What is Brovana?

Brovana is a brand-name prescription medication used to treat chronic obstructive pulmonary disease (COPD). COPD is a group of lung conditions that includes chronic bronchitis and emphysema. Brovana is a long-term treatment, so it's not used for COPD symptom flare-ups. The drug also isn't used to treat asthma.

Brovana contains the drug arformoterol tartrate, which belongs to a group of medications called long-acting beta2-adrenergic agonists (LABAs). These medications relax the muscles in your airways to help them stay open, making it easier for you to breathe.

Brovana comes as a solution (liquid mixture) that you use in a device called a jet nebulizer. The nebulizer turns the drug into a mist that you inhale through a face mask or mouthpiece. You'll usually take Brovana once in the morning and once in the evening.

Brovana isn't approved to be used in children because COPD doesn't affect children.

Effectiveness

In clinical studies, Brovana worked well to control the symptoms of COPD. Researchers measured FEV1, which is the amount of air you can blow out forcefully over 1 second. Brovana increased FEV1 by about 11% compared to a placebo (no active treatment).

Brovana was also shown to improve breathing and relax airway muscles better than a placebo for more than 12 hours.

Brovana generic

Brovana is available only as a brand-name medication. It's not currently available in generic form.

Brovana contains the active drug arformoterol tartrate.

Brovana dosage

Typically, your doctor will start having you take Brovana twice a day. Your doctor may adjust the dosage over time to reach the amount that's right for you. They'll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Brovana comes as a solution (liquid mixture) that you use in a device called a jet nebulizer. This type of nebulizer uses compressed air to turn the drug into a mist. You inhale the mist through a face mask or mouthpiece. Brovana comes in a single-use vial that contains the 15 mcg/2 mL solution. This is the only strength the drug comes in.

Dosage for COPD

For the treatment of chronic obstructive pulmonary disease (COPD), you'll usually take Brovana twice a day. You'll use one vial in your nebulizer in the morning and one in the evening. The use of more than two vials (30 mcg) a day isn't recommended.

You should always inhale the Brovana solution and never swallow or inject it.

What if I miss a dose?

If you forget to take a dose of Brovana, skip that dose. Don't try to make up the missed dose by using two vials of the medication at one time. Take your next dose when you'd usually have it.

To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Brovana is meant to be used as a long-term treatment. In clinical trials, Brovana was safe in people through 52 weeks of use. If you and your doctor determine that Brovana is working well for you, you'll likely take it long term.

Brovana side effects

Brovana can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Brovana. These lists don't include all possible side effects.

For more information on the possible side effects of Brovana, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you'd like to report to the FDA a side effect you've had with Brovana, you can do so through MedWatch.

More common side effects

The more common side effects of Brovana can include:

Most of these side effects may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Brovana aren't common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Heart-related side effects, such as increased blood pressure or heart rate. Symptoms can include:
    • chest pain
    • trouble breathing
  • Bronchospasm (sudden trouble breathing) right after using Brovana. Symptoms can include:
    • chest tightness
    • not being able to catch your breath
  • Hyperglycemia (high blood sugar). Symptoms can include:
    • headache
    • feeling more thirsty than usual
    • urinating more often than usual
    • feeling tired
  • Hypokalemia (low potassium levels). Symptoms can include:
    • muscle cramps
    • feeling tired or weak
    • irregular heartbeat (a heartbeat that's too fast, too slow, or uneven)
  • Bronchitis (an infection in your lungs). Symptoms can include:
    • cough, especially coughing up mucus
    • feeling tired
    • fever
  • Peripheral edema (swelling in your arms or legs). Symptoms can include:
    • skin that feels warm or tight
    • arm or leg that feels or looks swollen

Other serious side effects, explained in more detail below in "Side effect details," include:

  • allergic reactions

Side effect details

You may wonder how often certain side effects occur with this drug. Here's some detail on a few of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Brovana. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

There's no data in clinical trials on how many people had an allergic reaction to Brovana. However, about 4% of people who used Brovana had a rash while taking the medication. In comparison, 2% of people who took a placebo (no active treatment) had a rash.

Call your doctor right away if you have a severe allergic reaction to Brovana. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Pain

Pain may be a side effect while using Brovana. About 8% of people who took Brovana in clinical trials had pain, compared to only 5% of people who took a placebo. Chest pain and back pain were the most common types of pain that were reported.

Chest pain occurred in about 7% of people who took Brovana, compared to 6% of people who took a placebo. And about 6% of people who took Brovana had back pain. In comparison, back pain occurred in only about 2% of people who took a placebo.

