Formoterol Fumarate

Indications

Formoterol Fumarate is used for: Asthma, Chronic bronchitis, Emphysema, COPD

Adult Dose

Inhalation 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. Asthma Adult: As inhalation cap: 12 mcg bid via inhaler device, may be increased up to 24 mcg bid as necessary for severe cases. 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. Additional doses may be given as required. Max: 48 mcg/day (24 mcg/dose).

Child Dose

Inhalation Prophylaxis of exercise-induced asthma Child: >5 yr 12 mcg at least 15 min prior to exercise. Additional doses should not be taken w/in 12 hr. Asthma 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.

Renal Dose

Administration

Contra Indications

Hypersensitivity.

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. Lactation: not known if excreted in breast milk, use caution

Pregnancy-Lactation

Pregnancy Category: C Lactation: not known if excreted in breast milk, use caution

Interactions

Concomitant treatment with xanthine derivatives, steroids or diuretics may potentiate a possible hypokalaemic effect of beta-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 beta2-sympathomimetics. beta-adrenergic blockers can inhibit the effect of formoterol. Increased risk of arrhythmias in patients receiving concomitant anaesthesia with halogenated hydrocarbons.

Adverse Effects

Side effects of Formoterol Fumarate : >10% Viral infection (17.2%) 1-10% Bronchitis (4.6%), Chest infection (2.7%), Dyspnea (2.1%), Chest pain (1.9%), Tremor (1.9%), Dizziness (1.6%) Frequency Not Defined Angina, Arrhythmias, Hypo/hypertension, Tachycardia, Hypokalemia, Hyperglycemia, Metabolic acidosis, Headache, Insomnia, Paradoxical bronchospasm, Severe asthma exacerbation

Mechanism of Action

Formoterol relaxes the bronchial smooth muscle by selectively acting on beta2-receptors with minimal effect on heart rate. It has a long-acting effect.