Arformoterol (brand name, Brovana) is a bronchodilator in the long-acting beta agonists (LABAs) class. It is used to control wheezing, shortness of breath, coughing, and chest tightness in people with COPD. It works to relax and open the airways to the lungs, making breathing easier.

How does arformoterol for COPD work?

Arformoterol is a selective long-acting beta2-adrenergic receptor agonist that is more potent than a similar medication, formoterol.

It is effective by binding to the corresponding receptors, called beta-adrenoceptors, and activating them. These receptors are activated by stimulation of the adenyl cyclase, an enzyme of lung muscle cells and that is involved in the synthesis of cyclic adenosine monophosphate (cAMP). When cAMP levels are elevated, the muscle cells of the airways relax, leading to bronchodilation.

There are three types of beta-adrenoceptors, in three different types of cells: the muscle cells of the airways, of the heart, and of the adipose tissue cells. This means that even highly selective beta2-agonists like arformoterol may impact other cells, raising the possibility of cardiac effects.

Studies of arformoterol

Two 12-week, double-blind, placebo- and active-controlled studies took place in the U.S., involving almost 1,500 COPD patients.  In both, arformoterol inhalation solution 15 mcg twice daily led to a statistically significant improvement in mean FEV1 (about 11% from baseline), whereas the 25 mcg inhalation solution did not provide additional benefit. The 15 mcg arformoterol inhalation solution also improved bronchodilation in treated COPD patients compared to placebo.

Indications and side effects

Arformoterol is not intended for use in people with asthma, as people with asthma who take LABA medicines have an increased risk of serious flares. It is not known yet whether LABA medicines increase the same risk in people with COPD.

Arformoterol is designed to help relieve COPD symptoms. It also doesn’t relief sudden breathing difficulties. For sudden breathing difficulties, short-acting bronchodilators, such as albuterol, levalbuterol, ipratroprium or the combination albuterol /ipratropium, should be used under a physician’s direction.

Common  side effects of arformoterol include chest or back pain, diarrhea, sinus congestion, headache, tremor, nervousness, leg cramps, high blood potassium, shortness of breath, rash, fever, increased white cells count, vomiting, tiredness, leg swelling, chest congestion or bronchitis. Patients are not advised to stop arformoterol use suddenly, without the advice of their doctors.

There is no generic available for arformoterol.

 

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