If you have any type of pain after taking Brovana, talk with your doctor. They may be able to recommend ways to help you feel more comfortable.

Alternatives to Brovana

Other drugs are available that can treat chronic obstructive pulmonary disease (COPD). Some may be better suited for you than others. If you're interested in finding an alternative to Brovana, talk with your doctor. They can tell you about other medications that may work well for you.

Other medications that are used to treat COPD include:

  • Long-acting beta2-agonists (LABAs), such as:
    • formoterol (Foradil, Perforomist)
    • indacaterol (Arcapta)
    • salmeterol (Serevent)
    • olodaterol (Striverdi)
  • Short-acting beta2-agonists (SABAs), such as:
    • levalbuterol (Xopenex)
    • albuterol (Ventolin, ProAir)
  • Anticholinergic medications, such as:
    • ipratropium bromide (Atrovent)
    • aclidinium bromide (Tudorza Pressair)
    • glycopyrrolate (Seebri Neohaler)
    • tiotropium (Spiriva)
    • umeclidinium (Incruse Ellipta)
  • Combination inhalers (a LABA and an anticholinergic), such as:
    • formoterol/glycopyrrolate (Bevespi Aerosphere)
    • vilanterol/umeclidinium (Anoro Ellipta)
    • olodaterol/tiotropium (Stiolto Respimat)
  • Combination inhalers (a LABA and a corticosteroid), such as:
    • formoterol/budesonide (Symbicort)
    • formoterol/mometasone (Dulera)
    • salmeterol/fluticasone (Advair)
    • vilanterol/fluticasone furoate (Breo Ellipta)
  • Oral medications (drugs that are swallowed as a tablet, capsule, lozenge, or liquid), such as:
    • roflumilast (Daliresp)
    • theophylline (Theochron)

Brovana vs. Perforomist

You may wonder how Brovana compares to other medications that are prescribed for similar uses. Here we look at how Brovana and Perforomist are alike and different.

Uses

The Food and Drug Administration (FDA) has approved both Brovana and Perforomist to treat chronic obstructive pulmonary disease (COPD). COPD is a group of lung conditions that includes chronic bronchitis and emphysema. Neither drug is approved to treat asthma.

Both Brovana and Perforomist are maintenance medications, which means that they work over time. These drugs are meant to help you breathe better and prevent COPD symptoms from occurring.

Neither Brovana nor Perforomist should ever be used as a rescue treatment to treat a sudden COPD attack. And neither medication should be used in children.

Although Brovana and Perforomist don't contain the exact same drug ingredient, the two medications are very similar.

Drug forms and administration

Brovana contains the drug arformoterol tartrate. Perforomist contains the drug formoterol.

Brovana and Perforomist both come as a solution (liquid mixture) that you use in a device called a jet nebulizer. The nebulizer turns the drug into a mist that you inhale through a face mask or mouthpiece.

Brovana comes in a 15 mcg/2 mL vial, and Perforomist comes in a 20 mcg/2 mL vial. Both medications should be taken twice a day, once in the morning and once in the evening.

Side effects and risks

Brovana and Perforomist are both maintenance medications used to treat COPD. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Brovana, with Perforomist, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Brovana, with Perforomist, or with both drugs (when taken individually).

Effectiveness

The only condition both Brovana and Perforomist are used to treat is COPD.

These drugs haven't been directly compared in clinical studies, but studies have found both Brovana and Perforomist to be effective for treating COPD.

Costs

Brovana and Perforomist are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Brovana generally costs about the same as Perforomist. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Brovana vs. Spiriva

You may wonder how Brovana compares to other medications that are prescribed for similar uses. Here we look at how Brovana and Spiriva are alike and different.

Uses

The Food and Drug Administration (FDA) has approved both Brovana and Spiriva for the long-term treatment of symptoms in people with chronic obstructive pulmonary disease (COPD). COPD is a group of lung conditions that includes chronic bronchitis and emphysema.

Brovana and the form of Spiriva called Spiriva Handihaler aren't approved to treat asthma. However, the form of Spiriva called Spiriva Respimat is approved to treat asthma in adults as well as children ages 6 years and older.

Both Brovana and Spiriva are maintenance medications. This means that they work over time to help prevent your COPD symptoms from occurring.

Neither Brovana nor Spiriva should ever be used as a rescue treatment for sudden COPD attacks.

Drug forms and administration

Brovana contains the drug arformoterol tartrate. Spiriva contains the drug tiotropium.

Brovana comes as a solution (liquid mixture) that you use in a device called a jet nebulizer. The nebulizer turns the drug into a mist that you inhale through a face mask or mouthpiece. You should always inhale the Brovana solution and never swallow or inject it.

