Arformoterol

Arformoterol – or Brovana, its US brand name – is a drug that belongs to the bronchodilator family of medication.

Overview

Arformoterol is inhaled through the mouth via a nebulizer machine in order to open up the bronchial tubes and prevent blockages commonly associated with breathing-related conditions. It is most commonly used to treat COPD, and associated symptoms such as difficulty breathing, tightness in the chest, wheezing or coughing.

The drug is usually prescribed for daily use and, when used correctly, can reduce the severity of COPD. It does not, however, relieve the symptoms of a COPD attack if it has already begun. It is supplied in a liquid form in sachets and is then inserted into a nebulizer device, which turns the liquid into a mist. That mist is then inhaled through a mouthpiece).

COPD – the main condition for which Arformoterol is prescribed – is a type of lung disease that results in breathing problems and poor airflow to the lungs. The disease is a long-term condition that usually develops slowly over time. As COPD worsens, sufferers will find that everyday tasks, such as getting dressed, walking, household chores etc., become increasingly hard work. Long-term sufferers will experience shortness of breath and difficulty breathing when carrying out even the simplest of tasks.

COPD has a range of causes, but the most common is from prolonged tobacco inhalation. Other factors may contribute to a person’s vulnerability to COPD, such as genetics, air pollution, poor ventilation and other irritants. It is one of the main causes of death among long-term smokers.

COPD is preventable by making a choice to cut out the risk factors involved. Quitting smoking, as well as improving air quality and ventilation, before the disease has begun will decrease the chances of contraction. However, although the condition can be treated and brought down to a manageable level, it cannot be cured. There are instead long-term medications that can help to manage the disease.

Arformoterol is often used to treat COPD on a long-term basis and is usually recommended as part of a holistic treatment for COPD, with other elements including improved lifestyle and respiratory rehabilitation.

Conditions treated

  • Chronic obstructive pulmonary disease (COPD)
  • Respiratory problems

Type of medicine

  • Inhalation

Side effects

There are various side effects – and some are more common than others – which can be experienced by patients taking Arformoterol. Many of the side effects are nothing to worry about and are usually experienced to some degree by patients that are new to the drug. If symptoms persist, or if you find you are experiencing any of the more severe side effects, you should always contact your doctor for advice. Prolonged side effects may mean that the medication is not the right approach for you and may mean that you are prescribed a different drug.

Common side effects are:

  • headache
  • sleep problems such as insomnia or irregular sleep patterns
  • nausea, vomiting, diarrhea
  • general feeling of weakness
  • fever and sore throat
  • hoarseness of the voice
  • blocked up of sniffly nose
  • leg cramps

You should get in touch with your doctor straight away if you experience any of the following, more serious side effects after taking this medication:

  • bronchospasm – severe coughing, wheezing, difficulty breathing, tightness of the chest
  • pain in the chest, strong or pounding heart beat, tremors, feeling of restlessness
  • shortage of breath, difficulty catching breath
  • weight gain – sudden
  • swelling
  • mouth sores, including mouth ulcers – inside the mouth or on the lips
  • increase thirstiness or dry mouth syndrome
  • nausea or vomiting
  • light-headedness
  • fainting
  • muscle pain, weak feeling in the muscles
  • Confusion or forgetfulness
  • Increased urge to urinate

Dosage

Arformoterol is usually supplied in 15 mcg/2 strength and is typically inhaled by nebulation (a device or machine that turns your liquid medication into an inhalable mist) two times per day, once in the morning and once in the evening.

The maximum daily dose for maintenance is 30 mcg. This is usually prescribed on a long-term basis. For patients with a more serious case of COPD, or a deteriorating or acute progression, may be prescribed a different medication.

Do not attempt to drink or inject the medication. It should be administered only using a jet nebulizer connected to a compressor.

Major drug interactions

There are some drugs that may interfere with the effects of Arformoterol if taken at the same time. Some may even cause dangerous side effects when mixed. This is called a drug interaction – when one drug reacts with another to create a different outcome. There are 667 drugs that are known to have some level of interaction with Arformoterol. The severity of these interactions varies. You should always tell your doctor if you are already taking another medication, as this may mean that you are not suitable for Arformoterol, or may just mean your doctor will need to alter the dose available to you.

Of the 667 drugs that are known to cause an interaction with Arformoterol, there are 20 major drug interactions (with 61 different generic and brand names). These drugs should not be taken with Arformoterol:

  • bendroflumethiazide, nadolol
  • brimonidine, timolol ophthalmic
  • carteolol
  • carteolol ophthalmic
  • carvedilol
  • dorzolamide, timolol ophthalmic
  • hydrochlorothiazide, propranolol
  • hydrochlorothiazide, timolol
  • labetalol
  • letrozole, ribociclib
  • levobunolol ophthalmic
  • metipranolol ophthalmic
  • nadolol
  • penbutolol
  • pindolol
  • propranolol
  • ribociclib
  • sotalol
  • timolol
  • timolol ophthalmic

Warnings

There are various warnings for those taking Arformoterol, listed below. When taking this medication, you should take particular care to read the information label and to refrain from an unhealthy lifestyle. There are various substances, such as alcohol and cigarettes, that you should avoid.

