Arformoterol
Class: Selective beta-2-Adrenergic Agonists
VA Class: RE102
Chemical Name: (2R,3R)-2,3-dihydroxybutanedioate-N-[2-hydroxy-5-[(1R)-1-hydroxy-2-[[(1R)-2-(4-methoxyphenyl)-1-methylethyl]amino]ethyl]phenyl]-formamide
Molecular Formula: C19H24N2O4•C4H6O6
CAS Number: 200815-49-2
Brands: Brovana
Warning
Increased risk of asthma†-related death with long-acting β2-adrenergic agonists. (See REMS and see also Asthma-related Death under Cautions.)
Increased risk of asthma-related death considered class effect of long-acting β2-adrenergic agonists, including arformoterol.
All long-acting β2-adrenergic agonists, including arformoterol, contraindicated in patients with asthma without concomitant use of long-term asthma controller therapy. Safety and efficacy of arformoterol in patients with asthma not established.
Introduction
Bronchodilator; relatively selective long-acting β2-agonist.
Uses for Arformoterol
COPD
Long-term treatment of bronchoconstriction associated with COPD, including chronic bronchitis and emphysema.
Long-acting β2-adrenergic agonists recommended as maintenance therapy in patients with moderate (e.g., forced expiratory volume in 1 second [FEV1] ≥50 but <80% of predicted) to very severe COPD (e.g., FEV1 <30% of predicted or <50% of predicted plus chronic respiratory failure) who have persistent symptoms not relieved by as-needed therapy with short-acting bronchodilators (e.g., ipratropium, β2-adrenergic agonist).
Regular treatment with long-acting bronchodilators more effective and convenient than treatment with short-acting bronchodilators. Superiority of one long-acting bronchodilator over another currently not established. If inadequate response, may use a combination of long-acting bronchodilators, such as a long-acting inhaled anticholinergic agent (tiotropium) and a long-acting β2-adrenergic agonist.
In patients with severe (e.g., FEV1 <50% of predicted, history of repeated exacerbations) to very severe COPD, add regular treatment with an inhaled corticosteroid to long-acting bronchodilator therapy. If inadequate response or limiting adverse effects occur, add or substitute extended-release oral theophylline.
Not to be used for immediate relief of acute exacerbations of COPD. Use short-acting inhaled β2-agonist intermittently (as needed) for acute symptoms of COPD. (See Acute Exacerbations of COPD under Cautions.) Efficacy and safety of long-acting bronchodilators, with or without inhaled corticosteroids, during acute exacerbations of COPD not established.
Arformoterol Dosage and Administration
General
When arformoterol therapy is initiated, discontinue regular use of short-acting, inhaled β2-adrenergic agonists, and use such agen...
