DrugindexOnline^{2nd edition}

Generic name: Formoterol
Brand names: Foradil

Why is Formoterol prescribed?

Foradil relaxes the muscles in the walls of the airways, allowing them to expand. Taken on a twice-daily basis, it helps to control asthma in people who need regular treatment with short-acting inhalers, including people with nighttime asthma. Regular twice-daily use can also relieve tightening of the airways in people with Chronic Obstructive Pulmonary Disease, including chronic bronchitis and emphysema.

Taken on an as-needed basis, Foradil can also be used to prevent exercise-induced tightening of the airways (also called "exercise-induced asthma") in adults and children 12 years of age and older.

Most important fact about Formoterol

Foradil is used to prevent asthma attacks, and should not be used for the relief of acute asthma symptoms. Your doctor will prescribe a short-acting inhaler such as Proventil or Ventolin to use for acute asthma attacks.

How should you take Formoterol?

Foradil capsules are intended for use only with the Aerolizer inhaler; they should not be swallowed.

To use the system, place a capsule in the well of the Aerolizer, then press and release the buttons on the side of the device. This will pierce the capsule. The medication is dispersed into the air stream when you inhale rapidly and deeply through the mouthpiece. Do not exhale into the device and do not use a "spacer" with Formoterol. Detailed instructions are supplied with your prescription. If you have any questions, ask your doctor or pharmacist.

One rare occasions, the capsule may break into small pieces, which could reach the throat or mouth during inhalation. You can reduce the chance of breakage by storing the capsules in a dry place, keeping them in their blister pack until just before use, and piercing them only once.

Be sure your hands are dry before handling the capsules, and be careful to keep the Aerolizer dry, too--do not wash any part of the device. Discard the aerolizer when your prescription is finished. Replace it with the new one that comes with each refill.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule.

--Storage instructions...

Store at room temperature, away from heat and moisture. Leave the capsules in the blister pack until needed for use.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Foradil.

• More common side effects may include:
  Abdominal pain, allergic reaction, anxiety, back pain, bronchitis, chest infection, chest pain, difficulty breathing, difficulty speaking, dizziness, dry mouth, fatigue, fever, headache, high blood sugar, high or low blood pressure, inability to sleep, increased sputum, indigestion, irregular heartbeat, itching, muscle cramps, nausea, nervousness, rash, runny nose, sinusitis, sore throat, stomach upset, tonsillitis, tremor, unwell feeling, upper respiratory and viral infections, worsening of asthma

Why should Formoterol not be prescribed?

Foradil cannot be used for acute episodes of asthma that require intensive therapy. You'll also be unable to use Foradil if it gives you an allergic reaction.

Special warnings about Formoterol

Your doctor will probably prescribe additional medications for use along with Foradil. Steroid inhalers such as Beclovent and Flovent fight inflammation in the airways. Short-acting airway openers such as Proventil and Ventolin relieve acute attacks. Be sure to use these medications exactly as prescribed. Do not change the dosage or stop using them without consulting your doctor.

Be sure to keep track of how often you use your short-acting inhaler for relief of acute asthma symptoms. Your doctor will use this information to help determine how well Foradil is working. Notify your doctor if your symptoms worsen, if you need more inhalations of the short-acting inhaler than usual, or if Foradil seems to be getting less effective. Keep track of your peak flow readings, too. Call your doctor if you notice a drop in this measurement of lung capacity.

Do not use Foradil more often than prescribed. Excessive use can cause heart irregularities. Use Foradil with caution if you have any kind of heart disorder or high blood pressure. Notify your doctor immediately if you experience palpitations, chest pain, rapid heart rate, or tremor.

Do not use Foradil in combination with Serevent, Advair Diskus, or other long-acting inhalers. They contain the same type of active ingredient and will provide no extra benefit. If you've been using a short-acting inhaler on a routine basis, you should stop using it regularly and reserve it for occasional relief of acute attacks.

Call your doctor immediately if you develop hives, rash, or swelling, or if you have an asthma attack that does not respond to your usual medication. Foradil has been known to cause allergic reactions and acute asthma attacks.

Possible food and drug interactions when taking Formoterol

If Foradil is taken with certain other drugs, the effect of either may be increased, decreased, or altered. It is especially important to check with your doctor before combining Foradil with the following:

Antidepressants categorized as "tricyclics," such as Elavil and Tofranil
Antidepressants classified as "monoamine oxidase inhibitors," such as Nardil and Parnate
Beta blockers (drugs such as Inderal and Tenormin that are used to control blood pressure and treat various heart conditions)
Steroids such as prednisone and hydrocortisone
Theophylline (Theo-Dur, Slo-Phyllin)
Water pills (diuretics) such as HydroDIURIL or Lasix

Special information if you are pregnant or breastfeeding

The possibility of harm during pregnancy has not been ruled out. Foradil is recommended for pregnant women only if the potential benefit outweighs the potential risk. Inform your doctor immediately if you are pregnant or plan to become pregnant.

It's not known whether Foradil appears in breast milk. Use Formoterol with caution if you are nursing.

Recommended dosage

ASTHMA

For the long-term control of asthma in adults and children 5 years of age and older, the recommended dosage is 1 capsule every 12 hours. Do not use more than 2 capsules per day.

PREVENTION OF EXERCISE-INDUCED ASTHMA

For adults and children 12 years of age and older, the recommended dosage is 1 capsule at least 15 minutes before exercise. If a second dose is needed the same day, it must be taken at least 12 hours after the first dose. Do not exceed 2 capsules per day. If you are already taking Foradil on a regular twice-daily basis, do not take additional doses before exercise.

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The usual dosage is 1 capsule every 12 hours. Do not use more than 2 capsules a day. If your customary dosage fails to provide the usual relief, check with your doctor immediately. Other treatments may have to be added to your regimen.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Foradil overdose may include:
  Chest pain, dizziness, dry mouth fast or irregular heartbeat, fatigue, general feeling of illness, headache, heart palpitations, inability to sleep, muscle cramps, nausea, nervousness, seizures, tremor