Formoterol
A fast-acting, long-acting beta-2 agonist for COPD and, with budesonide, as an asthma preventer and reliever.
Also called eformoterol (older name).
Drug card
- How it works
- Activating airway beta-2 receptors for long-lasting bronchodilation
- Used for
- Maintenance treatment of COPD
- Asthma, combined with an inhaled corticosteroid
- Asthma preventer and reliever with budesonide
- Known for
- Asthma-related death when used without a steroid
- Its name
- -terol means a beta-2 agonist bronchodilator
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does formoterol work?
A long-acting beta-2 agonist with more than 200 times more activity at beta-2 than at beta-1 receptors. Inhaled, it acts locally in the lung: cyclic AMP rises, bronchial smooth muscle relaxes and mast cells release less histamine and leukotriene. Unlike salmeterol it starts to work quickly as well as lasting long.
Like other long-acting beta-2 agonists: LABAs stimulate the same airway beta-2 receptors as the short-acting drugs: cyclic AMP rises, bronchial smooth muscle relaxes and mast cells release fewer mediators. They stay active far longer, so they are inhaled twice a day to keep the airways open. In asthma they are given only with an inhaled corticosteroid, because a LABA alone raised the risk of asthma-related death.
Uses
What is formoterol used for?
- Maintenance treatment of COPD
- Asthma, combined with an inhaled corticosteroid
- Asthma preventer and reliever with budesonide
Side effects
Side effects of formoterol
- Asthma-related death when used without a steroidKnown forSerious
- Nausea and diarrhea
- Dry mouth
- Dizziness
- Insomnia
- Shaky hands (tremor)
- Palpitations and fast heartbeat
- Muscle cramps
- Low potassium (hypokalemia)Serious
- Raised blood sugar
- Arrhythmias and ECG changesSerious
- Paradoxical bronchospasmSerious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- In asthma it is contraindicated without an inhaled corticosteroid.
- It is not combined with another LABA-containing inhaler: excess use can cause fatal heart effects.
- Theophylline, steroids and diuretics add to low potassium; MAOIs, tricyclics and QT-prolonging drugs add heart risk.
- Beta blockers reduce its effect and can trigger bronchospasm.
Good to know: Its quick onset lets a budesonide and formoterol inhaler serve as both preventer and reliever in asthma (maintenance and reliever therapy, MART).
Remember it
A way to remember it
A LABA never goes out alone in asthma.
On its own a LABA raised asthma-related deaths; given in the same inhaler as an inhaled corticosteroid, large trials found no such rise.
Written for biofideX
Its name
-terol means beta-2 agonist bronchodilator
Salmeterol and formoterol are long-acting beta-2 agonists. Salbutamol and terbutaline lack the stem, though salbutamol's US name, albuterol, has it.
- Every drug name stem
Its class
Long-acting beta-2 agonists
Other long-acting beta-2 agonists with a card:
Easily mixed up with short-acting beta-2 agonists, inhaled antimuscarinics and inhaled corticosteroids.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Formoterol fumarate inhalation solution: label (DailyMed)
- Budesonide and formoterol inhalation aerosol: label (DailyMed)
- Formoterol (NCI Thesaurus)
- Budesonide inhalers (NHS)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Lungs and allergy
Formoterol is one of 16 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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