formoterol fumarate (redirected from Foradil)

formoterol fumarate,

a beta-adrenergic agonist used to treat chronic obstructive pulmonary disorder, maintain and treat asthma, and prevent exercise-induced bronchospasm.

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formoterol fumarate

Atimos Modulite (UK), Foradil (UK), Foradil Aerolizer, Oxis (UK)

Pharmacologic class: Sympathomimetic; long-acting, selective beta₂-adrenergic receptor agonist

Therapeutic class: Bronchodilator

Pregnancy risk category C

FDA Boxed Warning

• Drug may increase risk of asthma-related death. Give only as additional therapy for patients not adequately controlled on other asthma-controller medications or whose disease severity clearly warrants treatment with two maintenance therapies.
• In large placebo-controlled study, increase in asthma-related deaths occurred in patients receiving salmeterol; this finding may apply to formoterol.

Action

Stimulates intracellular adenylate cyclase, relaxing bronchial smooth muscle and inhibiting release of mediators of immediate hypersensitivity

Availability

Capsules for oral inhalation (used with Aerolizer inhaler): 12 mcg

⊘Indications and dosages

➣ Long-term maintenance of asthma; prevention or long-term maintenance of bronchospasm in patients with chronic obstructive pulmonary disease

Adults and children ages 5 and older: Contents of 1 capsule inhaled orally via Aerolizer q 12 hours

➣ Acute prevention of exercise-induced bronchospasm (on occasional, as-needed basis)

Adults and children ages 5 and older: Contents of 1 capsule inhaled orally via Aerolizer at least 15 minutes before start of exercise. Wait 12 hours after initial dose before giving repeat dose.

Contraindications

• Hypersensitivity to drug or its components
• Tachyarrhythmias

Precautions

Use cautiously in:
• acute asthma symptoms, deteriorating asthma, cardiovascular disorders, seizure disorders, thyrotoxicosis, diabetes, possible hypokalemia
• patients older than age 75
• labor
• pregnant or breastfeeding patients
• children younger than age 5.

Administration

• Be aware that drug is not intended for acute asthma attacks.
• Use capsules only with Aerolizer inhaler supplied.
• Keep capsules in blister until immediately before use.
☞ Make sure patient doesn't swallow capsules.

Route	Onset	Peak	Duration
Inhalation	Rapid	5 min	12 hr

Adverse reactions

CNS: tremor, dizziness, insomnia, anxiety

CV: chest pain

EENT: sinusitis, pharyngitis, tonsillitis

GI: dry mouth

Metabolic: hypokalemia, hyperglycemia

Musculoskeletal: muscle cramps, back pain, leg cramps

Respiratory: bronchitis, chest infection, dyspnea, upper respiratory tract infection, increased sputum

Skin: pruritus, rash

Other: dysphonia, viral infection, fever

Interactions

Drug-drug. Adrenergics: potentiation of formoterol's sympathomimetic effects

Beta-adrenergic blockers: partial or total inhibition of formoterol's effects

Cardiac glycosides, methylxanthines, potassium-wasting diuretics, steroids: potentiation of formoterol's hypokalemic effects, increased risk of arrhythmias

Disopyramide, MAO inhibitors, quinidine, phenothiazines, procainamide, tricyclic antidepressants: prolonged QTc interval, increased risk of ventricular arrhythmias

Halogenated hydrocarbon anesthetics: increased risk of arrhythmias

Levodopa, levothyroxine, oxytocin: impaired cardiac tolerance of formoterol

Drug-diagnostic tests. Blood glucose: increased level

Potassium: decreased level

Drug-behaviors. Alcohol use: impaired cardiac tolerance of formoterol

Patient monitoring

• Monitor pulmonary function test results.
• Monitor potassium and glucose levels.

Patient teaching

• Teach patient how to use capsules and Aerolizer inhaler provided.
• Instruct patient to keep capsules in blisters until immediately before use.
• Caution patient not to swallow capsules.
• Tell patient not to use drug for acute asthma attacks.
☞ Instruct patient to contact prescriber immediately if difficulty in breathing persists after using drug or if condition worsens.
• Caution patient to take drug exactly as prescribed and not to stop therapy even if he feels better.
• Tell patient to consult prescriber if he has been taking inhaled, short-acting drugs on a regular basis.
• Advise female patient to tell prescriber if she is pregnant or breastfeeding or if she plans to become pregnant.
• Caution patient to avoid alcohol during therapy.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.