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Generic Name:

formoterol, Inhalation powder

All Brands

  • Foradil (Discontinued)
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
SECTION 1 of 4

Highlights for formoterol

Inhalation powder
1

Formoterol comes as a nebulization solution for inhalation by mouth used to treat chronic obstructive pulmonary disease (COPD).

2

Formoterol is available as the brand-name drug Perforomist. It’s not available as a generic drug.

3

More common side effects of taking this drug include headaches, fast or irregular heart rate (palpitations), chest pain, tremors, trouble sleeping (insomnia), and nervousness.

4

You shouldn’t use this drug with another long-acting beta2-adrenergic agonist (LABA), such as salmeterol or arformoterol.

5

Don’t use formoterol to treat sudden symptoms of COPD. Use your rescue inhaler instead.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning indicates effects that may be dangerous.

Asthma-related death warning. People with asthma who take long-acting beta2-adrenergic agonist (LABA) medicines, such as formoterol, have an increased risk of death from asthma problems. Children and adolescents who take formoterol may have an increased risk of being hospitalized for asthma problems.

Not for sudden asthma symptoms

Don’t use formoterol to treat sudden symptoms of chronic obstructive pulmonary disease (COPD). Use your rescue inhaler instead.

Other long-acting beta2-adrenergic agonists (LABA)

You shouldn’t use this drug with an additional LABA drug, such as salmeterol or arformoterol, for any reason. Using both of these drugs together will increase your risk of an overdose that could lead to an irregular heartbeat, lactic acidosis, or death.

What is formoterol?

Formoterol is a prescription drug that comes as nebulization solution for inhalation. It isn’t available as a generic drug. It’s only available as the brand-name drug Perforomist.

Formoterol may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Formoterol nebulization solution is used to treat chronic obstructive pulmonary disease (COPD).

How it works

Formoterol is a long-acting beta2-adrenergic agonist (LABA). It helps the muscles around the airways in your lungs stay relaxed.

More Details

How it works

Formoterol is a long-acting beta2-adrenergic agonist (LABA). It helps the muscles around the airways in your lungs stay relaxed. This prevents symptoms of COPD, such as wheezing and shortness of breath, that can happen when the muscles around the airways tighten. Using formoterol makes it easier to breathe.

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SECTION 2 of 4

formoterol Side Effects

Inhalation powder

More Common Side Effects

Some of the more common side effects of formoterol include:

  • headaches

  • palpitations

  • chest pain

  • fast heart rate

  • tremor

  • insomnia

  • nervousness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have any of these serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

  • sudden breathing problems. Symptoms include:

    • wheezing
    • coughing
    • trouble breathing
  • serious allergic reactions. Symptoms include:

    • skin rash
    • hives
    • swelling of your face, mouth, and tongue
    • breathing problems
  • low blood potassium. Symptoms include:

    • muscle spasms
    • muscle weakness
    • abnormal heart rhythm
  • high blood sugar levels (hyperglycemia). Symptoms include:

    • frequent urination
    • intense thirst
    • blurred vision
    • headache
  • fast or irregular heart rate

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Formoterol doesn’t cause drowsiness. This drug may cause a fast heart rate or palpitations.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

formoterol May Interact with Other Medications

Inhalation powder

Formoterol can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that may interact with this drug

Asthma or chronic obstructive pulmonary disease drugs

These medications work in the same location as formoterol and can increase its effect. This may cause more side effects. 

These drugs include:

  • aformoterol
  • formoterol
  • salmeterol
  • vilanterol
  • levalbuterol
  • theophylline
  • xanthine

Decongestants

These medications work in the same location as formoterol and can increase its effect. This may cause more side effects.

These drugs include:

  • ephedrine
  • psuedophedrine
  • phenylephrine
  • epinephrine
  • norepinephrine
  • oxymetazoline
  • xylometazoline

Xanthine derivatives

Taking these drugs with formoterol can cause very low levels of potassium.  

These drugs include:

  • theophylline
  • xanthine

Water pills

Taking these drugs with formoterol can cause low levels of potassium and electrocardiogram changes.  

These drugs include:

  • furosemide
  • torsemide
  • bumetanide
  • hydrochlorothiazide
  • chlorthalidone
  • chlorothiazide
  • metolazone

Depression drugs

These medications can cause heart problems when taken with formoterol.  

