Formoterol

Indications
 Oral
Acute bronchospasm
Adult: 80 mcg bid.
Child: >6 mth: 4 mcg/kg/day, given in 2-3 divided doses.
Oral
Reversible airways obstruction
Adult: 80 mcg bid.
Child: >6 mth: 4 mcg/kg/day, given in 2-3 divided doses.
Inhalation
Acute bronchospasm
Adult: As inhalational capsule: 12 mcg bid; up to 24 mcg bid in severe cases. As dry powder inhaler: 6 or 12 mcg 1-2 times daily, up to 24 mcg bid in severe cases. As metered doses from aerosol inhaler (per inhalation into mouthpiece contains 12 mcg): 1-2 inhalations bid. As nebuliser: 20 mcg bid.
Child: As inhalational capsule: ≥5 yr: 12 mcg bid. As dry powder inhaler: ≥6 yr: 6 or 12 mcg 1-2 times daily; up to 48 mcg/day; max: 12 mcg/dose.
Inhalation
Reversible airways obstruction
Adult: As inhalational capsule: 12 mcg bid; up to 24 mcg bid in severe cases. As dry powder inhaler: 6 or 12 mcg 1-2 times daily, up to 24 mcg bid in severe cases. As metered doses from aerosol inhaler (per inhalation into mouthpiece contains 12 mcg): 1-2 inhalations bid. As nebuliser: 20 mcg bid.
Child: As inhalational capsule: ≥5 yr: 12 mcg bid. As dry powder inhaler: ≥6 yr: 6 or 12 mcg 1-2 times daily; up to 48 mcg/day; max: 12 mcg/dose.
Inhalation
Prophylaxis of exercise-induced bronchospasm
Adult: 6 or 12 mcg at least 15 minutes before exercise. Additional dose should only be given after 12 hr; not to be used in patients who are already using it for asthma maintenance.
Child: As fumarate: ≥5 yr: 6 or 12 mcg at least 15 minutes before exercise. Additional dose should only be given after 12 hr; not to be used in patients who are already using it for asthma maintenace.
Contraindications
 Hypersensitivity.
Warnings / Precautions
 Thyrotoxicosis; severe CV disorders e.g. ischaemic heart disease, tachyarrhythmias or severe heart burn; prolonged QT-interval. DM; pregnancy; lactation; children <5 yr; do not initiate or increase the dose during an exacerbation. May produce paradoxical bronchospasm.
Adverse Reactions
 Tremor, headache, tiredness, restlessness, dizziness, dry mouth, palpitation, tachycardia, muscle cramps, nausea.
Overdose Reactions
 Symptoms include angina, hypertension or hypotension, tachycardia, with rates up to 200 beats/minute, arrhythmias, nervousness, headache, tremor, seizures, muscle cramps, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, hypokalemia, hyperglycaemia, insomnia, metabolic acidosis. Treatment is symptomatic and supportive. Cardiac monitoring is recommended.
Drug Interactions
 Concomitant treatment with xanthine derivatives, steroids or diuretics may potentiate a possible hypokalaemic effect of β-agonists. Increased susceptibility to cardiac arrhythmias in patients treated with digitalis. Concomitant use with quinidine, disopyramide, procainamide, phenothiazines, antihistamines, MAOI or TCAs can prolong the QT-interval and increase the risk of ventricular arrhythmias. L-dopa, L-thyroxine, oxytocin and alcohol can impair cardiac tolerance towards β2-sympathomimetics. β-adrenergic blockers can inhibit the effect of formoterol. Increased risk of arrhythmias in patients receiving concomitant anaesthesia with halogenated hydrocarbons.
See Below for More formoterol Drug Interactions
Mechanism of Actions
 Formoterol relaxes the bronchial smooth muscle by selectively acting on β2-receptors with minimal effect on heart rate. It has a long-acting effect.
Storage Conditions
 Inhalation: Store below 25°C. Oral: Store below 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.
Storage
 Inhalation: Store below 25°C. Oral: Store below 25°C.
Available As
  • Formoterol 1 mcg
  • Formoterol 12 mcg
  • Formoterol Fumerate 12 mcg
  • Formoterol 18 mcg
  • Formoterol Fumerate 6 mcg
  • Formoterol 6 mcg
  • Formoterol 9 mcg

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