arformoterol

Absorption: Some systemic absorption occurs from pulmonary sites.

Distribution: Unknown.

Metabolism/Excretion: Mostly metabolized by the liver; 1% excreted unchanged in urine.

Half-Life: 26 hr.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
inhaln	unknown	30 min	12 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Acutely deteriorating COPD (onset of action is delayed);
Asthma.

Use Cautiously in:

Cardiovascular disorders including coronary insufficiency, arrhythmias and hypertension;
Hepatic impairment;
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk; may interfere with uterine contractility during labor;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Safety and effectiveness not established in children;
Geri: Older adults may be more sensitive to drug effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: ECG changes, tachycardia

Derm: rash

F and E: hypokalemia

GI: vomiting

Hemat: leukocytosis

MS: cramps

Neuro: headache, insomnia, nervousness, tremor, weakness

Resp: PARADOXICAL BRONCHOSPASM

Misc: fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

Concurrent use with monoamine oxidase inhibitors, tricyclic antidepressants or other agents that may prolong the QTc interval may result in serious arrhythmias and should be undertaken with extreme caution.
↑risk of hypokalemia with theophylline, corticosteroids, potassium-losing diuretics.
Beta blockers may ↓ therapeutic effects.
↑adrenergic effects may occur with concurrent use of adrenergics.

Route/Dosage ⬆ ⬇

Inhaln
(Adults ): 15 mcg twice daily via nebulization.

Availability ⬆ ⬇

(Generic available)

Inhalation solution for nebulization: 15 mcg/2 mL

Assessment ⬆ ⬇

Assess lung sounds, pulse, and BP before administration and periodically during therapy.
Monitor pulmonary function tests before initiating therapy and periodically during therapy to determine effectiveness of medication.
Observe for paradoxical bronchospasm (wheezing, dyspnea, tightness in chest) and hypersensitivity reaction (rash; urticaria; swelling of the face, lips, or eyelids). If condition occurs, withhold medication and notify physician or other health care professional immediately.

Implementation ⬆ ⬇

Inhaln: Administer twice daily, approximately 12 hrs apart. Solution is colorless; do not administer discolored solutions. Do not administer beyond expiration date. Do not mix with other drugs in nebulizer. Administer by inhalation only; do not inject or swallow medication. Store in foil pouches in refrigerator.

Patient/Family Teaching ⬆ ⬇

Instruct patient on proper technique use and advise patient to take arformoterol as directed. Do not use more than the prescribed dose. If a regularly scheduled dose is missed, skip the dose and resume regular schedule. Do not double doses. If symptoms occur before next dose is due, use a rapid-acting inhaled bronchodilator (e.g. albuterol). See Medication Administration Techniques for nebulizer instructions.
Advise patients who have been taking short-acting beta₂ agonists regularly to discontinue regular use and use only for symptomatic relief of acute respiratory symptoms.
Caution patient not to use arformoterol to treat acute symptoms. A rapid-acting inhaled beta-adrenergic bronchodilator should be kept on hand and used for relief of acute asthma attacks.
Advise patient to notify health care professional immediately if difficulty in breathing persists after use of arformoterol, if condition worsens, if more inhalations of rapid-acting bronchodilator than usual are needed to relieve an acute attack.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken, to avoid alcohol, and to consult health care professional before taking any new medications.
Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes ⬆ ⬇

Decreased dyspnea.
Improved breath sounds.

US Brand Names ⬆ ⬇

Code ⬆

NDC Code

63402- Sunovion Pharmaceuticals Inc.
- 63402-911- Brovana
  - 63402-911-08- 2 POUCH in 1 CARTON (63402-911-08) > 4 VIAL, SINGLE-DOSE in 1 POUCH (63402-911-03) > 2 mL in 1 VIAL, SINGLE-DOSE

63402- Sunovion Pharmaceuticals Inc.
- 63402-911- Brovana
  - 63402-911-30- 30 POUCH in 1 CARTON (63402-911-30) > 1 VIAL, SINGLE-DOSE in 1 POUCH (63402-911-01) > 2 mL in 1 VIAL, SINGLE-DOSE

63402- Sunovion Pharmaceuticals Inc.
- 63402-911- Brovana
  - 63402-911-31- 30 POUCH in 1 CARTON (63402-911-31) > 1 VIAL, SINGLE-DOSE in 1 POUCH (63402-911-02) > 2 mL in 1 VIAL, SINGLE-DOSE

63402- Sunovion Pharmaceuticals Inc.
- 63402-911- Brovana
  - 63402-911-64- 15 POUCH in 1 CARTON (63402-911-64) > 4 VIAL, SINGLE-DOSE in 1 POUCH (63402-911-04) > 2 mL in 1 VIAL, SINGLE-DOSE

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