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Formoterol

Formoterol, is a long-acting β2 agonist (LABA) used as a bronchodilator in the management of asthma and chronic obstructive pulmonary disease (COPD).

Formoterol has an extended duration of action, for up to 12 hours.

Short-acting β2 agonists such as salbutamol (albuterol), are effective for 4 h to 6 h. 

LABAs such as formoterol are used as symptom controllers to supplement corticosteroid therapy. 

LABAs are not recommended for the treatment of acute asthma, so a short-acting β2 agonist (e.g., salbutamol) is still required,

Trade names- Oxeze, Foradil

Pregnancy category AU: B3

Routes of administration Inhalation-capsules for oral inhalation, dry powder inhaler, metered-dose inhaler.

Protein binding 61% to 64%

Metabolism – Liver demethylation and glucuronidation (CYP2D6, CYP2C19, CYP2C9 and CYP2A6 involved)

Elimination half-life 10 h

Excretion- Kidney and fecal

It is also marketed in the combination formulations budesonide/formoterol and mometasone/formoterol.

The  use of long-acting β2 agonists could lead to a worsening of wheezing symptoms in some patients.

Available long-acting β2 agonists include salmeterol, formoterol, bambuterol, and sustained-release oral salbutamol.

Combinations of inhaled steroids and long-acting bronchodilators are becoming more widespread – combination preparations include fluticasone/salmeterol and budesonide/formoterol.

Inhaled formoterol works like other β2 agonists, causing bronchodilation by relaxing the smooth muscle in the airway so as to treat the exacerbation of asthma.

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