Recent clinical study

Although use of Arformoterol is safe in most cases, there has been one recent clinical study that has caused concern. The study found that more people using a medication similar to this to treat asthma have experienced more severe asthma attacks (resulting in hospital care or even death) than those not using the medication. (ref 1)

Smoking, alcohol and diet

You should not smoke while taking Arformoterol. This can reduce the impact of the medication significantly and make your condition worse. You should seek advice on how to reduce and stop inhaling tobacco if you are prescribed this medication.

You should generally refrain from drinking alcohol if you are taking Arformoterol as it can interfere with the effectiveness of the drug. Arformoterol can also leave you more vulnerable to the effects of alcohol, leading to light-headedness, dizziness, fatigue and sleep problems (insomnia). If you do decide to drink alcohol, you should do it in moderation. Women should stick to one drink per day maximum, and men two drinks per day.

Unless directed otherwise by your healthcare professional, you should not alter your diet as a result of taking this medication. However, you should maintain a healthy diet throughout the treatement.

Other diseases

There are various other conditions that might impact on the effectiveness of Arformoterol. Before prescribing a dose of Arformoterol, your doctor will ask you if you have or have had any other conditions. You need to be upfront about any conditions that you have. Holding back information – resulting in an incorrect prescription of Arformoterol – could be dangerous to your health as it may make your other conditions worse. The following conditions have been known to interact with Arformoterol:

  • Hypokalemia
  • Asthma
  • Hepatic Impairment
  • Seizures
  • Cardiovascular
  • Diabetes

Pregnancy and breast-feeding

There are some cases where this medication may be prescribed to patients that are pregnant – but this is only when the risk of harm to the unborn baby is judged to be less than that of the mother not taking the drug. There have been previous animal studies that have shown the drug to have a negative impact on unborn fetuses, so users should proceed with caution. (ref 2)

The doctor will be able to determine whether the benefits outweigh the risks on a case by case basis.

You should not take this medication if you are breastfeeding. Studies on animals have shown that the substance can get into breast milk. However, it is not known whether breast milk containing extracts of Arformoterol can cause harm to nursing infants.

Missing a dose

If you forget to take a dose, there will be no major impact. Just take the dose as soon as you remember. However, if it is closer to you next dose by the time you realise, then skip the missed dose completely. Don’t attempt to “double up” on doses to make up for missed ones. This could lead to symptoms of overdose and could set off any of the side effects listed above.

Overdose

If you take more than the recommended dose of Arformoterol, seek medical attention immediately if you are experiencing any side effects. In the first instance, you should call the poison control center on 1-800-222-1222. If the person who is overdosed is unconscious or not breathing, call 911 right away. You should always stick to the dosage prescribed by your doctor – do not attempt to increase your own dosage.

Symptoms of overdose are similar to those that are occasionally experienced as regular side effects; however, depending on the amount of the overdose, these can be extremely severe and even life-threatening. Symptoms include a fast, irregular heartbeat, muscle cramps, dizziness, weakness and excessive tiredness, uncontrollable shaking and chest pain.

Storage

You should keep your prescription of Arformoterol in the refrigerator, as it is most effective when kept at cold temperatures. The medication will be supplied in a foil pouch. You should always keep it in this pouch and only remove it when you are about to administer it. The medication must always be kept away from heat or light sources.

After you have opened the foil pouch, you must return all the excess doses to the foil and then return to the cool storage place.

If you have been prescribed multiple pouches of this medication, you can store the unopened pouches at room temperature (21 degrees centigrade) for up to six weeks. After this time has passed, do not use any remaining pouches, as they may have lost effectiveness in that time. Instead, dispose of the pouches in a safe and responsible way (see section below).

Disposal

Medicines such as Aroformeterol can play an important role in the treatment of several severe conditions. However, if they get into the wrong hands, they can cause grave danger.

If you have leftover medication that you no longer need, you should dispose of it in a safe and responsible way to ensure that it does not get into the possession of children or animals. Do not throw the medication out with regular garbage, and do not attempt to flush the medication down the toilet. The most responsible way to get rid of your unwanted medication is to use a special take-back scheme. These are designed especially for medicines to avoid them getting into the possession of anyone who they are not meant for. Most locations will have access to these schemes; however, if you cannot access any take-back programs, you can view the FDA’s website for information about how to safely dispose of medicines. (ref 3)

Summary

Arformoterol is a proven treatment for the symptoms of COPD and is commonly used for patients suffering from the disease or other similar respiratory conditions. If used correctly, the drug can be a safe, long-term treatment for managing the disease. Taken via inhalation, it offers an easy way for those suffering from COPD to ease their symptoms and live fuller, more comfortable lives. There has been a recent clinical study into similar medications that has caused concern; however, many people continue to use Arformoterol on a daily basis with no known negative health implications.

Arformoterol is usually recommended as part of a holistic treatment for the symptoms of COPD. As there is currently no cure for the disease – it can only be managed – the patient must also commit to making lifestyle changes and eliminating some of the causes that led to the disease in the first instance. When used in conjunction with healthy living – such as cutting out tobacco and improving air quality – Arformoterol can be used by people of a variety of ages.

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Last Reviewed:
December 25, 2017
Last Updated:
December 22, 2017
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