Formoterol (Inhalation)

Formoterol provides relief to the muscles within the airway for asthma patients.

Overview

Formoterol is a long-acting inhalant prescribed to alleviate symptoms and counteract bronchospasms in patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD). Foroterol can reduce the severity and quantity of asthma attacks when taken as prescribed daily. However, this inhaler cannot provide relief for asthma attacks that have already begun.

Signs of chronic obstructive pulmonary disease can also be treated by formoterol, including emphysema and chronic bronchitis.

Formoterol is an adrenergic bronchodilator medication, medications which open the air passages (bronchial tubes) within the lungs and are breathed in by mouth. Adrenergic bronchodilator medications provide relief for breath shortness, coughs and breathing difficulties by maximizing the air that flows within the bronchial tubes.

This medication has a prolonged period of action (it can last up to 12 hours) compared to short-acting inhalants that typically provide relief for a four to six hour duration. Formoterol is a long-acting beta-adrenoceptor agonist and is a system controller that should supplement prophylactic corticosteroid treatment. Long-acting beta-adrenoceptors are not suggested to treat acute asthma, which is why a short-acting inhalant that relieves symptoms is still necessary.

Formoterol can also stop wheezing that is brought on by exercise (this is known as bronchospasm that is exercise-induced).

This medication can only be obtained with a valid prescription from your physician.

Formoterol is available in solution, capsule and aerosol powder. It is manufactured under the US brand names Perforomist and Foradil Aerolizer.

Condition treated

  • Asthma

Type Of Medicine

  • Adrenergic bronchodilator

Side Effects

Medications can occasionally cause undesirable side effects in addition to the needed benefits they may provide. While it is not typical for every side effect listed below to take place, if they do happen, they could require medical care.

Consult with your physician right away if any of the subsequent side effects take place while you are on formoterol.

More common side effects ' medical care required

  • Weakness or tiredness (unusual)
  • Voice loss
  • Sore throat
  • Sneezing
  • Runny nose
  • Nasal congestion
  • Hoarseness or cough
  • Headache
  • Flu-like or cold-like symptoms
  • Fever
  • Ear congestion
  • Chills
  • Breathing difficulty
  • Body pains or aches

Less common side effects ' medical care required

  • Voice changes
  • Trauma
  • Tenderness or pain near the cheekbones or eyes
  • Swollen and tender glands within neck
  • Dry throat
  • Difficulty swallowing
  • Cough that produces mucus
  • Chest tightness
  • Chest discomfort or pain
  • Breathing issues (labored)
  • Breath shortness

Rare side effects ' medical care required

  • Urine decrease
  • Thirst increase
  • Pulse irregularity, quickness, or pounding
  • Noisy breathing
  • Heartbeat irregularity, quickness, or pounding
  • Fainting
  • Dry mouth
  • Convulsions
  • Appetite loss

Additional side effects (incidence rate not known) ' medical care required

  • Vision blurred
  • Swelling or puffiness of the tongue, lips, face, eyes, or eyelids
  • Sweating
  • Skin rash
  • Itching
  • Hives
  • Hive-like, large swelling on the feet, sex organs, legs, hands throat, tongue, lips, eyelids, or face
  • Faintness, lightheadedness, or dizziness when arising quickly from a sitting or lying position
  • Confusion

Seek immediate emergency care if you experience any of the overdose symptoms below:

  • Vomiting
  • Unconsciousness
  • Tingling or numbness in the lips, feet, or hands
  • Slow heartbeat
  • Sleeplessness
  • Pulse or heartbeat racing or pounding
  • Pounding or palpitations within ears
  • Nausea
  • Muscle pain
  • Muscle jerking or spasm of extremities
  • Maximized appetite or hunger
  • Lack of pulse or blood pressure
  • Increased frequency of urination
  • Heart stopped
  • General discomfort or feeling of illness
  • Consciousness loss (sudden)
  • Chest heaviness or tightness
  • Back, jaw, or arm pain

Occasionally, side effects may take place that will not require medical care. As your body becomes more accustomed to the medication, these side effects may disappear. In addition, your physician can inform you of more ways to either reduce or prevent certain side effects. Ask your medical care professional if the side effects are prolonged, become troublesome, or if you have any concerns or questions regarding them.

Less common side effects (medical care not required)

  • Skin redness
  • Shaking or trembling of the feet or hands
  • Restlessness
  • Muscle cramps
  • Leg cramps
  • Heightened levels of mucus within the lungs and throat
  • Feet, hands, arms, or leg shakiness
  • Difficulty sleeping
  • Back pain
  • Agitation

Additional side effects not included here can also take place for certain patients. If other side effects are noticed, please check with your medical care professional.

