Perforomist: Black Box Warnings

Perforomist: Adult Dosing

Dosage forms: 20 mcg/2 mL neb

COPD maintenance

20 mcg NEB bid

Max: 40 mcg/day

Perforomist: Peds Dosing

This information is currently unavailable or not applicable for this drug.

Perforomist: Contraindications/Cautions

• hypersens. to drug/class/compon.
• acute asthma
• caution if hypersens. to milk protein (DPI)
• caution if cardiovascular dz
• caution if HTN
• caution if cardiac arrhythmia
• caution if hypokalemia
• caution if diabetes mellitus
• caution if hyperthyroidism
• caution if seizure disorder

Perforomist: Drug Interactions

Contraindicated

• phenothiazines

Avoid/Use Alternative

• budesonide/formoterol inhaled

• fluticasone/salmeterol inhaled

• sotalol

Monitor/Modify Tx

• A2R blocker/HCTZ combos

• ACE inhibitor/HCTZ combos

• amiodarone

• amphotericins

• antiarrhythmics, class Ia

• beta blocker/thiazide combos

• budesonide

• carbonic anhydrase inhibitors, systemic

• carboplatin

• chloroquine phosphate

• cisapride

• cisplatin

• clarithromycins

• corticosteroids, systemic

• dasatinib

• digoxin

• diuretics, loop

• diuretics, potassium-sparing/HCTZ

• diuretics, thiazide

• dofetilide

• dolasetron

• droperidol

• erythromycins

• flecainide

• foscarnet

• haloperidol

• ibutilide

• insulin inhaled

• lapatinib

• meperidine/promethazine

• methadone

• paliperidone

• pentamidine

• pimozide

• polyethylene glycol/electrolytes

• quetiapine

• ranolazine

• sodium phosphate

• telithromycin

• vorinostat

Caution Advised

• atomoxetine

• beta blockers, systemic

• linezolid

• MAOIs, all

• propafenone

• quinolones, QT prolongers

• tricyclic antidepressants

• ziprasidone

Perforomist: Adverse Reactions

Serious Reactions

• bronchospasm, paradoxical
• asthma exacerbation
• death, asthma-related (rare)
• anaphylaxis (rare)
• angioedema (rare)
• hypokalemia
• arrhythmias

Common Reactions

• URI
• dyspepsia
• chest pain
• back pain
• fever
• diarrhea
• nausea/vomiting
• dry mouth
• dizziness
• insomnia
• nervousness
• tremor
• palpitations
• tachycardia
• hyperglycemia, transient

Perforomist: Safety Monitoring

Pregnancy: C

Lactation: Safety Unknown

Monitoring Parameters: no routine tests recommended

Perforomist: Pharmacology

Metabolism: liver extensively; CYP450: 2A6, 2C9/19, 2D6 substrate; Info: minimal systemic absorption

Excretion: urine primarily 59-62% (10% unchanged), feces 32-34%; Half-life: 10h

Class: Bronchodilators

Mechanism Of Action
stimulates beta2-adrenergic receptors, relaxing airway smooth muscle (selective beta agonist)

Perforomist: Manufacturer/Pricing

Manufacturer: Dey Laboratories DEA/FDA: Rx

Perforomist: Patient Education

• Generic Name: formoterol

• Pronounced: for MOE ter all

• Brand Name: Foradil Aerolizer

What is the most important information I should know about formoterol inhalation?

Do not use formoterol inhalation to treat an asthma attack that has already begun. It will not work fast enough to reverse your symptoms. Use another, short-acting inhalation medication to treat an asthma attack.

Formoterol inhalation may increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits in using formoterol inhalation.

Asthma is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.

Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack.

What is formoterol inhalation?

Formoterol is a long-acting bronchodilator that relaxes muscles in the airways to improve breathing.

Formoterol inhalation is used to prevent bronchospasm in people with reversible obstructive airways disease, including symptoms of night-time asthma. It is also used in people with chronic obstructive pulmonary disease (COPD) such as emphysema and chronic bronchitis.

