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What should I discuss with my healthcare provider before using arformoterol inhalation (Brovana)?

You should not use this medication 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 arformoterol could cause this same effect in people with chronic obstructive pulmonary disease. Use only the prescribed dose of this medication, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits of using arformoterol inhalation.

To make sure you can safely use arformoterol, tell your doctor if you have any of these other conditions:

• heart disease, a heart rhythm disorder, or high blood pressure;
• epilepsy or other seizure disorder;
• diabetes;
• glaucoma;
• a thyroid disorder;
• liver disease; or
• a personal or family history of "Long QT syndrome."

FDA pregnancy category C. It is not known whether arformoterol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether arformoterol passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medication to anyone under 18 years old without your doctor's advice.

How should I use arformoterol inhalation (Brovana)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

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

If you were switched from a short-acting bronchodilator to arformoterol inhalation, 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).

Arformoterol solution for inhalation is for use only with a standard jet nebulizer machine connected to an air compressor. Do not mix arformoterol 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.

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.

COPD is usually treated with a combination of different drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

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.

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