Consult with your doctor regarding medical advice for side effects. The FDA also accepts reports of observed side effects, and they can be reached by calling 1-800-FDA-1088.

Dosage

Only take formoterol as prescribed by your physician. Never take more of it and do not take it more frequently than the medication label recommends, unless instructed otherwise by your physician. Using this medication more frequently could cause the chance of undesirable side effects taking place to increase.

Formoterol cannot provide relief for asthma attacks that have begun already. Patients who need to relieve an asthma attack that has already begun should take a different medication. If there is not another option for medications for you to take, or if you have questions regarding this matter, please consult with your physician.

This medication must be taken daily to counteract asthma or COPD attacks at dosage times that are regularly spaced out, according to the instructions by your physician.

If you have already been taking formoterol and would like to stop, please discuss with your physician prior to stopping. Your doctor may recommend for you to gradually reduce doses of this medication before stopping outright.

The solution manufactured with formoterol should be paired with a nebulizer (jet) connected to a high-flow air compressor. The inhalant solution has a medication overview guide in the prescription. Follow and read all instructions cautiously. Consult your physician with any concerns or questions.

For use with the inhalant solution in nebulizer:

1. After opening the pouch (foil), use medication right away.
2. Remove the lid from the vial and push all of the medication into the nebulizer cup.
3. Do not mix other types of inhalant solutions within the nebulizing mechanism.
4. Attach the nebulizer to the mouthpiece or face mask.
5. Breathe in the medication through the mouthpiece or face mask.
6. Breathe in through the nebulizer for around nine minutes; this is how long the nebulizer cup should take to be empty.
7. Clean the nebulizer and every part of it after use.

Formoterol powder should only be used with a designated inhaler. It typically comes with patient instructions and a medication overview. Always read instructions thoroughly prior to taking this medication. If the directions are difficult to understand, or you are not completely sure about how the inhaler is used, ask your physician for a demonstration of how to use it. In addition, consult with your physician to see if they can watch you use the inhaler to ensure that you know how to use it correctly.

For formoterol inhalation powder use:

1. Ensure your hands are completely dry prior to handling formoterol.
2. The foil package is a blister container of capsules. Only remove a capsule from the blister card when you are having a dose.
3. Put the capsule in the capsule-chamber at the bottom area of inhaler. Never swallow the capsule. Never put a capsule onto the mouthpiece.
4. Grasp the mouthpiece upright and push both of the buttons simultaneously, but only push the buttons once overall. A click should signal to you that the capsule has been pierced.
5. Breathe out completely. Do not breathe out in the mouthpiece.
6. Angle your head backwards somewhat. Maintain a level positioning of the inhaler, and keep the blue buttons to each side (on the right and left side, accordingly).
7. Breathe in deeply and quickly.
8. Take the inhaler away from the mouth. Hold a breath for as long as possible and finally exhale.
9. After use, open the inhaler, and take out and dispose of the capsule that is empty. Do not let the used capsule remain in the inhalant chamber after use.
10. Proceed to close the mouthpiece. Return the cover of the inhaler to its original position.

Note:

  • Never wash the interior or exterior of the inhaler. Ensure the equipment remains dry at all times.
  • Never use this inhaler for another type of medication.
  • Never use a spacer with formoterol.
  • This inhaler may be reused. However, a new inhaler should be used with every refill of the medication.

Different patients will most likely require varied doses of formoterol. Only refer directly to the medication label instructions or the orders given by your doctor. The information listed in this summary provides an overview of only the typical doses of formoterol. If you are given a dose that varies from the information listed here, do not adjust your dose unless otherwise instructed by your physician.

The strength of formoterol will determine the dose you are given. Also, the total number of doses taken per day, the time allotted between the doses, and the total duration for which the medication is taken depends directly on the medical issue for which you need this medication.

Inhalation powder dosage instructions

To counteract an asthma attack:

  • Adults, adolescents, and children over five: Take 12 micrograms (one capsule) orally with the inhaler once per 12-hour period.
  • Children under age five: A physician must determine dosage information.

To prevent bronchospasm that is exercise-induced

  • Adults, adolescents, and children over age five: Take 12 micrograms (one capsule) through mouth with the inhaler at least 15 minutes prior to exercising, as required.
  • Children under age five: The doctor must always determine dose for young children.

