PharmaceuticalBeta-2 agonistBronchodilatorLABA

Arformoterol

Also known as Brovana · (R,R)-formoterol

Written by enwyReviewed 15 Jul 20261 sources0 comments

Arformoterol is the (R,R)-enantiomer of formoterol, a long-acting beta-2 agonist delivered by nebulised solution for the maintenance treatment of COPD. It offers the same 12-hour bronchodilation as racemic formoterol in a single-isomer nebulised form. It has no meaningful physique or fat-loss use; its role is COPD maintenance in patients who benefit from nebulisation.

01 Overview

Arformoterol is the pharmacologically active (R,R)-enantiomer isolated from racemic formoterol. It is a long-acting selective beta-2 agonist supplied as a nebuliser solution and dosed twice daily for the long-term maintenance of bronchoconstriction in COPD. Isolating the active enantiomer was intended to deliver bronchodilation at a lower total drug mass.

As a LABA it carries the class warning against monotherapy in asthma (it is licensed for COPD, not asthma). Its systemic sympathomimetic effects — tremor, palpitations, hypokalaemia — parallel those of other beta-2 agonists. It is not used as a cutting or thermogenic agent; the nebulised route and low systemic exposure give little metabolic effect.

02 Mechanism

Single (R,R)-enantiomer long-acting beta-2 agonist. Selectively activates beta-2 receptors to raise cyclic AMP and relax airway smooth muscle, giving ~12-hour bronchodilation from a nebulised dose.

03 Dosing

Tier	Dose	Route	Notes
COPD maintenance	15 mcg	Inhaled	15 mcg nebulised twice daily; not for acute relief or asthma.

04 Effects

Effect	Magnitude	Evidence
Sustained bronchodilationLong-acting relief of airflow obstruction in COPD from a nebulised dose.	~12 hour duration	Clinical
Improved lung functionImproves FEV1 and symptom control as COPD maintenance therapy.	FEV1 improvement	Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Tremor and palpitationsFine tremor, palpitations and nervousness from systemic beta-2 stimulation.	Mild	Common	Clinical
Increased severe events (asthma monotherapy)Class effect: LABA monotherapy in asthma is associated with increased severe asthma events; arformoterol is licensed only for COPD.	Severe	Rare, off-label asthma use	Clinical
HypokalaemiaBeta-2-mediated intracellular potassium shift.	Moderate	With high doses	Clinical

06 Legal status

United States

Prescription drug

FDA-approved as Brovana for COPD maintenance; not indicated for asthma. · as of Jan 2026

07 References

Arformoterol tartrate for COPD maintenancePrescribing information / clinical review

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.