Formoterol Fumarate

A to Z Drug Facts

Formoterol Fumarate

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(fore-MOE-ter-ole FEW-mah-rate)

Foradil Aerolizer

Inhalation powder in capsules

12 mcg (as fumarate)

Class: Bronchodilator

Sympathomimetic

Action Relaxes bronchial smooth muscles.

Indications Long-term maintenance treatment of asthma; prevention of bronchospasms; prevention of exercise-induced bronchospasm; concomitant therapy with short-acting beta₂-agonists, inhaled or systemic corticosteroids, and theophylline therapy; long-term administration in the maintenance of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

Contraindications Standard considerations.

Route/Dosage

Maintenance Treatment of Asthma

ADULTS AND CHILDREN ³ 5 yr: Inhalation 12 mcg q 12 hr.

Prevention of Exercise-Induced Bronchospasm

ADULTS AND CHILDREN ³ 12 yr: Inhalation 12 mcg 15 min prior to exercise given on an occasional, as-needed basis.

Maintenance Treatment of COPD

ADULTS: Inhalation 12 mcg q 12 hr (max, 24 mcg/24 hr).

Interactions

Diuretics, Steroids, Xanthine Derivatives: May potentiate the hypokalemic effect of formoterol. Nonpotassium Sparing Diuretics (eg, Loop or Thiazide Diuretics) ECG changes and hypokalemia may be worsened by formoterol. MAOIs, Tricyclic Antidepressants, Drugs Known to Prolong the QTc Interval Formoterol may potentiate these agents, increasing the risk of cardiac arrhythmia. Beta Blockers Effects of both agents may be inhibited.

Lab Test Interferences None well documented.

Adverse Reactions CARDIOVASCULAR: Angina; hypertension; hypotension; tachycardia; arrhythmias; palpitations. CNS: Nervousness; headache; tremor; dizziness; fatigue; malaise; insomnia; dysphoria. EENT: Rhinitis; tonsillitis. GI: Dry mouth; nausea; gastroenteritis; abdominal pain; dyspepsia. METABOLIC: Hypokalemia; hyperglycemia; metabolic acidosis. OTHER: Muscle cramps; chest infection; viral infection.

Precautions

Pregnancy: Category C. Lactation: Undetermined. CHILDREN: Safety and efficacy in children < 5 yr not established. Cardiovascular Effects: Since formoterol can produce clinically important cardiovascular effects, use with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmia, and hypertension. Paradoxical Bronchospasm: If paradoxical bronchospasm occurs, discontinue formoterol and institute alternative therapy. Acute Worsening, or Deteriorating Asthma: Use of formoterol in these conditions is inappropriate.

PATIENT CARE CONSIDERATIONS

Administration/Storage

This medication is available only as a dry powder for oral inhalation.
Administer only with supplied inhaler.
Do not use a spacer with the inhalation powder. Keep inhaler dry and never wash. Store medication-filled capsules in their blisters and only remove immediately before using. Capsules are for inhalation only and should not be swallowed.
Store capsules in blisters at controlled room temperature. Protect from heat and moisture.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies. Note history of coronary artery disease, arrhythmias, hypertension, or seizures.
Ensure that baseline pulmonary function tests have been completed.
Note frequency and severity of asthma attacks.

OVERDOSAGE: SIGNS & SYMPTOMS
	Angina, hypertension, hypotension, tachycardia, arrhythmias, nervousness, headache, tremor, seizures, muscle cramps, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, hypokalemia, hyperglycemia, insomnia, metabolic acidosis, cardiac arrest, death

Patient/Family Education

Explain name, dose, action, and potential side effects of drug.
Instruct patient on the proper storage and use of the dry powder inhaler, referring to the instruction sheet included with the medication.
Remind patient that capsules should only be used with the Aerolizer Inhaler and should not be taken by mouth.
Inform patient to never wash the Aerolizer Inhaler and to have dry hands when handling the capsules containing the medication.
Advise patient using > 1 inhaled medication to use short-acting bronchodilator medication first if needed and then use this medicine. Take inhaled corticosteroids or other inhaled controller medications last.
Remind patient that this medicine should not be used more frequently than bid (morning and evening) for maintenance treatment of asthma.
Remind patient that if using this medicine to prevent exercise-induced bronchospasm, to use ³ 15 min before exercise and not to take additional doses for ³ 12 hr.
Remind patient that this medication is not a “rescue medication” and is not to be used for the treatment of acute or deteriorating asthma.
Advise patient if asthma symptoms worsen immediately after using this medication, to stop using it and inform health care provider immediately.
Inform patient that formoterol is not a substitute for inhaled or oral corticosteroids and not to stop or reduce the dose of their corticosteroid medication.
Advise patient to contact health care provider if medication no longer seems to control asthma symptoms or if increasing doses of the short-acting bronchodilator (“rescue” medicine) are needed. This may indicate worsening asthma.

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