Overview
Formoterol is a long-acting beta2-adrenergic agonist (LABA) bronchodilator used for maintenance treatment of asthma and COPD. It provides rapid onset (within 1-3 minutes) and prolonged duration (up to 12 hours) of bronchodilation.
Mechanism of Action
Selectively stimulates beta2-adrenergic receptors in bronchial smooth muscle, leading to activation of adenylate cyclase and increased intracellular cyclic AMP. This causes relaxation of bronchial smooth muscle and inhibition of mediator release from mast cells.
Indications
- Maintenance treatment of asthma in patients ≥5 years
- Prevention of exercise-induced bronchospasm
- Maintenance treatment of COPD including chronic bronchitis and emphysema
Dosage
Asthma: 12 mcg capsule inhaled twice daily via Aerolizer inhaler. Exercise-induced bronchospasm: 12 mcg at least 15 minutes before exercise (not for additional doses within 12 hours). COPD: 12 mcg inhaled twice daily. Maximum dose: 24 mcg per day.
Black Box Warning
Increased risk of asthma-related death (black box warning)
Contraindications
- Hypersensitivity to formoterol or components
- Treatment of acute asthma attacks or status asthmaticus
- Monotherapy for asthma (must be used with inhaled corticosteroids)
Side Effects
- Headache
- Tremor
- Palpitations
- Tachycardia
- Nervousness
- Dizziness
- Cough
- Dry mouth
- Muscle cramps
- Hypokalemia
Interactions
- Beta-blockers (may reduce effectiveness)
- Diuretics (may worsen hypokalemia)
- MAO inhibitors and tricyclic antidepressants (may potentiate cardiovascular effects)
- Other sympathomimetic agents (additive effects)
- Xanthine derivatives and steroids (may increase hypokalemic effects)