When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to arformoterol or formoterol.

How to Use This Medicine:
Liquid

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Use the medicine immediately after you open the foil pouch.
• Do not swallow or inject the medicine. Only inhale the medicine.
• You will use this medicine with an inhaler device called a nebulizer. The nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Keep the medicine in the foil pouch until you are ready to use it. Store the medicine at room temperature or in the refrigerator, away from heat and direct light. Do not freeze. You can keep the medicine for up to 6 weeks if you store it at room temperature.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use arformoterol together with similar inhaled medicines such as salmeterol/fluticasone or formoterol.
• Some medicines can affect how arformoterol works. Tell your doctor if you are taking any of the following:
  
  • A monoamine oxidase (MAO) inhibitor
  • Antibiotics, such as erythromycin, levofloxacin, moxifloxacin, sparfloxacin
  • Asthma medicine, such as aminophylline, theophylline
  • Beta-blocker medicine, such as atenolol, metoprolol, propranolol
  • Diuretics (water pills), such as furosemide, torsemide, hydrochlorothiazide
  • Medicine to treat mental illness, such as haloperidol, mesoridazine, pimozide, prochlorperazine, quetiapine, thioridazine, ziprasidone
  • Steroid medicine, such as dexamethasone, prednisolone, prednisone
  • Tricyclic antidepressant medicine

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have asthma, liver disease, heart or blood vessel disease, heart rhythm problems, high blood pressure, a seizure or thyroid disorder, diabetes, or an electrolyte imbalance (such as a low potassium level).
• Tell your doctor if you are also using any other medicine for your COPD. Your doctor may want you to use your other medicine only during a severe COPD exacerbation.
• Do not use arformoterol if you are having any symptoms of a COPD exacerbation. Your doctor may prescribe another medicine for you to use instead. If the other medicine does not work as well, tell your doctor right away.
• If you have asthma, you may have severe asthma attacks when you use arformoterol. Talk to your doctor about any questions or concerns you have.
• Do not use more medicine or use it more often than directed by your doctor. Too much of this medicine may be life-threatening.
• This medicine may cause a life-threatening breathing problem called paradoxical bronchospasm.
• Do not give this medicine to a child unless your doctor tells you to.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Call your doctor if your symptoms do not improve or if they get worse.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate
• Chest pain
• Confusion, drowsiness, restlessness, or fast, deep breathing
• Dry mouth, increased thirst or hunger, muscle cramps, and nausea or vomiting
• Eye pain, changes in vision
• Fast, pounding, or uneven heartbeat
• Lightheadedness, dizziness, or fainting
• Numbness or weakness in your arm or leg, or on one side of your body
• Red or black stools, or dark urine
• Shortness of breath or trouble breathing, cold sweat, and bluish skin
• Stomach pain, flushed, dry skin, and fruit-like breath odor
• Sudden or severe headache, problems talking or walking
• Swelling in your hands, ankles, or feet
• Tremors or nervousness
• Unusual tiredness or weakness, trouble sleeping

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088