Formoterol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Inhalation Asthma As inhalation cap: 12 mcg bid via inhaler device, increased up to 24 mcg bid in severe cases. As metered-dose dry powd inhaler: 6 or 12 mcg 1-2 times/day, up to 24 mcg bid in severe cases. As metered-dose aerosol: 12-24 mcg bid. Doses are given in combination w/ an inhaled corticosteroid. Prophylaxis of exercise-induced asthma 12 mcg at least 15 min prior to exercise. COPD As inhalation cap: 12 mcg bid via inhaler device. As metered-dose dry powd inhaler: 12 mcg 1-2 times/day. As metered-dose aerosol: 12 mcg bid. Max: 48 mcg/day (24 mcg/dose). As soln for nebulisation: 20 mcg bid.
Dosage Details
Inhalation/Respiratory
Asthma
Adult: As inhalation cap: 12 mcg bid via inhaler device, may be increased up to 24 mcg bid as necessary for severe cases. As metered-dose dry powd inhaler: 6 or 12 mcg 1-2 times daily, up to 24 mcg bid in severe cases. As metered-dose aerosol: 12-24 mcg bid. Doses are given in combination w/ an inhaled corticosteroid.
Child: As inhalational cap: ≥5 yr 12 mcg bid via inhaler device. As metered-dose dry powd inhaler: ≥6 yr 6-12 mcg 1-2 times daily.

Inhalation/Respiratory
Prophylaxis of exercise-induced asthma
Adult: 12 mcg at least 15 min prior to exercise. Additional doses should not be taken w/in 12 hr.
Child: ≥5 yr Same as adult dose.

Inhalation/Respiratory
Chronic obstructive pulmonary disease
Adult: As inhalation cap: 12 mcg bid via inhaler device. As metered-dose dry powd inhaler: 12 mcg 1-2 times daily. As metered-dose aerosol: 12 mcg bid. Additional doses may be given as required. Max: 48 mcg/day (24 mcg/dose). As soln for nebulisation: 20 mcg bid.
Contraindications
Treatment of status asthmaticus, other acute episodes of asthma or COPD. Monotherapy in asthma treatment.
Special Precautions
Patient w/ CV disease, CNS disorders, hyperthyroidism, hypokalaemia, DM, phaeochromocytoma, seizure disorder. Not intended for the relief of bronchospasm. Pregnancy and lactation.
Adverse Reactions
Asthma: Viral infection, bronchitis, chest infection, dyspnoea, chest pain, tremor, dizziness, insomnia, tonsillitis, rash, dysphonia, serious asthma exacerbation. COPD: Upper resp tract infection, back pain, pharyngitis, chest pain, sinusitis, fever, leg cramps, muscle cramps, anxiety, pruritus, increased sputum, dry mouth.
Potentially Fatal: Paradoxical bronchospasm.
Inhalation/Respiratory: C
Patient Counseling Information
This drug may cause dizziness and other similar effects, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor pulmonary function, BP, heart rate, CNS stimulation; serum glucose and K levels.
Overdosage
Symptoms: Nausea, vomiting, headache, tremor, somnolence, palpitations, tachycardia, ventricular arrhythmias, metabolic acidosis, hypokalaemia, hyperglycaemia, prolonged QT-interval, HTN. Management: Supportive and symptomatic treatment. May consider use of cardioselective β-blockers but w/ extreme caution. Monitor serum K levels.
Drug Interactions
Increased risk of ventricular arrhythmia w/ drugs that prolong QT-interval (e.g. quinidine, disopyramide, procainamide, phenothiazines, antihistamines, erythromycin). Increased adverse effects w/ other sympathomimetic drugs. Increased CV effects w/ MAOIs, macrolides, or TCAs. Increased risk of hypokalaemia w/ xanthine derivatives, steroids, or non K-sparing diuretics. Increased risk of arrhythmias w/ concomitant anaesth w/ halogenated hydrocarbons. Increased bronchodilating effects w/ anticholinergic drugs. Antagonistic effect w/ β-blockers.
Action
Description: Formoterol stimulates intracellular adenyl cyclase, the enzyme that catalyses the conversion of ATP to cyclic-3', 5'-adenosine monophosphate (cAMP) resulting in relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from mast cells.
Onset: Powd for inhalation: W/in 3 min.
Duration: Approx 12 hr.
Pharmacokinetics:
Absorption: Rapidly absorbed (inhalation). Time to peak plasma concentration: 1-3 hr.
Distribution: Plasma protein binding: 61-64%.
Metabolism: Largely metabolised via glucuronidation and O-demethylation.
Excretion: Via urine (10 %, as unchanged drug). Half-life: 10 hr.
Chemical Structure

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Storage
Inhalation cap: Prior to dispensing: Store between 2-8°C. After dispensing: Store between 20-25°C. Soln for nebulisation: Prior to dispensing: Store between 2-8°C. After dispensing: Store between 2-25°C.
ATC Classification
R03AC13 - formoterol ; Belongs to the class of adrenergic inhalants, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
Disclaimer: This information is independently developed by MIMS based on Formoterol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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