Brovana comes in a 15 mcg/2 mL vial. You'll normally take the medication twice a day, once in the morning and once in the evening.

Spiriva is used in an inhaler device called a Handihaler. Spiriva Handihaler is also known as a dry powder inhaler. To use Spiriva, you put an 18-mcg capsule into the Handihaler and then inhale the contents of the capsule. It's important to never swallow Spiriva capsules. You'll use Spiriva only once a day.

Spiriva is also available as Spiriva Respimat, which uses a different type of inhaler. Spiriva Respimat doesn't require capsules. The drug comes as a cartridge that releases a fine mist for you to inhale. The cartridge lasts for a month before it needs to be replaced. You'll use Spiriva Respimat once a day.

Side effects and risks

Brovana and Spiriva both contain medications that are used long term to treat COPD. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Brovana, with Spiriva, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Brovana, with Spiriva, or with both drugs (when taken individually).

  • Can occur with Brovana:
  • Can occur with Spiriva:
    • new or worsening glaucoma (increased pressure in your eyes)
    • new or worsening urinary retention (trouble urinating or painful urination)
  • Can occur with both Brovana and Spiriva:
    • allergic reactions
    • bronchospasm (sudden trouble breathing) right after using your medication

Effectiveness

The only condition both Brovana and Spiriva are used to treat is COPD.

The use of Brovana and Spiriva in treating COPD has been directly compared in a clinical study. Researchers looked at people who took just Brovana, just Spiriva, or both Brovana and Spiriva. Because Brovana and Spiriva act in different ways, it's possible that the two drugs can be used together.

People who took Brovana, Spiriva, or both Brovana and Spiriva all had improved lung function after 2 weeks of use. "Improved lung function" means that they had better control of airflow through their lungs. People who used both Brovana and Spiriva had the most improved breathing.

One test that's used to measure lung function is called FEV1, which stands for forced expiratory volume in 1 second. This is the amount of air you can push out of your lungs in 1 second after taking a deep breath.

In the study, people who took just Brovana had an increase in FEV1 of 0.10 L of air. In comparison, people who took just Spiriva had an increase of 0.08 L of air. People who took both Brovana and Spiriva had an increase of 0.22 L of air. This means that people who took both Brovana and Spiriva had a greater increase in the amount of air they were able to breathe out than people who took either Brovana or Spiriva alone.

The study also showed that people who took just Brovana, just Spiriva, or both drugs needed to use the rescue medication levalbuterol (Xopenex) less often. After 2 weeks of treatment, the percentage of people who used their rescue medication each day:

  • decreased from 80.3% to 52.6% in the Brovana group
  • decreased from 80.0% to 47.5% in the Spiriva group
  • decreased from 83.3% to 33.3% in the Brovana and Spiriva group

Costs

Brovana and Spiriva are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Spiriva Handihaler and Spiriva Respimat usually cost less than Brovana. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Brovana use with other drugs

Brovana is a medication that's used for maintenance treatment of chronic obstructive pulmonary disease (COPD). This means that it works over time to ease your symptoms. Brovana shouldn't be used to treat flare-ups of COPD such as sudden trouble breathing, so your doctor may recommend a second medication.

Brovana with rescue inhalers such as albuterol

In case you have a COPD flare-up while taking Brovana, your doctor will likely prescribe a type of medication called a short-acting beta2-agonist (SABA). These drugs are commonly called rescue inhalers. They work much more quickly than Brovana to ease your symptoms and help you breathe better.

Examples of rescue inhalers include albuterol (ProAir) and levalbuterol (Xopenex).

Brovana uses

The Food and Drug Administration (FDA) approves prescription drugs such as Brovana to treat certain conditions. Brovana may also be used off-label for other conditions. Off-label use is when a drug that's approved to treat one condition is used to treat a different condition.

Brovana for COPD

Brovana is used as a long-term treatment for people with chronic obstructive pulmonary disease (COPD). COPD is a group of lung conditions that includes chronic bronchitis and emphysema. About 11 million people in the United States are living with COPD, according to the American Lung Association. And as of 2017, COPD was the third leading cause of death by disease in the United States.

COPD often causes trouble breathing and swelling in your lungs. One of the conditions that can occur with COPD, chronic bronchitis, can cause you to cough up mucus for a long period of time. Another COPD-related condition is emphysema, in which the lungs have become damaged. This damage means that your body is getting less oxygen.

If you have COPD, you may:

  • cough with or without mucus
  • feel tired
  • have trouble breathing
  • wheeze

Effectiveness

Clinical studies of Brovana measured how well people's lungs worked with a test called FEV1. This stands for forced expiratory volume in 1 second. That's the amount of air you can push out of your lungs in 1 second after taking a deep breath.

