Other Brands/Names

Symbicort, Innovair, Duaklir Genuair.

How It Works

Formoterol is an inhaled long-acting beta-2 receptor agonist (LABA). In the lungs, it acts as a bronchodilator by relaxing the smooth muscles of the bronchial airways, helping them open so air can move more easily.

Its effects persist for many hours because the drug can be retained within airway cells. Formoterol also shows anti-inflammatory activity, although the clinical importance of this effect has not been clearly established.

Indications

Formoterol is indicated for chronic obstructive pulmonary disease (COPD), asthma, and for preventing exercise-induced bronchospasm.

You can find additional reading on these conditions in Ai Care resources:

• COPD
• Asthma

Contraindication

Formoterol is contraindicated in status asthmaticus, in other acute episodes of asthma or COPD, and as monotherapy for asthma.

Side Effects

Side effects can occur in certain conditions. The following are possible side effects of formoterol use, including:

• Treatment of asthma: Viral infections, bronchitis, chest infections, shortness of breath, chest pain, tremors, dizziness, insomnia, tonsillitis, rash, dysphonia.

• COPD: Upper respiratory tract infections (URTIs), back pain, pharyngitis, chest pain, sinusitis, fever, muscle cramps, leg cramps, anxiety, itchy skin, increased phlegm, dry mouth.

• Fatal bronchial muscle disorders.

Types

Dry-powder inhaler: 160/4.5 mcg and 80/4.5 mcg per dose.

Dosage

Treatment and prevention of asthma attacks

• Dose: 12 mcg by inhalation twice daily. If needed, the dose may be increased to 24 mcg twice daily. Therapy is typically used together with an inhaled corticosteroid.

Treatment of COPD

• Dose: 12 mcg by inhalation twice daily. Additional inhalations may be considered based on clinical status. The maximum total daily dose is 48 mcg.

Prophylaxis of exercise-induced asthma

• Adults: 12 mcg inhaled at least 15 minutes before exercise. Do not repeat before 12 hours have passed.

Safety

Pregnant women:

Category C (animal studies have shown fetal adverse effects, and there are no adequate controlled studies in pregnant women). Use only when the expected benefit justifies the potential risk.

Breastfeeding mothers:

It is unknown whether formoterol is excreted in human milk. Do not use without consulting and receiving approval from a doctor.

Drug Interactions

Formoterol may raise the risk of heart rhythm disturbances when combined with medicines such as quinidine, disopyramide, procainamide, phenothiazines, certain antihistamines, and erythromycin. It may also increase adverse effects with other sympathomimetics, and cardiovascular events may rise when used alongside MAOIs, macrolides, or TCAs.

The risk of hypokalemia may increase with xanthine derivatives, corticosteroids, and potassium-sparing diuretics. Arrhythmia risk may be higher with halogenated hydrocarbon anesthetics. Bronchodilator effects may be enhanced with anticholinergics. Beta-blockers can antagonize its effect.

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