For treatment of COPD (maintenance)

  • Adults, adolescents, and young children over age five: Take 12 micrograms (one capsule) once for every 12-hour period.
  • Children under age five: A physician must calculate safety and dosage information.

Inhalation solution dosage instructions

For treatment of COPD:

  • Adults should take 20 micrograms (one vial) twice daily through the nebulizer (morning and night).

Missed dose

If a dose of formoterol is missed accidentally, the patient should allow the missed dose to remain skipped and return to the normal dosage routine. Never double doses of this medication.

Interactions

Drug Interactions

While some medications should never be combined, certain circumstances may warrant the combination, even if there is a chance that an interaction may take place. In these situations, your physician will likely lower the dose, or they may choose to take other types of precautions for your safety.

When you're taking formoterol, it is highly important that your medical care professional is aware of whether you are taking any of the subsequent medications. These medications could potentially have a significant interaction with formoterol. This list is not entirely all-inclusive.

Patients should not take formoterol with any of the medications listed below. Your physician may choose not to prescribe this drug to you or they may alternatively change other medications you may be taking.

  • Thioridazine
  • Saquinavir
  • Piperaquine
  • Pimozide
  • Sparfloxacin
  • Ziprasidone
  • Amisulpride
  • Mesoridazine
  • Dronedarone
  • Cisapride
  • Terfenadine
  • Bepridil
  • Amifampridine

It is not typically suggested to combine formoterol with any of the medications below, but certain circumstances may necessitate the combination. If both medications end up being prescribed at the same time, your physician may wish to alter the dosage or adjust the dosage frequency for either medication.

  • Zuclopenthixol
  • Vinflunine
  • Vemurafenib
  • Triptorelin
  • Tacrolimus
  • Sulpiride
  • Sotalol
  • Quetiapine
  • Pitolisant
  • Pimavanserin
  • Pasireotide
  • Panobinostat
  • Nafarelin
  • Metronidazole
  • Levofloxacin
  • Leuprolide
  • Ivabradine
  • Hydroxyzine
  • Hydroxychloroquine
  • Histrelin
  • Goserelin
  • Gonadorelin
  • Fluoxetine
  • Escitalopram
  • Efavirenz
  • Donepezil
  • Domperidone
  • Deslorelin
  • Delamanid
  • Degarelix
  • Dabrafenib
  • Buserelin
  • Aripiprazole
  • Anagrelide
  • Amiodarone

Other Interactions

Some prescription drugs should not be taken near mealtime or when having specific kinds of food due to the higher likelihood of interaction taking place. The use of tobacco or alcohol in addition to some medications can also encourage more interactions to occur. Patients should consult with their doctor to determine how formoterol interacts with tobacco, alcohol and food.

Medical Interactions

Patients with additional medical issues can experience impacts on the effectiveness of formoterol. Ensure your medical care professionals are familiar with any type of medical illness you may have, especially the following:

  • Asthma attack (acute)
  • COPD attack (severe)
  • Angina (serious chest pain)
  • COPD attack (serious)
  • Diabetes
  • Blood vessel or heart disease (aneurysm)
  • Heart rhythm issues (arrhythmia)
  • High blood pressure (hypertension)
  • Hyperthyroidism (overactive thyroid)
  • Hypokalemia (potassium deficiency within the blood)
  • Ketoacidosis (acids within blood)
  • Adrenal gland issue (pheochromocytoma)
  • Seizures 'take caution; conditions can be made worse
  • Lactose intolerance'take caution, lactose is present in the capsule form of formoterol

Warnings

If you plan on taking formoterol long-term, it is highly important that you visit your physician regularly for visits. Regular checkups will give the doctor an opportunity to examine whether the medication is working as it should and check for undesirable side effects. If symptoms become worse or are not better within several days, see your physician.

Inform your physician if you are already taking any other kind of medication for COPD. Your physician may ask that you stop taking the other medication and take it only if you suffer a severe COPD attack. Always follow your physician's instructions with regards to how any medication should be taken.

Formoterol should not be taken while a serious COPD attack is taking place, or if you have already experienced signs of a COPD attack. Your physician may suggest another medication to be taken during instances where an acute COPD attack transpires. If you encounter issues regarding the effectiveness of the alternate, inform your physician immediately.

This medication should be taken only as a supplementary treatment. It is intended for patients who are not able to be prescribed other kinds of asthma medications (inhaled corticosteroids, for instance), or for patients with asthma who need a total of two medications. Consult with your physician if any questions arise.

