From the Guidelines
Formoterol should never be used as monotherapy for asthma due to increased risk of severe asthma exacerbations; it should always be paired with an anti-inflammatory medication, as recommended by the most recent guidelines 1.
Key Points
- Formoterol is a long-acting beta-2 agonist (LABA) medication primarily used to treat asthma and chronic obstructive pulmonary disease (COPD) 1.
- It works by relaxing the smooth muscles in the airways, helping to keep them open for up to 12 hours, which improves breathing.
- Formoterol is typically prescribed as an inhalation medication, often in combination with an inhaled corticosteroid for better symptom control, with common brand names including Foradil, Oxis, and Perforomist, and typical dosing of 12-24 mcg twice daily 1.
- Unlike short-acting rescue inhalers, formoterol should be used regularly as maintenance therapy, not for immediate symptom relief.
- Side effects may include tremors, headache, palpitations, and muscle cramps, and patients should be monitored for paradoxical bronchospasm and cardiovascular effects, especially those with heart conditions 1.
Usage Guidelines
- The 2020 focused updates to the asthma management guidelines recommend that formoterol should be used in combination with an inhaled corticosteroid for long-term control and prevention of symptoms in moderate or severe persistent asthma 1.
- The guidelines also emphasize the importance of using formoterol as part of a comprehensive treatment plan that includes anti-inflammatory medications and other therapies as needed 1.
- In patients with COPD, formoterol may be used in combination with other medications, such as long-acting muscarinic antagonists (LAMAs) and inhaled corticosteroids, to improve symptoms and reduce exacerbations 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Overview of Fomoterol
- Fomoterol is a long-acting selective beta2-adrenoceptor agonist used in the treatment of chronic obstructive pulmonary disease (COPD) 2.
- It has a rapid onset of action, with a bronchodilator effect that lasts for at least 12 hours 2.
Efficacy of Fomoterol
- Studies have shown that fomoterol improves lung function and health-related quality of life, and reduces symptoms in patients with COPD 2, 3.
- Fomoterol has been found to be more effective than oral slow-release theophylline or inhaled ipratropium bromide in improving lung function and reducing symptoms 2.
- Combination therapy with fomoterol and ipratropium bromide has been shown to be more effective than albuterol (salbutamol) and ipratropium bromide in improving lung function and reducing symptoms 2.
Combination Therapy with Budesonide
- The combination of budesonide and fomoterol has been found to be more effective than either component alone in addressing many important aspects of COPD, such as pulmonary function, symptoms, and health-related quality of life 4.
- This combination has also been shown to be more effective than fluticasone/salmeterol in preventing exacerbations in COPD 5.
- A study found that budesonide/formoterol users had fewer total exacerbations compared to fluticasone/salmeterol users in asthma patients 6.
Safety and Tolerability
- Fomoterol has been found to be well tolerated in clinical trials, with a similar incidence of adverse events to placebo and inhaled ipratropium bromide 2, 3.
- There were no significant differences between fomoterol and placebo or comparator drugs in cardiovascular adverse events in patients with COPD 2.