Formoterol inhalation may also be used for other purposed not listed in this medication guide.

What should I discuss with my healthcare provider before using formoterol inhalation?

Formoterol may increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits in using formoterol inhalation.

Before using this medication, tell your doctor if you are allergic to formoterol, or if you have:

• a food or drug allergy;
• heart disease or high blood pressure;
• epilepsy or other seizure disorder;
• diabetes; or
• a thyroid disorder.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use formoterol inhalation.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use formoterol inhalation without telling your doctor if you are breast-feeding a baby.

Do not give this medication to a child younger than 5 years old.

How should I use formoterol inhalation?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.

Do not use formoterol inhalation to treat an asthma attack that has already begun. It will not work fast enough to reverse your symptoms. Use another, short-acting inhalation medication to treat an asthma attack.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. This device is not to be used with a spacer. Ask your doctor or pharmacist if you have any questions.

Formoterol capsules are for use only in the Foradil Aerolizer device. Use only one capsule at a time. Do not take the capsules by mouth. Never place a capsule in the mouthpiece of the inhaler.

If you are using formoterol inhalation to prevent exercise-induced asthma, use the medicine 15 minutes before exercising, or as directed by your doctor. Allow at least 12 hours to pass before you use the medicine again.

It is important to use formoterol inhalation regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Asthma is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.

Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack.

Store formoterol at room temperature, away from moisture, light, and heat. Keep each capsule in the blister pack until you are ready to use one. Be sure your hands are dry when handling a formoterol capsule.

Do not try to clean or take apart the Aerolizer device. Throw it away when your capsules run out. Always use the new device provided with the medication when you get your prescription refilled.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include chest pain, nervousness, dry mouth, nausea, sleep problems (insomnia), tremors, chest pain, fast or irregular heartbeats, feeling weak or light-headed, fainting, or seizure (convulsions).

What should I avoid while using formoterol inhalation?

Avoid using other long-acting inhaled bronchodilators such as salmeterol (Advair, Serevent) while you are using formoterol inhalation.

What are the possible side effects of formoterol inhalation?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• chest pain, fast or pounding heartbeats, tremors, shaking, or restless feeling;
• wheezing, choking, or other breathing problems after using this medication;
• increased thirst or hunger, urinating more than usual; or
• worsening asthma symptoms.

Less serious side effects may include:

• dizziness, anxiety, headache;
• sleep problems (insomnia);
• back pain, muscle cramps;
• sore throat, dry mouth, cough, stuffy nose;
• skin rash, itching; or
• changes in your voice.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect formoterol?

Before using formoterol inhalation tell your doctor if you are taking any of the following medicines:

• cisapride (Propulsid);
• droperidol (Inapsine);
• methadone (Methadose);
• pentamidine (NebuPent, Pentam);
• caffeine, diet pills, cold medicine, or a stimulant medication;
• antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), telithromycin (Ketek);
• medicines to treat psychiatric disorder, such as pimozide (Orap), haloperidol (Haldol), or thioridazine (Mellaril);
• heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace);
• a beta-blocker such as acebutolol (Sectral), atenolol (Tenormin), betaxolol (Kerlone), bisoprolol (Zebeta), carteolol (Cartrol), carvedilol (Coreg), esmolol (Brevibloc), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), penbutolol (Levatol), pindolol (Visken), propranolol (Inderal, InnoPran), sotalol (Betapace), or timolol (Blocadren);
• antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil);
• a diuretic (water pill) such as bumetanide (Bumex), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril), indapamide (Lozol), metolazone (Mykrox, Zarxolyn), torsemide (Demadex); or
• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

This list is not complete and there may be other drugs that can interact with formoterol inhalation. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about formoterol.

---

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Perforomist: Pill Pictures

This information is currently unavailable or not applicable for this drug.