Seek emergency care immediately if any of the following situations take place:

  • Symptoms become worse or are not better after one week of use
  • Your normal inhaler (short-acting) is not working as it should and it needs to be used more frequently (for example, one entire canister of the short-acting inhalant is used in an eight week time frame, or you need it four or more times in a period of two consecutive days).
  • A noticeable decrease in the peak flow is noticed when you are measuring as instructed by your physician

Patients may also be prescribed an anti-inflammatory medication (for example, steroids) when taking this medication. The anti-inflammatory medication should not be stopped even if the asthma seems to improve, unless otherwise instructed by your physician.

While this medication can reduce the quantity of asthma episodes, it can also increase the likelihood that a severe asthma attack may take place when they happen. Read carefully about risks such as these in the medication overview guide and talk with your pharmacist or doctor about any concerns or questions you may have.

This medication can trigger paradoxical bronchospasm, meaning that your wheezing or breathing could become worse. This condition can be life-threatening. This medication should be stopped immediately if patients experience wheezing, breath shortness, breathing difficulty or coughing after taking formoterol.

Anaphylaxis can also occur after you take formoterol. This condition may be life-threatening and emergency medical care must be provided to the patient. Contact your physician immediately if you experience swelling of the mouth, face or hands, have difficulty swallowing, have issues breathing, encounter hoarseness, itching or rash while taking formoterol.

Low potassium levels within the blood (hypokalemia) may result from taking formoterol. Always consult with your physician if you experience two or more of the subsequent symptoms: urine decrease, convulsions, thirst increase, mouth dryness, heartbeat irregularity, appetite loss, mood shifts, muscle cramps or pains, vomiting or nausea, tingling or numbness in the lips, feet or hands, weakness or tiredness (unusual), or breath shortness.

Other medications should not be taken unless approved by your physician. This refers to both prescription and nonprescription medications, as well as vitamins or herbal remedies.

When contemplating whether a medication is right for you, you must first compare the potential benefits of the medication against the possible dangers. You must make this decision with your doctor. For formoterol, consider the following:

Allergies

Inform your physician if you've experienced allergic reactions to formoterol or other medications. Also let your physician know if you have allergies to animals, preservatives, dyes or foods. Label ingredient summaries should be read carefully to avoid any allergic reactions.

Specific demographic use

Pediatric

Current research has not outlined any issues that are significant for children over the age of five. Children under age five should not be prescribed this medication, as the effectiveness and safety of formoterol has not been established for young children.

Geriatric

Current research has not identified issues with formoterol that are specifically related to the elderly population. However, older patients typically have more age-related issues with regards to blood vessel or heart disease, which could require additional care for formoterol patients.

Pregnancy

Patients who are interested in taking formoterol should take caution. Either animal research has demonstrated a negative effect and research has not yet been completed for pregnant women or neither animal studies nor research on pregnant women has been conducted.

Breastfeeding

Adequate research has not been conducted to examine which impacts (if any) take place for women who are breastfeeding. Women should compare the possible benefits with the potential dangers prior to taking this medication at the same time as breastfeeding.

Storage

Do not keep this medication in an area that is easily accessible to children. Never keep medication that is no longer required or that is expired. Consult your doctor to find out methods of disposing of unused medications.

Keep formoterol in a sealed container far from hot or frozen temperatures. This medication should be kept at room temperature only. The chemical makeup of the medication can be negatively impacted from moisture and direct light as well.

Keep the capsules in the blister wrapping until ready to inhale.

Summary

Formoterol is a long-acting respiratory inhaler that improves signs and counteracts bronchospasm for patients who have asthma and COPD. Foroterol can decrease the intensity and frequency of asthma attacks when taken as directed each day. However, foroterol cannot relieve asthma attacks for patients if the attack has already begun. This medication is highly beneficial for wheezing that is triggered by exercise (exercise-induced bronchospasm).

This medication has a long period of action (lasting 12 hours maximum) when compared to short-acting inhalants that typically provide relief for a four to six hour duration. Formoterol is a long-acting beta-adrenoceptor agonist and is a system controller that should complement prophylactic corticosteroid care. Long-acting beta-adrenoceptors are not advised to treat acute asthma, which is why a short-acting inhalant that alleviates symptoms is still required for patients.

Formoterol is intended to be used as a supplementary medication only. This medication is intended for patients who cannot have other types of asthma medications, such as inhaled corticosteroids, as well as patients who need more than one medication.