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formoterol (inhalation)

Pronunciation

Generic Name: formoterol (inhalation) (for MOE ter all)
Brand Name: Foradil Aerolizer, Perforomist

What is formoterol inhalation?

Formoterol inhalation is a long-acting bronchodilator. It relaxes muscles in the airways to improve breathing.

The Foradil brand of formoterol is used to prevent asthma attacks or exercise-induced bronchospasm in adults and children who are at least 5 years old.

The Foradil and Perforomist brands of formoterol are used to prevent bronchospasm in adults with chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis.

Formoterol inhalation may also be used for purposes not listed in this medication guide.

What is the most important information I should know about formoterol inhalation?

Do not use this medicine to treat a sudden asthma or bronchospasm attack. It will not work fast enough. Use only a fast-acting inhalation medicine.

Formoterol may increase the risk of asthma-related death or hospitalization. Use only the prescribed dose of this medicine, and follow all patient instructions for safe use.

If you use formoterol for asthma, you must use it together with another long-term asthma control medication. Seek medical attention if you think any of your asthma medications are not working as well as usual.

What should I discuss with my healthcare provider before using formoterol inhalation?

You should not use formoterol if you are allergic to it. Do not use formoterol inhalation to treat asthma without using another long-term asthma control medicine (such as an inhaled steroid).

Formoterol may increase the risk of death or hospitalization in people with asthma, but the risk in people with COPD is not known. Talk with your doctor about your individual risk.

To make sure formoterol inhalation is safe for you, tell your doctor if you have:

  • a food or drug allergy;

  • heart disease or high blood pressure;

  • epilepsy or other seizure disorder;

  • diabetes;

  • a thyroid disorder;

  • pheochromocytoma (tumor of the adrenal gland); or

  • a history of aneurysm (swelling of an artery).

Foradil capsules may contain lactose and milk protein. Talk to your doctor before using this form of formoterol if you have allergies or severe problems with lactose (milk sugar).

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using formoterol.

It is not known whether formoterol inhalation passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Foradil should not be given to a child younger than 5 years old. Perforomist is is not approved for use by anyone younger than 18 years old.

How should I use formoterol inhalation?

Follow all directions on your prescription label. Use only the prescribed dose of this medicine, and do not use it for longer than your doctor recommends.

If you use formoterol for asthma, you must use it together with another long-term asthma control medication. Use all medications as directed by your doctor. Do not change your doses or medication schedule without your doctor's advice.

For asthma or COPD, formoterol is usually given 2 times a day, about 12 hours apart. To prevent exercise-induced asthma, use the medicine 15 minutes before exercising and allow 12 hours to pass before using the medicine again. Follow your doctor's dosing instructions very carefully.

Formoterol is not a rescue medicine. It will not work fast enough to treat an asthma or bronchospasm attack. Use only a fast acting inhalation medicine for an attack. Tell your doctor if any of your medicines seem to stop working as well in controlling your asthma or COPD.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Any child using formoterol inhalation should be supervised by an adult while using this medicine.

Formoterol capsules are for use only in the Foradil Aerolizer device provided. Do not take the capsule by mouth. Use only one capsule at a time. Use dry hands when handling the capsule. Never place a capsule in the mouthpiece of the inhaler.

The Foradil Aerolizer inhalation device is not to be used with a spacer.

Perforomist solution is for use only with a standard jet nebulizer machine connected to an air compressor. Do not mix formoterol with other medicines in the nebulizer. Do not take this medicine by mouth or swallow it while inhaling.

To use the Perforomist solution with a nebulizer:

  • Open the foil pouch and single-use vial. Squeeze all of the medicine out into the chamber of the nebulizer. Attach the mouthpiece or face mask to the drug chamber. Then, attach the chamber to the compressor.

  • Sit upright in a comfortable position. Place the mouthpiece into your mouth or put the face mask on, covering your nose and mouth. Turn on the compressor.

  • Breathe in slowly and evenly until you have inhaled all of the medicine (usually 5 to 10 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.

  • Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

Use formoterol inhalation regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Seek medical attention if you think your asthma medications are not working as well. An increased need for medication could be an early sign of a serious asthma attack.

Store this medicine at room temperature away from moisture and heat. Keep all capsules and vials in their original packaging until you are ready to use a dose. Throw away any Perforomist solution vials that have not been used within 3 months.

Do not try to clean or take apart the Aerolizer device. Throw it away when your capsules run out. Always use the new device provided with the medication when you get your prescription refilled.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include chest pain, fast or irregular heartbeats, nervousness, tremors, feeling weak or light-headed, fainting, or seizure (convulsions).

What should I avoid while using formoterol inhalation?

Do not use a second form of formoterol (Bevespi, Dulera, Symbicort) or other long-acting inhaled bronchodilator (arformoterol, salmeterol, Advair, Brovana, Serevent) without your doctor's advice.

Formoterol inhalation side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have;

  • wheezing, choking, or other breathing problems after using this medicine;

  • pounding heartbeats or fluttering in your chest;

  • nervousness, trouble sleeping;

  • worsening asthma symptoms;

  • high blood sugar--increased thirst or urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or

  • low potassium--leg cramps, constipation, numbness or tingling, muscle weakness or limp feeling.

Common side effects may include:

  • dizziness, anxiety, tremors;

  • chest pain;

  • headache, sleep problems (insomnia);

  • stomach pain, indigestion, nausea;

  • sore throat, cough, runny nose, sinus pain;

  • muscle cramps; or

  • viral infections.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Formoterol dosing information

Usual Adult Dose for Bronchospasm Prophylaxis:

Prevention of Exercise-Induced Bronchospasm (EIB):
Formoterol inhalation capsule:
-12 mcg (1 inhalation) orally using the aerolizer inhaler at least 15 minutes before exercise as needed.

