicidality/depression warning is intrinsic to roflumilast, not a KAP interaction.
Roflumilast and ketamine have no clinically significant pharmacologic interaction. The FDA warning for psychiatric reactions (suicidal ideation, depression, anxiety, insomnia) is real and intrinsic to PDE4 inhibition; we want to know about it for KAP planning so we can track mood changes against your roflumilast timeline, but there's no drug-interaction concern with ketamine.
If you take Daliresp regularly and are considering at-home ketamine therapy, the combination is generally safe at therapeutic doses. This page covers the brief pharmacologic context and what we do at intake.
How Daliresp interacts with ketamine
Roflumilast selectively inhibits PDE4, raising intracellular cAMP and reducing pro-inflammatory cytokines in COPD. The psychiatric side effects are dose-related and intrinsic. CYP3A4/CYP1A2 substrate; ketamine doesn't affect roflumilast levels meaningfully.
What we do at intake
Disclose dose and how long you have been on it. Tell us about any mood or sleep changes since starting.
Bottom line
Roflumilast and ketamine have no clinically significant pharmacologic interaction. The FDA warning for psychiatric reactions (suicidal ideation, depression, anxiety, insomnia) is real and intrinsic to PDE4 inhibition; we want to know about it for KAP planning so we can track mood changes against your roflumilast timeline, but there's no drug-interaction concern with ketamine.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Daliresp (Roflumilast) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 22, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.