(ar'' for moe' ter ol)

Brand Name(s): Brovana^®

WHY is this medicine prescribed?

Arformoterol inhalation is used to control wheezing, shortness of breath, coughing, and chest tightness caused by chronic obstructive pulmonary disease (COPD; a group of lung diseases, which includes chronic bronchitis and emphysema). Arformoterol is in a class of medications called long-acting beta agonists (LABAs). It works by relaxing and opening air passages in the lungs, making it easier to breathe.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Arformoterol comes as a solution (liquid) to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled). It is usually inhaled twice a day in the morning and the evening. Inhale arformoterol at around the same times every day, and space your doses about 12 hours apart. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use arformoterol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Do not swallow or inject arformoterol inhalation.

Do not use arformoterol inhalation to treat sudden attacks of COPD. Your doctor will prescribe a short-acting beta agonist medication such as albuterol (Accuneb, Proair, Proventil, Ventolin) to use during attacks. If you were using this type of medication on a regular basis before you began treatment with arformoterol, your doctor will probably tell you to stop using it regularly, but to continue to use it to treat attacks.

If your COPD symptoms become worse, if arformoterol inhalation becomes less effective, if you need more doses than usual of the medication you use to treat sudden attacks, or if the medication you use to treat attacks does not relieve your symptoms, your condition may be getting worse. Do not use extra doses of arformoterol. Call your doctor right away.

Arformoterol controls the symptoms of chronic obstructive pulmonary disease but does not cure the condition. Continue to use arformoterol even if you feel well. Do not stop using arformoterol without talking to your doctor. If you suddenly stop using arformoterol, your symptoms may worsen.

To use arformoterol inhalation, follow these steps:

1. Open the foil pouch by tearing through the rough edge along the edge of the pouch and remove the vial. Look at the solution in the vial to be sure it is colorless. If it is not colorless, call your doctor or pharmacist and do not use the solution.
2. Twist off the top of the vial and squeeze all of the liquid into the reservoir of your nebulizer. Do not add any other medications to the nebulizer because it may not be safe to mix them with arformoterol. Use all nebulized medications separately unless your doctor specifically tells you to mix them.
3. Connect the nebulizer reservoir to your mouthpiece or facemask.
4. Connect the nebulizer to the compressor.
5. Sit upright and place the mouthpiece in your mouth or put on the facemask.
6. Turn on the compressor.
7. Breathe calmly, deeply, and evenly until mist stops forming in the nebulizer. This should take between 5 and 10 minutes.
8. Clean the nebulizer according to the manufacturer's instructions.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before using arformoterol inhalation,

• tell your doctor and pharmacist if you are allergic to arformoterol, formoterol (Perforomist, in Bevespi, Dulera, Symbicort), any other medications, or any of the ingredients in arformoterol solution. Ask your pharmacist for a list of the ingredients.

• Some medications should not be taken with arformoterol inhalation. Other medications may cause dosing changes or extra monitoring when taken with arformoterol inhalation. Make sure you have discussed any medications you are currently taking or plan to take before using arformoterol inhalation with your doctor and pharmacist. Before starting, stopping, or changing any medications while using arformoterol inhalation, please get the advice of your doctor or pharmacist..

• The following nonprescription products may interact with arformoterol inhalation: medications for colds such as phenylephrine (Sudafed PE), and pseudophedrine (Sudafed). Be sure to let your doctor and pharmacist know that you are taking these medications before you start using arformoterol inhalation. Do not start any of these medications while using arformoterol inhalation without discussing with your healthcare provider..

• tell your doctor if you have asthma. Your doctor will tell you not to use arformoterol unless you are using it along with an inhaled steroid medication.

• tell your doctor if you have or have ever had an irregular heartbeat; QT prolongation (an irregular heart rhythm that can lead to fainting, loss of consciousness, seizures, or sudden death); high blood pressure; seizures; diabetes; or heart, liver, or thyroid disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using arformoterol, call your doctor.

• you should know that arformoterol inhalation sometimes causes wheezing and difficulty breathing immediately after it is inhaled. If this happens, call your doctor right away. Do not use arformoterol inhalation again unless your doctor tells you that you should.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Skip the missed dose and continue your regular dosing schedule. Do not inhale a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Arformoterol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nervousness
• uncontrollable shaking of a part of the body
• headache
• dizziness
• tiredness
• lack of energy
• not feeling well
• flu symptoms
• swelling of arms or legs
• difficulty falling asleep or staying asleep
• pain, especially back pain
• diarrhea
• nausea
• vomiting
• cramps
• dry mouth

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• fast or pounding heartbeat
• chest pain
• hives
• rash
• swelling of the eyes, face, tongue, lips, mouth, hands, feet, ankles, or lower legs
• increased difficulty breathing or swallowing

Arformoterol may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the foil pouch it came in, tightly closed, and out of reach of children. Protect the medication from heat and light. You may store the medication in the refrigerator until the expiration date printed on the package has passed, or you may store the medication at room temperature for up to 6 weeks. Dispose of any medication that has been stored at room temperature for longer than 6 weeks, or that has been removed from the foil pouch and not used immediately.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• chest pain
• fast, pounding, or irregular heartbeat
• nervousness
• headache
• uncontrollable shaking of a part of the body
• dry mouth
• muscle cramps
• nausea
• dizziness
• excessive tiredness
• weakness
• difficulty falling asleep or staying asleep

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Before having any laboratory test (especially those that involve methylene blue), tell your doctor and the laboratory personnel that you are using arformoterol.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: October 15, 2023.