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Formoterol

(for moh' te rol)

Brand name(s): Foradil

Why is this medication prescribed?

Formoterol is used to treat wheezing, shortness of breath, and troubled breathing caused by asthma and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis, emphysema, and other lung diseases. It also is used to prevent breathing difficulties (bronchospasm) during exercise. Formoterol is in a class of medications called long-acting beta agonists. It works by relaxing and opening air passages in the lungs, making it easier to breathe.

How should this medicine be used?

Formoterol comes as a powder-filled capsule to inhale by mouth using a special inhaler. For the treatment of asthma and COPD, formoterol is usually inhaled twice a day. For the prevention of breathing difficulties during exercise, formoterol is inhaled 15 minutes before exercise. After inhaling formoterol, do not use another dose for 12 hours. To help you remember to use formoterol, use it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use formoterol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Do not use formoterol during an attack of asthma or COPD. Your doctor will prescribe a short-acting inhaler to use during attacks. If you are using formoterol twice a day, do not use another dose before exercising.

Formoterol controls symptoms of asthma and other lung diseases but does not cure them. Do not stop using formoterol without talking to your doctor.

Before you use the formoterol inhaler the first time, read the written instructions that come with it. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler while he or she watches.

To use the inhaler, follow these steps:

• Separate one capsule from the blister pack by tearing along the dotted lines. Remove the capsule from its package immediately before use by peeling off the paper backing and pushing the capsule through the foil.
• Pull off the inhaler cover and twist the mouthpiece open in the direction shown by the arrow on the mouthpiece.
• Place the capsule in the chamber. Do not place it directly into the mouthpiece. Twist closed.
• Hold the inhaler upright and, at the same time, press in both side buttons once. You will hear a click as the capsule is punctured. Release the buttons.
• Turn the inhaler on its side, making sure the blue buttons are pointing to the sides.
• Exhale (breathe out) as completely as possible, but not into the mouthpiece.
• Tilt your head back slightly, place the mouthpiece in your mouth, and close your lips. Breathe in fast, steadily, and deeply. As the medicine is released from the capsule, you'll get a sweet taste and hear a whirring noise. (If you don't, the capsule may be stuck. Tap on the side of the inhaler to loosen the capsule and inhale again. Do not press the side buttons again.)
• Remove the inhaler from your mouth and hold your breath for as long as you comfortably can. Then exhale.
• Open the inhaler to see if there is any powder left in the capsule. If there is, repeat steps 5-8.
• Once the capsule is empty, remove it and throw it away. Do not leave it in the chamber. Close the mouthpiece and replace the cover.

Formoterol capsules should only be used with the special inhaler and should not be taken by mouth. Store capsules in the package and remove them immediately before use. Avoid exposing the capsules to moisture, and handle them with dry hands.

Do not use the dry powder inhaler with a spacer. Do not exhale into the device. Keep the inhaler dry; do not wash it. Always use the new inhaler that comes with a refill of your medication.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking formoterol,

• tell your doctor and pharmacist if you are allergic to formoterol or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aminophylline (Phyllocontin, Truphylline); amiodarone (Cordarone); antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); cisapride (Propulsid); diet pills; disopyramide (Norpace); diuretics ('water pills'); dofetilide (Tikosyn); dyphylline (Dilor, Lufyllin); erythromycin (E.E.S., E-Mycin, Erythrocin); medications for colds; monoamine oxidase (MAO) inhibitors, including phenelzine (Nardil) and tranylcypromine (Parnate); moxifloxacin (Avelox); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); other inhaled beta agonists; oxtriphylline (Choledyl SA); pimozide (Orap); procainamide (Procanbid, Pronestyl); quinidine (Quinidex); sotalol (Betapace, Betapace AF); sparfloxacin (Zagam); theophylline (Theobid, Theo-Dur); and thioridazine (Mellaril). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had irregular heartbeats, high blood pressure, heart disease, seizures, thyroid disease, or diabetes.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using formoterol, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking formoterol.
• if you have been using a short-acting beta agonist inhaler such as albuterol (Proventil, Ventolin) on a regular basis (for example, four times a day), you should stop using it regularly when you start using formoterol. Keep your other inhaler to use during an attack of asthma or COPD.

What special dietary instructions should I follow?

Talk to your doctor about drinking beverages that contain caffeine while taking this medicine.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Formoterol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nervousness
• headache
• tremor
• dry mouth
• muscle cramps
• upset stomach
• extreme tiredness
• dizziness
• difficulty falling asleep or staying asleep

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• rapid, pounding, or irregular heartbeat
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty swallowing or breathing
• hives
• rash
• chest pain
• thirst
• flushing
• dry skin
• frequent urination
• loss of appetite

Formoterol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

• chest pain
• fainting
• rapid, pounding, or irregular heartbeat
• nervousness
• headache
• tremor
• seizures
• muscle cramps
• dry mouth
• upset stomach
• dizziness
• excessive tiredness
• difficulty falling asleep or staying asleep
• thirst
• dry mouth
• tiredness
• flushing
• dry skin
• frequent urination
• loss of appetite
• trouble breathing

What other information should I know?

Keep all appointments with your doctor.

If your asthma symptoms become worse, if formoterol inhalation becomes less effective, or if you need more doses than usual of a short-acting beta agonist, your asthma may be getting worse. Call your doctor.

If your sputum (the matter you cough up during an asthma attack) thickens or changes color from clear white to yellow, green, or gray, call your doctor; these changes may be signs of an infection.

To relieve dry mouth or throat irritation caused by formoterol inhalation, rinse your mouth with water, chew gum, or suck sugarless hard candy after using formoterol.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Last Revised - 01/01/2003

American Society of Health-System Pharmacists, Inc. Disclaimer

The MedMaster™ Patient Drug Information database provides information copyrighted by the American Society of Health-System Pharmacists, Inc., Bethesda, Maryland Copyright© 2004. All Rights Reserved.

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