Formoterol is a long-acting bronchodilator that works by relaxing muscles in the airways to improve breathing. Formoterol inhalation is used for the maintenance treatment of bronchial asthma. It is also used to prevent asthma attacks that are brought on by exercise (exercise-induced asthma). It is used only to prevent asthma attacks, not to treat an attack already in progress. Formoterol will not work fast enough to give relief during an asthma attack. Formoterol inhalation is also used in the treatment of chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.
Important things to know if you are using formoterol inhalation:
1. If you notice that you require more than your usual or more than the maximum
amount of any asthma medication in a 24-hour period, inform your doctor. This
could be an early sign of a serious asthma attack.
2. Do not use formoterol more often than is prescribed by your doctor. It may seriously affect the heart and could even lead to death.
3. Do not substitute formoterol inhalation for any other short-acting asthma medications, especially if you are having an acute asthma attack. Formoterol is a long-acting medication used to treat chronic asthma but not to treat an acute asthma attack.
4. It is very important that you use the formoterol inhaler properly so that the
medicine gets into the lungs. Do not use a spacer and never exhale into the device.
Before using formoterol inhalation, tell your doctor if you have any of the following conditions: heart disease, high blood pressure, or irregular heartbeats; epilepsy or another seizure disorder; diabetes; an overactive thyroid (hyperthyroidism); liver disease; or kidney disease.
Formoterol inhalation is not known to pass into breast milk or to be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is also not approved for use by children younger than 5 years of age.
Seek emergency medical attention for suspected symptoms of a formoterol overdose. These include angina or chest pain; fast or irregular heartbeats or a fluttering heart; nervousness; muscle cramps; dry mouth; tiredness; insomnia; seizures; tremor; weakness; headache; nausea; and vomiting.
Avoid situations that may trigger an asthma attack such as exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens.
Discontinue using formoterol inhalation and seek emergency medical attention if you experience any of the following uncommon but serious side effects: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
or chest pain or fast or irregular heartbeats.
Other, less serious side effects are dizziness or lightheadedness; tremor or nervousness;
rash; cold or viral infection; nausea; or changes in your voice. For any unusual side effect, inform you attending physician.
Drug interactions may occur if you are using formoterol inhalation while taking any of the following medicines: a beta-blocker such as atenolol (Tenormin), metoprolol (Lopressor), propranolol (Inderal), acebutolol (Sectral), bisoprolol (Zebeta), carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), or pindolol (Visken); a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or protriptyline (Vivactil); a diuretic (water pill) such as hydrochlorothiazide (HCTZ, HydroDiuril, Esidrix, Microzide, Oretic, others), chlorothiazide (Diuril), chlorthalidone (Thalitone, Hygroton), metolazone (Mykrox, Zaroxolyn), indapamide (Lozol), furosemide (Lasix), bumetanide (Bumex), ethacrynic acid (Edecrin), torsemide (Demadex), and others; a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate); or a diet medicine or a decongestant.
Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products that may possibly interact with formoterol or make your condition worse.
Formoterol fumarate has a molecular weight of 840.9, and its empirical formula is (C19H24N2O4)2·C4H4O4·2H2O. Formoterol fumarate is a white to yellowish crystalline powder, which is freely soluble in glacial acetic acid, soluble in methanol, sparingly soluble in ethanol and isopropanol, slightly soluble in water, and practically insoluble in acetone, ethyl acetate, and diethyl ether. The AEROLIZER Inhaler is a plastic device used for inhaling FORADIL. The amount of drug delivered to the lung will depend on patient factors, such as inspiratory flow rate and inspiratory time. Under standardized in vitro testing at a fixed flow rate of 60 L/min for 2 seconds, the AEROLIZER Inhaler delivered 10 mcg of formoterol fumarate from the mouthpiece. Peak inspiratory flow rates (PIFR) achievable through the AEROLIZER Inhaler were evaluated in 33 adult and adolescent patients and 32 pediatric patients with mild-to-moderate asthma. Mean PIFR was 117.82 L/min (range 34-188 L/min) for adult and adolescent patients, and 99.66 L/min (range 43-187 L/min) for pediatric patients. Approximately ninety percent of each population studied generated a PIFR through the device exceeding 60 L/min.
Formoterol has the following structural formula: