Formoterol

Sounds like 'for-MOE-ter-ol'

Key points about formoterol

  • Formoterol is used to improve breathing problems caused by asthma and COPD and to prevent them from recurring.
  • It is a bronchodilator medicine which works by opening the air passaged to the lungs.
  • Formoterol is also called Oxis or Foradil.
  • Find out how to use it safely and possible side effects.
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Formoterol is used to improve breathing problems caused by asthma and COPD and to prevent them from recurring. It eases symptoms such as wheezing, coughing and shortness of breath. Formoterol works by opening air passages in your lungs to make breathing easier.

  • Formoterol must be used every day. It is a long-acting bronchodilator, which means that it works throughout the day. It reduces your symptoms over the long term. 
  • For asthma, formoterol should be used together with other medicines called corticosteroids or preventers such as beclomethasone, budesonide or fluticasone.

In New Zealand formoterol is available in different brands and inhaler devices:

  • Oxis turbuhaler 
  • Foradil (capsules with an Aerolizer inhalation device).

Foradil contains the active formoterol powder in a capsule form, which is for inhalation only. The powder from the capsule is breathed into the lungs using the aerolizer inhalation device provided.
Do not swallow the capsules — they must be used by inhaling the contents of the capsule with the Aerolizer inhaler. Using an inhaler device enables the medicine to go straight into your airways when you breathe in. This means that your airways and lungs are treated, but very little of the medicine gets into the rest of your body. 

  • The dose of formoterol will be different for different people depending on the severity of your symptoms and the strength of your inhaler.
  • Oxis turbuhaler:  1-2 inhalations once or two times a day.  
  • Foradil: 1 or 2 capsules inhaled once or two times a day.
  • Before exercise: If you are using your inhaler to prevent asthma brought on by exercise or a known allergen, the usual dose is 1–2 inhalations in the morning or at least 15 minutes before exercise or exposure to the allergen. 
  • Always use your formoterol exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to use, how often to use it and any special instructions. 

Tips

  • Keep using your inhaler every day. Do not stop using it, even if you feel better. Since asthma and COPD are long-term conditions, prevention with formoterol is ongoing and it will need to be used every day for months or years.
  • Try to use your inhaler at the same time each day, to help you to remember to use it regularly.
  • If you miss a regular dose, you can take it as soon as you remember. But if it is nearly time for your next dose, just take your next dose at the right time.

To get the most benefit, it is important to use the correct technique. Ask your doctor, pharmacist or nurse to explain how to use your inhaler. Even if you have been shown before, ask them to show you again how to use your inhaler if you still have any questions. Here is some guidance.

(Healthify He Puna Waiora, NZ & Auckland District Health Board, 2018)

Using your turbuhaler

  • Open: unscrew and remove the cap. Hold the turbuhaler upright.
  • Load the dose: twist the base anticlockwise and then back in the other direction until you hear a click. Your turbuhaler is now loaded with one dose of medicine
  • Breathe out: breathe out, away from the turbuhaler. Do not blow directly into the turbuhaler.
  • Inhale your dose: place the mouth piece in your mouth and form a seal with your lips. Breathe in deeply. Remove the turbuhaler and hold your breath for up to 10 seconds.
  • Close: replace the cap and twist until it is on properly.

Cleaning and storing your turbuhaler: wipe the mouthpiece with a clean dry tissue. Do not wash the mouthpiece or allow it to get wet when cleaning. Keep the cap on when not in use. The device may clog if exhaled or dribbled into or if stored in an area of high humidity with the cap off or unsealed.

When to start a new turbuhaler: there is a window under the mouthpiece on the outside of the turbuhaler called a dose indicator window. When it turns red it is time to get a new turbuhaler. 

Foradil contains the active formoterol powder in a capsule form, which is for oral inhalation only. The powder from the capsule is inhaled (breathed into the lungs) using the Aerolizer inhalation device provided. Do not swallow the capsules — they must be used by inhaling the contents of the capsule with the Aerolizer inhaler. Ask your doctor, pharmacist or nurse to explain how to use your inhaler.

  • Do you have heart disease?
  • Do you have an overactive thyroid (hyperthyroid)?
  • Do you have high blood pressure (hypertension)?
  • Are you pregnant or breastfeeding?
  • Do you have diabetes?
  • Do you have lactose intolerance?
  • Do you have an irregular heartbeat or rhythm, including a very fast pulse?
  • Do you play competitive or professional sport?

If so, it’s important that you tell your doctor or pharmacist before you start using formoterol. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Like all medicines formoterol can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Side effects What should I do?
  • A different taste in your mouth
  • Dry mouth
  • Nausea (feeling sick)
  • Headache
  • Cough
  • These are quite common when you first start using formoterol, and usually go away with time.
  • Tell your doctor if troublesome.
  • Fast heart rate
  • Feeling nervous, restless, agitated
  • Trembling or shakiness
  • Problems sleeping
  • Tell your doctor if troublesome.
  • Sudden worsening of breathing problems 
  • Tell your doctor immediately or phone HealthLine on 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product(external link)

Foradil(external link) Medsafe Consumer Information Sheets
Oxis Turbuhaler(external link) Medsafe Consumer Information Sheets
Formoterol(external link) New Zealand Formulary Patient Information

References

  1. Formoterol fumarate dihydrate(external link) New Zealand Formulary

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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