Researchers found that Brovana increased FEV1 by an average of 11% compared to a placebo (no active treatment). Brovana was also shown to improve breathing and relax airway muscles better than a placebo for more than 12 hours.

Brovana is a maintenance medication, which means that it treats your COPD over time. You shouldn't take Brovana to treat any sudden symptoms of COPD because the drug doesn't work right away. So for COPD flare-ups, your doctor will likely recommend using a rescue inhaler such as albuterol (ProAir) or levalbuterol (Xopenex).

Brovana for other conditions

In addition to the use listed above, you may wonder if Brovana is used for certain other conditions.

Brovana for asthma (not an appropriate use)

Brovana shouldn't be used to treat asthma. The drug hasn't been studied in people with asthma, so it's not known if Brovana is safe to use for the condition.

Brovana is a type of drug called a long-acting beta2-agonist (LABA). It's known that LABAs should never be used without an inhaled corticosteroid in people with asthma. The use of LABAs alone in people with asthma can increase the risk of serious asthma-related symptoms that can lead to a hospital stay or death.

Common questions about Brovana

Here are answers to some frequently asked questions about Brovana.

Can I use other inhaled medications with Brovana when I have COPD exacerbations?

Yes, you can use Brovana with a type of medication called a short-acting beta2-agonist (SABA). SABAs are often called rescue inhalers, and you use them when you have sudden trouble breathing. This sudden flare-up of symptoms is known as an exacerbation.

Examples of rescue inhalers include albuterol (ProAir) and levalbuterol (Xopenex).

Brovana is a type of drug called a long-acting beta2-agonist (LABA). And sometimes LABAs are used along with an inhaled corticosteroid such as budesonide (Pulmicort) or tiotropium (Spiriva).

Both LABAs and inhaled corticosteroids can improve your breathing and help your lungs work better. If one medication isn't enough to help you, your doctor may recommend that you use both a LABA and an inhaled corticosteroid to improve your breathing even more.

You shouldn't use Brovana with a second LABA medication. Taking two LABA medications together can cause serious side effects such as chest pain and increased blood pressure. For some examples of other LABA medications to avoid while taking Brovana, see the "Alternatives to Brovana" section above.

If you have questions about Brovana or other medications to help treat chronic obstructive pulmonary disease (COPD), talk with your doctor.

Is Brovana a steroid?

No, Brovana isn't a steroid medication. Brovana is a type of drug called a long-acting beta2-agonist (LABA), which works by relaxing the muscles that let air into your lungs. This helps you breathe easier.

What does Brovana taste like?

It's unclear. Some people don't notice an aftertaste following a dose of Brovana. However, other people have an unpleasant taste in their mouth after using a nebulizer. (A nebulizer is a device that turns a drug into a mist that you inhale.)

If you use Brovana and then have an unpleasant taste that's bothersome to you, talk with your doctor. They can suggest ways to help make the medication easier to take.

Should I use Brovana for sudden breathing problems?

No. Brovana is used to treat your COPD long term. For sudden breathing problems, your doctor will likely recommend a rescue inhaler such as albuterol (ProAir) or levalbuterol (Xopenex). These medications work much faster than Brovana to treat COPD flare-ups.

If you feel that your breathing isn't being controlled well, talk with your doctor. They can suggest other ways to help treat your COPD symptoms.

I'll be using a nebulizer to take Brovana. How is that different from using an inhaler?

Brovana is a solution (liquid mixture) that you use in a device called a nebulizer. The nebulizer turns the drug into a mist that you can easily inhale so it reaches your lungs.

Nebulizers are very simple to use. You put the vial of Brovana into your nebulizer, put on the face mask or mouthpiece, and breathe normally for a certain time. You don't have to coordinate your breathing to make sure that you're getting your proper dose, as you do with an inhaler.

However, nebulizer treatments do take a little bit longer to use than inhalers. Each Brovana dose usually takes about 5 to 10 minutes to inhale. You'll also need to have a nebulizer machine to use Brovana.

If you have questions about Brovana or how to use a nebulizer, ask your doctor.

Brovana and alcohol

There are no known interactions between Brovana and alcohol. However, studies show that alcohol use may increase your risk for lung infections such as pneumonia. Drinking alcohol may also increase your risk for sudden symptoms such as trouble breathing.

If you drink alcohol, talk with your doctor. They can tell you how much is safe for you to drink during your treatment.

