Brovana (arformoterol tartrate)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Arformoterol tartrate, a relatively selective long-acting beta2-agonist, is a bronchodilator.
Arformoterol, a synthetic sympathomimetic amine, is a relatively selective long-acting beta2 agonist. Arformoterol is the R, R-enantiomer of formoterol, which occurs as a racemic mixture; only the R, R-enantiomer of formoterol is active. Arformoterol stimulates beta2-adrenergic receptors and apparently has little or no effect on beta1-adrenergic receptors.
Arformoterol is twice as potent as racemic formoterol.
Arformoterol's beta2-adrenergic effects appear to result from stimulation of the production of cyclic adenosine-3,5-monophosphate (cAMP) by activation of adenyl cyclase. Increased concentrations of cAMP are associated with relaxation of bronchial smooth muscle and suppression of some aspects of inflammation, such as inhibition of release of proinflammatory mast-cell mediators (e.g., histamine, leukotrienes). Some studies in animals suggest that arformoterol inhibits allergen-induced infiltration of eosinophils into airways and reduces histamine-induced extravasation of plasma proteins (e.g., albumin).
Tolerance to the bronchoprotective effects of arformoterol (diminished effect on FEV1) has been reported after 6 weeks of treatment, with loss of protection at the end of the 12-hour dosing period.
Arformoterol is extensively metabolized, mainly via glucuronidation by uridine disphosphoglucuronosyltransferase (UGT) isoenzymes and to a limited extent via O-demethylation by the cytochrome P-450 (CYP) isoenzymes 2D6 and 2C19.
USES: Arformoterol is used as a long-term (maintenance) treatment to prevent and decrease wheezing and shortness of breath caused by breathing problems (such as chronic obstructive pulmonary disease, including chronic bronchitis and emphysema). Arformoterol belongs to the class of drugs known as long-acting beta agonists (LABAs). Arformoterol is also known as a bronchodilator.
It works by relaxing the muscles around the airways so that they open up and you can breathe more easily. Controlling symptoms of breathing problems can decrease time lost from work or school. This medication does not work right away and should not be used for sudden attacks of breathing trouble.
Your doctor must prescribe a quick-relief medicine/inhaler (such as albuterol, also known as salbutamol) for sudden shortness of breath while you are using arformoterol. You should always have a quick-relief inhaler with you. Arformoterol is not approved to treat asthma.
People with asthma using long-acting inhaled beta agonists (such as arformoterol) without also using an inhaled corticosteroid may have an increased risk of serious (sometimes fatal) breathing problems.
Generic name: arformoterol tartrate
Pronunciation: (AR-for-MOE-ter-ol)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Brovana
Indications
The following indications are listed for Brovana:
- Bronchospasm Prevention With Copd
Also known as: Copd With Bronchospasms Prophylaxis.
Dosing
Dosage of arformoterol tartrate is expressed in terms of arformoterol.
Delivery of oral inhalation solution to the lungs depends on the type of jet nebulizers used, performance of the compressor, and other factors such as the patient's inspiratory flow. (See Administration under Dosage and Administration.)
For long-term symptomatic treatment of chronic obstructive pulmonary disease, the usual adult dosage of arformoterol is 15 mcg twice daily by oral inhalation via nebulization. Higher dosages provide no additional therapeutic benefit and may increase risk of adverse effects. Maximum recommended dosage is 30 mcg daily.
No dosing information is available for this tab.
No dosing information is available for this tab.
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Drug interactions
Arformoterol is minimally metabolized by cytochrome P-450 (CYP) 2D6 and 2C19 isoenzymes; does not inhibit CYP isoenzymes 1A2, 2A6, 2C9/10, 2C19, 2D6, 2E1, 3A4/5, or 4A9/11.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
Known hypersensitivity to arformoterol, formoterol, or any ingredient in the formulation.
All long-acting beta2-adrenergic agonists, including arformoterol, are contraindicated in patients with asthma without concomitant use of long-term asthma controller therapy; safety and efficacy of arformoterol in patients with asthma+ have not been established. (See Asthma-related Death under Warnings/Precautions: Warnings, in Cautions.)
There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
Pain (unspecified), chest pain, back pain, diarrhea, sinusitis, leg cramps, dyspnea, rash, flu syndrome, peripheral edema, lung disorder.
There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
No enhanced messaging available.
Safety and efficacy not established in pediatric patients. COPD does not occur in children.
Category C. (See Users Guide.)
Distributed into milk in rats. It is not known whether arformoterol is distributed into human milk. Use caution.
No substantial differences in safety and efficacy observed relative to younger adults, but increased sensitivity cannot be ruled out. Incidence of ventricular ectopy with arformoterol therapy in geriatric patients 65-75 years of age is comparable to that with placebo.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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