Brovana

Generic Name: arformoterol inhalation (ar for MOE ter ole)

What is Brovana?

Brovana (arformoterol) is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Brovana is used to prevent bronchoconstriction in people with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It will not treat a bronchospasm attack that has already begun.

Brovana may also be used for purposes other than those listed in this medication guide.

Important information about Brovana

Do not use this medication to treat a sudden bronchospasm attack. It will not work fast enough to reverse your symptoms. Use another, faster-acting inhalation medication to treat sudden attacks of bronchospasm. Call your doctor right away if you feel that this medicine is not working as well as usual, or if you think you need to use more than usual. An increased need for medication could be an early sign that your condition is getting worse. Salmeterol, a medicine similar to arformoterol, has been shown to increase the risk of asthma-related death. It is not known whether Brovana could cause this same effect in people with chronic obstructive pulmonary disease. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Talk with your doctor about your individual risks and benefits in using Brovana.

Before using Brovana

Do not use Brovana if you are allergic to arformoterol. Salmeterol, a medicine similar to arformoterol, has been shown to increase the risk of asthma-related death. It is not known whether Brovana could cause this same effect in people with COPD. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Talk with your doctor about your individual risks and benefits in using Brovana.

Before using Brovana, tell your doctor if you are allergic to any medications, or if you have:

heart disease, a heart rhythm disorder, or high blood pressure;

epilepsy or other seizure disorder;

diabetes;

glaucoma;

a thyroid disorder;

If you have any of these conditions, you may not be able to use Brovana, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. Brovana may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use Brovana without telling your doctor if you are breast-feeding a baby. Do not give Brovana to anyone under 18 years old without your doctor’s advice.

How should I use Brovana?

Use Brovana exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.

Brovana comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Do not use Brovana to treat a sudden bronchospasm attack. It will not work fast enough to reverse your symptoms. Use another, faster-acting inhalation medication to treat sudden attacks of bronchospasm. If you were switched from a short-acting bronchodilator to Brovana, stop using the other bronchodilator and use it only for a sudden bronchospasm attack. Short-acting bronchodilators include albuterol (Proventil, Ventolin, Combivent), bitolterol (Tornalate), levalbuterol (Xopenex), metaproterenol (Alupent, Metaprel), or pirbuterol (Maxair).

Brovana solution for inhalation is for use only with a standard jet nebulizer machine connected to an air compressor. Do not mix Brovana with other medicines in the nebulizer. Do not take this medicine by mouth or swallow it.

To use the solution with a nebulizer:

Open the foil pouch and squeeze all of the medicine out into the chamber of the nebulizer. Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor.

Sit upright in a comfortable position. Place the mouthpiece into your mouth or put the face mask on, covering your nose and mouth. Turn on the compressor.

Breathe in slowly and evenly until you have inhaled all of the medicine (usually 5 to 10 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.

Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

COPD is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.

Keep this medicine in the foil pouch until you are ready to use it. Once a pouch is opened, you must use the medicine right away. Throw the empty pouch away where children and pets cannot get to it.

Store the foil pouches in the refrigerator but do not allow them to freeze. You may store the foil pouches at room temperature but you must use them within 6 weeks. Store the single-use vials at room temperature and protect them from heat and light. Do not use any medicine if it does not look clear and colorless in the vial.

What happens if I miss a dose?

Skip the missed dose and wait until your next regularly scheduled dose. Do not use two doses at the same time. It is important to use Brovana regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of Brovana can be fatal.

Symptoms of an Brovana overdose may include chest pain, fast or irregular heartbeats, nervousness, tremor, muscle cramps, feeling light-headed, and fainting.

What should I avoid while using Brovana?

Do not use a second long-acting inhaled bronchodilator such as formoterol (Foradil) or salmeterol (Serevent, Advair) unless your doctor has told you to.

Brovana side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

bronchospasm (wheezing, chest tightness, trouble breathing);

chest pain, fast or pounding heart beats, restless feeling, tremor;

feeling short of breath, even with mild exertion;

swelling, rapid weight gain;

white patches or sores inside your mouth or on your lips; or

dry mouth, increased thirst, drowsiness, restless feeling, confusion, nausea, vomiting, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, or fainting.

Other, less serious side effects may be more likely to occur, such as:

weakness; headache, sleep problems (insomnia);

nausea, vomiting, diarrhea;

leg cramps;

fever;

stuffy nose, dry mouth; or

hoarseness or deepened voice.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Brovana?

Before using Brovana, tell your doctor if you are using any of the following drugs:

aminophylline (Truphylline) or theophylline (Elixophyllin, Respbid, Slo-Bid, Theo-Dur, Uniphyl);

antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), sparfloxacin (Zagam), or telithromycin (Ketek);

antidepressants such as amitriptyline (Elavil, Etrafon), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), or nortriptyline (Pamelor);

a beta-blocker such as atenolol (Tenormin), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), sotalol (Betapace), and others;

a diuretic (water pill) such as amiloride (Midamor, Moduretic), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), and others;

heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan, Pronestyl), or quinidine (Cardioquin, Quinaglute);

an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam);

narcotic medication such as fentanyl (Actiq, Duragesic, Ionsys), hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Percocet), propoxyphene (Darvocet, Darvon); or

steroids (prednisone and others).

If you are using any of these drugs, you may not be able to use Brovana, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Brovana. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.