Brovana interactions

Brovana can interact with several other medications. It's not known to interact with supplements or foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Brovana and other medications

Below is a list of medications that can interact with Brovana. This list doesn't contain all drugs that may interact with Brovana.

Before taking Brovana, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Brovana and other COPD medications

Other medications used to treat chronic obstructive pulmonary disease (COPD) include short-acting beta2-agonists (SABAs) and long-acting beta2-agonists (LABAs). Brovana is a type of LABA.

You shouldn't use Brovana along with any other LABA medications. Using more than one LABA medication can increase your risk for side effects such as increased blood pressure and heart rate. The drugs may also cause hyperglycemia (high blood sugar) or hypokalemia (low potassium levels). Deaths have been reported in people who used more than the recommended dosage of LABA medication. Taking more than one LABA at a time may increase your risk for this happening.

Examples of other LABA medications include:

  • formoterol (Foradil, Perforomist)
  • indacaterol (Arcapta)
  • salmeterol (Serevent)
  • olodaterol (Striverdi)

During your Brovana treatment, your doctor may recommend a SABA medication in case you have sudden trouble breathing. SABAs are often called rescue inhalers. Using a SABA too frequently when taking Brovana may increase your risk for side effects such as higher blood pressure and heart rate.

Examples of SABA medications include:

  • albuterol (ProAir)
  • levalbuterol (Xopenex)

Before you start to take Brovana, talk with your doctor. They can advise you on the right LABA medication for you. Your doctor can also tell you how often it's safe to use your rescue inhaler during your Brovana treatment.

Brovana and aminophylline or theophylline

Using Brovana along with aminophylline or theophylline (Theochron) may cause you to have an increased risk for certain side effects. Each of these three lung medications can lower the potassium level in your blood. So taking Brovana with either aminophylline or theophylline can lower the potassium level even further.

Each of these three drugs can also increase your heart rate and blood pressure. So using aminophylline or theophylline with Brovana may cause larger increases in your heart rate and blood pressure.

In clinical trials of people who took both theophylline and Brovana, the people's blood pressure increased by about 6 to 8 mmHg. And people's heart rates increased by about two to three beats a minute. These blood pressure and heart rate statistics were in comparison to people who took Brovana without theophylline.

However, these studies were very small. So more research is needed to see if using these medications together will cause a significant increase in heart rate and blood pressure. Additional studies are also needed to see if the increase in blood pressure and heart rate is enough to cause a risk for heart attack or stroke in these people.

If you're taking aminophylline or theophylline, talk with your doctor before using Brovana. They may suggest a different treatment.

Brovana and steroids

Taking steroid medications along with Brovana may increase your risk for hypokalemia. This condition can cause you to have muscle cramps, feel tired, or have an irregular heartbeat (a heartbeat that's too fast, too slow, or uneven).

Examples of steroid medications include prednisone (Rayos) and methylprednisolone (Medrol).

If you're taking a steroid medication while using Brovana, your doctor may test your blood more often to monitor your potassium levels. This can help prevent them from becoming too low.

Brovana and diuretics

Using Brovana along with a diuretic medication may cause you to have hypokalemia. This condition is more likely to occur with a specific type of diuretic called non-potassium-sparing diuretics, which are also known as loop or thiazide diuretics. Taking a non-potassium-sparing diuretic along with Brovana can also change the electrical activity of your heart.

Examples of non-potassium-sparing diuretics include:

  • chlorthalidone
  • hydrochlorothiazode (Microzide)
  • indapamide
  • bumetanide (Bumex)
  • furosemide (Lasix)
  • ethacrynic acid (Edecrin)

If you use a diuretic with Brovana, your doctor may test your blood more often. By monitoring your potassium levels, your doctor may help prevent them from becoming too low. In addition, your doctor may use an electrocardiogram (ECG) to monitor your heart during your treatment.

Brovana and monoamine oxidase inhibitors (MAOIs)

Taking Brovana with a monoamine oxidase inhibitor (MAOI) medication may cause a heart rhythm problem called QT prolongation. This condition can change your heart rhythm, causing fast or irregular heartbeats. QT prolongation may not cause any symptoms, but sometimes it can be serious and lead to fainting or seizures.

Examples of MAOI medications include:

  • phenelzine (Nardil)
  • selegiline (Emsam)
  • tranylcypromine (Parnate)
  • isocarboxazid (Marplan)

If you take an MAOI medication, talk with your doctor before starting to use Brovana. They may monitor your heart more often while you're taking both medications or suggest a different treatment.

Brovana and tricyclic antidepressants

Using Brovana along with tricyclic antidepressant medications may increase your risk for a heart rhythm disorder called QT prolongation. For more about QT prolongation, see "Brovana and monoamine oxidase inhibitors (MAOIs)" right above.

