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arformoterol (Rx)Brand and Other Names:Brovana, Erdotin

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nebulizer solution

  • 15mcg/2mL
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Chronic Obstructive Pulmonary Disease

15 mcg inhaled via nebulization twice daily (AM & PM)

Not to exceed 30 mcg/day

Renal Impairment

Dose adjustment not necessary

Hepatic Impairment

Use caution; systemic drug exposure prolonged; dose adjustment not necessary

Saftety and efficacy not established

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Interactions

Interaction Checker

arformoterol and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Back pain (6%)

            Chest pain (7%)

            Diarrhea (6%)

            Dyspnea (4%)

            Flu syndrome (3%)

            Leg cramps (4%)

            Lung disorder (2%)

            Pain (8%)

            Peripheral edema (3%)

            Rash (4%)

            Sinusitis (5%)

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            Warnings

            Black Box Warnings

            Long-acting beta2-adrenergic agonists (LABAs), such as arformoterol, may increase the risk of asthma-related deaths; therefore, when treating patients with asthma, this drug should only be used as additional therapy for patients not adequately controlled on other asthma controller medications (eg, low-to-medium dose inhaled corticosteroids) or whose disease severity clearly warrants initiation of treatment with 2 maintenance therapies, including LABAs

            Because of this risk, use of LABAs for the treatment of asthma without a concomitant long-term asthma control medication, such as an inhaled corticosteroid, is contraindicated

            Once asthma control is achieved and maintained, assess the patient at regular intervals and step down therapy (eg, discontinue LABA) if possible without loss of asthma control, and maintain the patient on a long-term asthma control medication, such as an inhaled corticosteroid

            Do not use LABAs if asthma is adequately controlled on low or medium dose inhaled corticosteroids

            Available data from controlled clinical trials suggest that LABA increase the risk of asthma-related hospitalization in pediatric and adolescent patients; for pediatric and adolescent patients with asthma who require addition of a LABA to an inhaled corticosteroid, a fixed-dose combination product containing both an inhaled corticosteroid and LABA should ordinarily be considered to ensure adherence with both drugs

            Safety and efficacy of arformoterol in patients with asthma not established

            Contraindications

            Hypersensitivity to arformoterol or formoterol, or any ingredients

            Concurrency with other long-acting beta2-agonists

            Treatment of asthma without a concomitant long-term asthma control medication, such as an inhaled corticosteroid

            Cautions

            May cause paradoxical bronchospasm

            Long-acting beta2-agonists may increase risk of asthma-related death

            Use caution in cardiovascular disorder (arrhythmias, HTN, CAD), hepatic impairment, hypokalemia, thyrotoxicosis, seizure disorders

            Risk of hypokalemia (usu transient not requiring supplementation)

            Combined with asthma controller medication (e.g., inhaled corticosteroid)

            Use only if not adequately controlled by asthma controller medications

            Use only for shortest duration of time

            Beta2-agonists may increase serum glucose (use with caution in patients with diabetes)

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Not known if excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Long-acting beta2-agonist, R,R-enantiomer of racemic formoterol; relaxes bronchial smooth muscle by acting selectively on beta2-receptors

            Pharmacokinetics

            Excretion: Urine (67%); feces (22%)

            Onset: 7-20 min

            Half-life: 26hr

            Peak plasma time: 0.5-3hr

            Peak Plasma: 4.3 pg/mL

            AUC: 34.5 pg.hr/mL

            Protein Bound: 52-65%

            Metabolism: uridine diphosphoglucuronosyltransferases (glucuronidation), CYP2D6, CYP2C19 (O-demethylation)

            Renal Clearance: 8.9 L/hr

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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