(al-fer-mo-te-rol) ,


(trade name)


Therapeutic: bronchodilators
Pharmacologic: adrenergics
Pregnancy Category: C


Maintenance treatment to prevent bronchospasm in chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.


Produces accumulation of cyclic adenosine monophosphate (cAMP) at beta-adrenergic receptors, resulting in relaxation of airway smooth muscle. Relatively specific for beta2 (pulmonary) receptors.

Therapeutic effects



Absorption: Some systemic absorption occurs from pulmonary sites.
Distribution: Unknown.
Metabolism and Excretion: Mostly metabolized by the liver; 1% excreted unchanged in urine.
Half-life: 26 hr.

Time/action profile

inhalnunknown30 min12 hr


Contraindicated in: Hypersensitivity; Acutely deteriorating COPD (onset of action is delayed); Pediatric: Safety not established; Concurrent use of other long-acting beta2 agonist bronchodilators.
Use Cautiously in: Cardiovascular disorders including coronary insufficiency, arrhythmias and hypertension; Hepatic impairment; Geriatric: May be more sensitive to drug effects; Obstetric / Lactation: Safety not established; use only when maternal benefit outweighs fetal risk, may inhibit contractions during labor.

Adverse Reactions/Side Effects

Central nervous system

  • headache
  • insomnia
  • nervousness
  • weakness


  • asthma-related death (life-threatening)
  • paradoxical bronchospasm (life-threatening)


  • ECG changes
  • tachycardia


  • vomiting


  • rash

Fluid and Electrolyte

  • hypokalemia


  • leukocytosis


  • cramps


  • tremor


  • hypersensitivity reactions including anaphylaxis
  • fever


Drug-Drug interaction

Concurrent use with MAO inhibitors, tricyclic antidepressants or other agents that may prolong the QTc interval may result in serious arrhythmias and should be undertaken with extreme caution.↑ risk of hypokalemia with theophylline, corticosteroids, potassium-losing diuretics.Beta blockers may ↓ therapeutic effects.↑ adrenergic effects may occur with concurrent use of adrenergics.


Inhalation (Adults) 15 mcg twice daily via nebulization.


Inhalation solution for nebulization: 15 mcg/2 mL

Nursing implications

Nursing assessment

  • Assess lung sounds, pulse, and BP before administration and periodically during therapy.
  • Monitor pulmonary function tests before initiating therapy and periodically during therapy to determine effectiveness of medication.
  • Observe for paradoxical bronchospasm (wheezing, dyspnea, tightness in chest) and hypersensitivity reaction (rash; urticaria; swelling of the face, lips, or eyelids). If condition occurs, withhold medication and notify physician or other health care professional immediately.

Potential Nursing Diagnoses

Ineffective airway clearance (Indications)


  • Inhalation: Administer twice daily, approximately 12 hrs apart. Solution is colorless; do not administer discolored solutions. Do not administer beyond expiration date. Do not mix with other drugs in nebulizer. Administer by inhalation only; do not inject or swallow medication.

Patient/Family Teaching

  • Instruct patient on proper technique use and advise patient to take arformoterol as directed. Do not use more than the prescribed dose. If a regularly scheduled dose is missed, skip the dose and resume regular schedule. Do not double doses. If symptoms occur before next dose is due, use a rapid-acting inhaled bronchodilator (e.g. albuterol). See for nebulizer instructions.
  • Inform patient that arformoterol may increase the risk of asthma-related death.
  • Advise patients who have been taking short-acting beta2 agonists regularly to discontinue regular use and use only for symptomatic relief of acute respiratory symptoms.
  • Caution patient not to use arformoterol to treat acute symptoms. A rapid-acting inhaled beta-adrenergic bronchodilator should be kept on hand and used for relief of acute asthma attacks.
  • Advise patient to notify health care professional immediately if difficulty in breathing persists after use of arformoterol, if condition worsens, if more inhalations of rapid-acting bronchodilator than usual are needed to relieve an acute attack.
  • Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Decreased dyspnea.
  • Improved breath sounds.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
Arformoterol mitigates the Cl[sub]2 toxicity on airway reactivity and alveolar fluid clearance by increasing lung cyclic AMP level.[17] Rolipram inhibits degradation of the intracellular signaling molecule cyclic AMP, which alleviates pulmonary edema, inflammation, and AHR.[37]
Arrhythmias in patients with chronic obstructive pulmonary disease (COPD): Occurrence frequency and the effect of treatment with the inhaled long-acting beta2-agonists arformoterol and salmeterol.
Sunovion's track record of discovery, development and commercialization of important therapies has included Brovana (arformoterol tartrate), Latuda (lurasidone HCI), and most recently Aptiom (eslicarbazepine acetate).
It must be remembered that the later adrenergic agents (albuterol, bitolterol, pirbuterol, levalbuterol, salmeterol, formoterol, and arformoterol) are much more beta 2 specific than previous agents such as epinephrine and isoetherine.
arformoterol (for nebuliser use), and carmoterol, indacaterol, and new long-acting anticholinergics (10)
(24) Although not commercially available at the time when my patients were transitioned to BIS, arformoterol tartrate inhalation solution 15 [micro]g/2 mL (Brovana[R]; Sepracor Inc, Marlborough, MA) also has been shown to be stable physically and chemically when mixed with BIS 0.25 mg/2 mL or 0.5 mg/2 mL.
A New Drug Application (NDA) for arformoterol tartrate inhalation solution remains under review at the FDA.
* long-acting [[beta].sub.2]-agonists (LABAs), such as arformoterol, indacaterol, formoterol, olodaterol, salmeterol, and vilanterol
Long-acting agents, such as salmeterol, formoterol, and arformoterol are indicated for maintenance bronchodilation and control of bronchospasm, and for control of nocturnal symptoms in asthma or other obstructive diseases.
Arformoterol - Sepracor has completed more than 100 preclinical studies and 16 clinical studies for arformoterol inhalation solution as a maintenance treatment for COPD.
(5,12,13) In a study of patients receiving formoterol 12 meg compared with 15-mcg and 25-mcg doses of arformoterol, those taking formoterol had a lower exacerbation rate than those on either strength of arformoterol (22% vs 32% and 31%, respectively).
Arformoterol is the latest b2-selective agonist with a long-acting bronchodilatory effect of up to 12 hours in duration.