Aroneb

Indications

Aroneb is prescribed for the long-term management of bronchoconstriction associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is administered twice daily, in the morning and evening.

Important Limitations: Aroneb nebulizer solution is not intended for the treatment of acute COPD exacerbations. Additionally, individuals with asthma using long-acting beta-2 adrenergic agonists (LABAs) like Aroneb may face an increased risk of asthma-related mortality.
Consult a registered healthcare professional before using this medication.

Description

Aroneb is a salt formulation of Arformoterol, specifically the (R,R)-enantiomer of formoterol. This selective beta-2 adrenergic bronchodilator exhibits double the potency of racemic formoterol, which contains both the (S,S) and (R,R) enantiomers. The (S,S)-enantiomer is significantly less potent, approximately 1,000-fold less so, as a beta-2 agonist compared to its (R,R) counterpart. In laboratory studies, Arformoterol has shown effectiveness in inhibiting the release of mast cell mediators, such as histamine and leukotrienes, from human lung tissue.

Dosage & Administration

The standard dosage of Arformoterol nebulizer solution is one 15 mcg unit-dose ampoule, to be administered via nebulization twice daily (morning and evening). It is advised not to exceed a total daily dose of 30 mcg (15 mcg twice daily).

Pediatric Use: COPD is not diagnosed in children, and the safety and efficacy of Arformoterol nebulizer solution in pediatric patients have not been determined.
Consult a registered healthcare professional before using this medication.

Interactions

Concurrent use of other adrenergic medications may enhance the effects of Aroneb. Xanthine derivatives, steroids, diuretics, and non-potassium-sparing diuretics may contribute to hypokalemia or lead to changes in ECG readings. Additionally, MAO inhibitors, tricyclic antidepressants, and drugs that prolong the QTc interval may amplify cardiovascular effects. Beta-blockers can diminish the effectiveness of Aroneb.

Side Effects

Common side effects include pain, chest pain, back pain, diarrhea, sinusitis, leg cramps, shortness of breath, rash, flu-like symptoms, peripheral edema, and pulmonary issues. Serious risks may arise, particularly for asthma patients using LABA medications, as they face an elevated risk of asthma-related fatalities. Seek immediate medical attention if you experience:

• Rapid worsening of breathing difficulties
• Inadequate relief from breathing issues after using a rescue inhaler

Pregnancy & Lactation

Pregnancy Category C. The use of Arformoterol nebulizer solution during pregnancy should only be considered if the benefits outweigh the potential risks to the fetus. It remains unclear whether arformoterol is secreted in human breast milk.

Precautions & Warnings

Aroneb nebulizer should not be initiated in patients experiencing acute deterioration. Caution is advised for individuals with cardiovascular or seizure disorders, thyrotoxicosis, or sensitivity to sympathomimetic agents. Life-threatening paradoxical bronchospasm may occur.

Overdose Effects

As with any inhaled sympathomimetic medication, an overdose of Aroneb nebulizer solution can lead to severe consequences, including cardiac arrest and potential death.

Therapeutic Class

Bronchodilator

Storage Conditions

Store Aroneb nebulizer solution at temperatures between 2-8°C, away from light and excessive heat. Do not freeze, and ensure it is kept out of reach of children.