Examples of tricyclic antidepressants include:

  • amitriptyline
  • nortriptyline (Pamelor)
  • doxepin (Silenor)
  • imipramine (Tofranil)
  • desipramine (Norpramin)

If you're taking a tricyclic antidepressant medication, talk with your doctor before starting to take Brovana. They may monitor your heart more often while you're taking both medications or suggest a different treatment.

Brovana and beta-blockers

Taking Brovana along with a beta-blocker medication may cause neither medication to work properly. This is because beta-blockers block beta receptors (proteins on the outside of cells that act like docking stations), and Brovana stimulates beta receptors. So the effects of two medications cancel each other out.

However, there's an increased risk of bronchospasm when you use Brovana and a beta-blocker together. A bronchospasm is a sudden narrowing of your airways that makes it harder to breathe.

Examples of beta-blockers include:

  • atenolol (Tenormin)
  • metoprolol (Lopressor, Toprol XL)
  • propranolol (Inderal)
  • nadolol (Corgard)
  • nebivolol (Bystolic)
  • carvedilol (Coreg)

It's best to avoid taking beta-blockers while you're using Brovana. However, in some situations, such as treating high blood pressure, a beta-blocker may be the best option for you. In such cases, your doctor will recommend a specific beta-blocker medication that will have the fewest negative effects on your breathing.

Brovana and medications that can cause QT prolongation

Some medications may cause a heart rhythm change called QT prolongation. For more about QT prolongation, see "Brovana and monoamine oxidase inhibitors (MAOIs)" above.

Here are some examples of medications that can cause QT prolongation.

Certain heart medications such as:

  • amiodarone (Pacerone)
  • procainamide
  • disopyramide (Norpace)
  • dofetilide (Tikosyn)
  • sotalol (Betapace)

Certain antipsychotic or antidepressant medications such as:

  • haloperidol (Haldol)
  • chlorpromazine
  • ziprasidone (Geodon)
  • risperidone (Risperdal)
  • citalopram (Celexa)

Certain antibiotics or antifungal medications such as:

  • levofloxacin
  • moxifloxacin (Avelox)
  • erythromycin (Erythrocin)
  • clarithromycin (Biaxin XL)
  • fluconazole (Diflucan)
  • ketoconazole (Nizoral)

Certain opioid use disorder treatments such as:

  • methadone (Dolophine)

If you're taking any of these medications or other drugs that may cause QT prolongation, talk with your doctor before starting to take Brovana. They may monitor your heart more often while you're taking both medications or suggest a different treatment.

Brovana and herbs and supplements

There aren't any herbs or supplements that have been specifically reported to interact with Brovana. However, you should still check with your doctor or pharmacist before using any of these products while taking Brovana.

Brovana cost

As with all medications, the cost of Brovana can vary. To find current prices for Brovana in your area, check out GoodRx.com:

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you'll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance company may require you to get prior authorization before they approve coverage for Brovana. This means that your doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Brovana.

If you're not sure if you'll need to get prior authorization for Brovana, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Brovana, or if you need help understanding your insurance coverage, help is available.

Sunovion Pharmaceuticals Inc., the manufacturer of Brovana, offers a program called Sunovion Answers. Specialists working with this program can help answer your questions about the cost of Brovana. For more information, call 844-276-8262.

How to take Brovana

You should take Brovana according to your doctor or healthcare provider's instructions.

Brovana comes as a solution (liquid mixture) that you use in a device called a jet nebulizer. This type of nebulizer uses compressed air to turn the drug into a mist. By inhaling the mist through a mask or mouthpiece, the drug can reach your lungs.

Your doctor or pharmacist will first show you how to use your nebulizer. For each dose, you'll breathe through a face mask or mouthpiece for 5 to 10 minutes. With a face mask, you can breathe through your nose or mouth. With a mouthpiece, you have to breathe through your mouth for the treatment. Usually, your doctor will let you decide if you prefer a face mask or a mouthpiece.

For more information about how to use this medication, see the directions on the Brovana website.

Be sure to never swallow the Brovana solution or inject it into your body. And you shouldn't use the medication to treat sudden symptoms of COPD such as trouble breathing. For such cases, your doctor will likely prescribe a rescue inhaler such as albuterol (ProAir) or levalbuterol (Xopenex).

When to take

You should take Brovana twice a day, once in the morning and once in the evening. Your doses should be about 12 hours apart.

To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

How Brovana works

Brovana is used to treat chronic obstructive pulmonary disease (COPD), which is a group of lung conditions that includes chronic bronchitis and emphysema.