Comments:
-Protection may last up to 12 hours when used intermittently as needed for prevention.
-Additional doses should not be taken for 12 hours.
-Regular, twice-daily dosing has not been studied in preventing EIB.
-Patients receiving a twice daily dose for treatment of asthma should not use additional doses for prevention of EIB; a short-acting bronchodilator may be required.

Inhalation powder:
-6 mcg or 12 mcg before exercise
-Maximum dose: 48 mcg within a 24-hour period

Uses:
-Acute prevention of EIB when administered on an occasional, as-needed basis.
-Use as a single agent for the prevention of EIB in patients who do not have persistent asthma.
-For the prevention of EIB in patients with persistent asthma on a long-term asthma control medication treatment, such as an inhaled corticosteroid.

Usual Adult Dose for Asthma -- Maintenance:

Formoterol 12 mcg inhalation capsule:
-12 mcg (1 inhalation) orally every 12 hours using the aerolizer inhaler
-Maximum dose: 24 mcg daily

Inhalation powder:
-6 mcg or 12 mcg inhaled orally every 12 hours
-Maximum dose: 24 mcg twice a day (total of 48 mcg daily)

Comments:
-More frequent administration or administration of a larger number of inhalations is not recommended.
-If symptoms arise between doses, an inhaled short-acting beta2-agonist should be taken for immediate relief.
-The inhalation powder is available in two strengths, 6 mcg or 12 mcg per inhalation. Use the higher strength when doses of 12 mcg or more, twice daily, are required.

Uses:
-Treatment of asthma
-Prevention of bronchospasm only as concomitant therapy with a long-term asthma control medication, such as an inhaled corticosteroid, in patients with reversible obstructive airways disease, including symptoms of nocturnal asthma.

Usual Adult Dose for Chronic Obstructive Pulmonary Disease -- Maintenance:

Formoterol 12 mcg inhalation capsule:
-12 mcg (1 inhalation) orally every 12 hours using the aerolizer inhaler
-Maximum daily dosage: 24 mcg

Formoterol 20 mcg/2 mL inhalation solution:
-One 20 microgram/2 mL unit dose vial orally via jet nebulizer with a facemask or mouthpiece twice a day.

Comments:
-The twice daily dose should be administered in the morning and evening.
-The efficacy and safety of the inhalation solution when mixed with other drugs in a nebulizer have not been established.
-Seek medical advice if the recommended maintenance treatment regimen fails to provide the usual response, as this is often a sign of destabilization of COPD. Re-evaluate current treatment and consider additional therapeutic options.

Use:
-Long-term maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

Usual Pediatric Dose for Bronchospasm Prophylaxis:

Prevention of Exercise-Induced Bronchospasm (EIB):
Formoterol 12 mcg inhalation capsule:
Less than 5 years: Not approved.
5 years or older:
-12 mcg (1 inhalation) orally using the aerolizer inhaler at least 15 minutes before exercise as needed.

Comments:
-Protection may last up to 12 hours when used intermittently as needed for prevention.
-Additional doses should not be taken for 12 hours.
-Regular, twice-daily dosing has not been studied in preventing EIB.
-Patients receiving a twice daily dose for treatment of asthma should not use additional doses for prevention of EIB and may require a short-acting bronchodilator.

Inhalation powder:
-6 mcg or 12 mcg inhaled orally before exercise
-Maximum dose: 24 mcg within a 24-hour period

Uses:
-Acute prevention of EIB when administered on an occasional, as-needed basis.
-Use as a single agent for the prevention EIB in patients who do not have persistent asthma.
-For the prevention of EIB in patients with persistent asthma on a long-term asthma control medication treatment, such as an inhaled corticosteroid.

Usual Pediatric Dose for Asthma -- Maintenance:

Formoterol 12 mcg inhalation capsule:
Less than 5 years: Not approved.
5 years or older:
-12 mcg (1 inhalation) orally every 12 hours using the aerolizer inhaler
-Maximum dose: 24 mcg daily

Inhalation powder:
Less than 6 years: Not approved.
6 to 16 years:
-6 mcg or 12 mcg inhaled orally every 12 hours
-Maximum dose: 12 mcg twice a day (total of 24 mcg daily)
16 years or older:
-6 mcg or 12 mcg inhaled orally every 12 hours
-Maximum dose: 24 mcg twice a day (total of 48 mcg daily)

Comments:
-For patients with asthma less than 18 years of age requiring addition of a LABA to an inhaled corticosteroid, a fixed-dose combination product containing both an inhaled corticosteroid and LABA should be used to ensure adherence with both drugs.
-If the use of a separate long-term asthma control medication (e.g., inhaled corticosteroid) and LABA is clinically indicated, take appropriate steps to ensure adherence with both treatment components. If adherence cannot be assured, a fixed-dose combination product containing both an inhaled corticosteroid and LABA is recommended.
-The inhalation powder is available in two strengths, 6 mcg or 12 mcg per inhalation. Use the higher strength when doses of 12 mcg or more, twice daily, are required.

Uses:
-Treatment of asthma
-Prevention of bronchospasm only as concomitant therapy with a long-term asthma control medication, such as an inhaled corticosteroid, in patients with reversible obstructive airways disease, including symptoms of nocturnal asthma.

What other drugs will affect formoterol?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • theophylline;

  • a diuretic or "water pill";

  • a beta-blocker--atenolol, carvedilol, metoprolol, propranolol, sotalol, and others; or

  • an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

This list is not complete. Other drugs may interact with formoterol inhalation, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about formoterol inhalation.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.01.

Date modified: June 01, 2017
Last reviewed: January 06, 2017

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