With bronchitis, the linings of your airways become inflamed (swollen), which makes them thicker. More mucus forms in your airways as well, so they become more narrow. This can make it harder to breathe and cause you to cough up mucus. Bronchitis is considered chronic if you have such a cough for more than 3 months a year for longer than 2 years.

With emphysema, air sacs in your lungs become damaged, making your lungs less elastic. This can cause you to have a long-term cough and make it harder to breathe.

When you have COPD, trouble breathing and narrowed airways tend to get worse over time.

What Brovana does

Brovana is a type of medication called a long-acting beta2-adrenergic agonist (LABA). LABA medications work by relaxing the muscles in your airways. This opens up your airways and makes it easier for you to breathe. LABA drugs can also help prevent the symptoms of COPD, such as coughing, wheezing, and shortness of breath.

How long does it take to work?

Brovana can start working within a few minutes after you take it. The medication should keep easing your COPD symptoms for about 12 hours after your dose. It's important to take Brovana twice a day so that it continues to work.

In clinical trials of Brovana, people's airways started opening about 6.7 minutes after they took the drug, making it easier to breathe. People's airways were the most open about 1 to 3 hours after they took Brovana.

Brovana and pregnancy

It's not known if Brovana can cause birth defects or miscarriage. There are currently no studies of pregnant women who took Brovana. In animal studies, there were some birth defects, developmental delays, and infant deaths. However, the animals were given 370 to 8,400 times the recommended dose in humans.

It's possible that Brovana and other similar drugs may cause contractions in the uterus (an organ in a woman's reproductive system). Because of this possible effect, you shouldn't take Brovana while you're in labor unless your doctor tells you to.

More studies are needed to see if Brovana is safe for women to take during pregnancy. If you're pregnant or planning to become pregnant, talk with your doctor about whether Brovana is right for you.

Brovana and birth control

It's not known if Brovana is safe to take during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you're using Brovana.

Brovana and breastfeeding

It's not known if Brovana is safe to use while you're breastfeeding. There are no animal or human data showing the effects of Brovana on breastfed children. However, in an animal study, Brovana was seen in the mothers' breast milk. Keep in mind that animal studies don't always predict what happens in humans.

If you're breastfeeding, talk with your doctor before taking Brovana. They can review the pros and cons of the medication with you.

Brovana precautions

Before taking Brovana, talk with your doctor about your health history. Brovana may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Chronic obstructive pulmonary disease (COPD) that suddenly worsens. You shouldn't take Brovana if you have chronic obstructive pulmonary disease (COPD) that's quickly getting worse. It may be a life-threatening condition. Ask your doctor what other medication may be a better choice for you.
  • Sudden symptoms, such as trouble breathing. If you're having sudden trouble breathing, you shouldn't use Brovana to ease your symptoms. Brovana is a long-term maintenance medication, which means that it helps treat COPD over time. For COPD flare-ups, your doctor may prescribe a rescue inhaler such as albuterol (ProAir) or levalbuterol (Xopenex).
  • Heart disorders, such as high blood pressure. Brovana may cause an increase in your heart rate or blood pressure. The drug may also change the electrical activity of your heart. If you already have high blood pressure or another heart disorder, talk with your doctor before taking Brovana. They may monitor your heart more often during your Brovana treatment.
  • Seizure disorders. Brovana may stimulate your central nervous system (CNS), which includes your spinal cord and brain. Using medications that activate your CNS may increase the risk of a seizure if you have a history of seizures. If you have a seizure disorder, talk with your doctor before taking Brovana. They may suggest a different medication.
  • Thyroid disorders. If you have hyperthyroidism (an overactive thyroid), you shouldn't take Brovana. Sometimes drugs called beta-blockers are used to treat hyperthyroidism. And if you take Brovana with a beta-blocker, neither medication may work properly. Ask your doctor what other medication may be a better choice for you. For more information, see the "Brovana interactions" section above.
  • Allergic reaction. If you've had an allergic reaction to Brovana or any of its ingredients, you shouldn't use Brovana. You should also avoid taking Brovana if you're allergic to any other type of long- or short-acting beta2-agonist medications (LABAs or SABAs). If you're not sure if you're allergic, talk with your doctor.
  • Asthma. You shouldn't take Brovana to treat asthma. It's not known if Brovana is a safe and effective medication for the condition. LABA medications such as Brovana should never be used by themselves to treat asthma. This is because the drugs can increase the risk for a hospital stay or death if you have asthma.
  • Diabetes. Brovana may increase your blood sugar level, causing hyperglycemia (high blood sugar). If you have diabetes, talk with your doctor before starting to take Brovana. They may have you check your blood sugar more often during your Brovana treatment.
  • Liverproblems. Your liver breaks down Brovana in your body. So if you have liver problems, your body may not get rid of Brovana as quickly as it should. This can cause the medication to build up in your body. If you have liver problems, talk with your doctor before starting to take Brovana.
  • Pregnancy. It's not known if Brovana is safe to use during pregnancy. For more information, please see the "Brovana and pregnancy" section above.
  • Breastfeeding. It's not known if Brovana is safe to use while breastfeeding. For more information, please see the "Brovana and breastfeeding" section above.

Note: For more information about the potential negative effects of Brovana, see the "Brovana side effects" section above.

Brovana overdose

There were no cases of Brovana overdoses noted during clinical trials. However, using more than the recommended dosage of Brovana can lead to serious side effects. It's possible that a heart attack or death can occur from a Brovana overdose.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you've taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Brovana expiration, storage, and disposal

When you get Brovana from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Store Brovana in the refrigerator between 36°F and 46°F (2° to 8°C). Protect the medication from heat and light, and keep the drug in the foil pouch until you're ready to use it. After you open the foil pouch, you should put unused Brovana vials back into the pouch and store them there. But you should use opened Brovana vials right away.

You can also store unopened foil pouches at room temperature (68°F to 77°F/20°C to 25°C) for a maximum of 6 weeks. If you keep Brovana at room temperature and don't use it within 6 weeks, you must throw out the medication.

Disposal

If you no longer need to take Brovana and have leftover medication, it's important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Professional information for Brovana

The following information is provided for clinicians and other healthcare professionals.

Indications

Brovana is approved for use in adults with chronic obstructive pulmonary disease (COPD). It should be used as a long-term maintenance treatment to decrease bronchoconstriction in patients with COPD.

Mechanism of action

Brovana is a long-acting beta2-adrenergic agonist (LABA). It works by stimulating adenyl cyclase in the cells, causing conversion of adenosine triphosphate to cyclic-3',5'-adenosine monophosphate (cyclic AMP). Cyclic AMP causes bronchodilation via relaxation of bronchial smooth muscles. Cyclic AMP also inhibits the release of hypersensitivity mediators that may contribute to COPD symptoms.

The active drug ingredient in Brovana is arformoterol, which is the (R,R)-enantiomer of formoterol (Perforomist). Arformoterol has a two times greater potency than the racemic form of formoterol.

Pharmacokinetics and metabolism

The average steady-state peak for Brovana occurred about 30 minutes after Brovana was administered. A substantial amount of systemically absorbed Brovana is due to pulmonary absorption. This was seen in a study where patients received Brovana plus activated charcoal compared to Brovana alone. Patients who received both Brovana and activated charcoal had a decrease in the AUC of Brovana over 6 hours (0-6h) by 27% and a decrease in Cmax by 23% compared to patients who just received Brovana alone. The half-life of Brovana is about 26 hours in patients taking the approved dose for 14 days.

Brovana may be significantly protein bound. In vitro studies determined that Brovana bound human plasma protein at rates of about 52% to 65%. However, this may differ for in vivo studies, for which there is no current data.

Metabolism of Brovana is believed to occur by two different means. The primary metabolism is by glucuronidation and secondary metabolism occurs by O-demethylation. In vitro studies show that Brovana is metabolized mainly by human uridine diphosphoglucuronosyltransferase isozymes. In the secondary metabolism, cytochrome P450 isozymes work to metabolize Brovana. The two main CYP enzymes that are involved are CYP2D6 and CYP2C19.

Elimination is believed to mainly occur in urine and secondarily in feces. In a small study where oral radiolabeled Brovana was given, 63% was found in urine and 11% in feces within 48 hours post-dose. In total, 89% of the drug was recovered within 14 days.

Contraindications

Brovana is contraindicated for use in people with a history of allergic reaction to Brovana, formoterol, or any of the product ingredients. It is also contraindicated for use in patients with asthma without an inhaled corticosteroid. Using a LABA medication alone in patients with asthma increases risk of asthma-related hospitalization and death.

Storage

Brovana should be stored in the refrigerator between 36°F and 46°F (2° to 8°C). The solution should be protected from heat and light and kept in the foil pouch until it's ready to be used. After the foil pouch is opened, any unused Brovana vials should put back into the pouch and stored there. Opened Brovana vials should be used right away.

Unopened foil pouches can also be stored at room temperature from 68°F to 77°F (20°C to 25°C) for a maximum of 6 weeks. If the medication is kept at room temperature and not used within 6 weeks, it must be discarded.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.