These drugs include:

  • loop diuretics
    • bumetanide
    • furosemide
    • indapamide
    • torsemide
  • thiazide diuretics
    • chlorthalidone
    • chlorthiazide
    • hydrochlorot
    • hiazide
    • metolazone

Blood pressure drugs

These medications work the exact opposite of formoterol. This decreases the effectiveness of formoterol. It may also cause bronchospasms when taken together.

These drugs include:

  • beta blockers, such as:
    • acebutolol
    • arotinolol
    • atenolol
    • betaxolol
    • bisoprolol
    • esmolol
    • metoprolol
    • nadolol
    • nebivolol
    • penbutolol
    • pindolol
    • propranolol
    • timolol (systemic)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Formoterol warnings
heart problems
People with heart problems, including high blood pressure

Formoterol may cause chest pain, high or low blood pressure, fast heart rate, and irregular heart rhythms. These effects may make your heart problem worse. Let your doctor know if you have heart disease

seizures
People with seizures

Formoterol may cause seizures. Let your doctor know before starting this drug if you have a seizure disorder.

thyroid problems
People with thyroid problems

Your formoterol dosage may need to be changed if you have thyroid problems. Your body may process this drug differently if you have hyperthyroidism or hypothyroidism.

diabetes
People with diabetes

Formoterol may increase your blood sugar levels.

history of aneurysm
People with a history of aneurysm or pheochromocytoma

Let your doctor know before starting this drug if you have a history of any of these conditions. Formoterol can make them worse.

Pregnant women
Pregnant women

Formoterol is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. 

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

breast-feeding
Women who are breast-feeding

It isn’t known if formoterol passes into breast milk. If it does, it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

children
For children

The brand-name drug Perforomist hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

call the doctor
When to call the doctor

Call your healthcare provider or get medical care right away if:

  • your breathing problems worsen with formoterol
  • you need to use your rescue inhaler more often than usual
  • your rescue inhaler doesn’t work as well to relieve symptoms
  • you need to use 4 or more inhalations of your rescue inhaler medication for 2 or more days in a row
  • you use 1 whole canister of your rescue inhaler medication in 8 weeks
  • your peak flow meter results decrease (your healthcare provider will tell you the numbers that are right for you)
allergies
Allergies

Formoterol can cause a severe allergic reaction. Symptoms include: 

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take formoterol (Dosage)

Inhalation powder

All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Chronic obstructive pulmonary disease (COPD)

Brand: Perforomist

Form: Nebulizer solution
Strengths: 20 mcg/2 mL
Adult dosage (ages 18 years and older)

The usual dose is 1 vial of Perforomist solution in your nebulizer every 12 hours. If you have any shortness of breath in between doses, use your rescue inhaler for relief.

Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Asthma/bronchospasm

Brand: Perforomist

Form: Nebulizer solution
Strengths: 20 mcg/2 mL
Adult dosage (ages 18 years and older)

The usual dose is 1 vial of Perforomist solution in your nebulizer every 12 hours. If you have any shortness of breath in between doses, use your rescue inhaler for relief.

Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Exercise-induced bronchospasm

Brand: Perforomist

Form: Nebulizer solution
Strengths: 20 mcg/2 mL
Adult dosage (ages 18 years and older)

The usual dose is 1 vial of Perforomist solution in your nebulizer every 12 hours. If you have any shortness of breath in between doses, use your rescue inhaler for relief.

Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Formoterol comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your symptoms will get worse. Your lung function will decline and you’ll have more trouble breathing.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms may include:

  • chest pain
  • change in blood pressure or heart rate
  • headaches
  • tremors
  • seizures
  • muscle cramps or weakness
  • dry mouth
  • fast or irregular heart rate (palpitations)
  • nausea
  • dizziness
  • fatigue
  • not feeling well (malaise)
  • trouble sleeping (insomnia)
  • heavy sweating

If you think you’ve taken too much of the drug, act right away. Call your doctor or local poison control center, or go to the nearest emergency room.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell this drug is working

Your symptoms will be better controlled, and you’ll have fewer attacks or sudden symptoms of trouble breathing.

Formoterol is used for long-term treatment.

Important considerations for taking formoterol
take with or without food
You can take formoterol with or without food
timing
Take your doses 12 hours apart
storage
Store this drug carefully
See Details
medication is refillable
A prescription for this medication is refillable
See Details
Travel
Travel
See Details
Self-management
Self-management
See Details
Clinical monitoring
Clinical monitoring
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
Hidden costs
Hidden costs
See Details
prior authorization required
Insurance
See Details

Store this drug carefully

  • Store it between 36°F and 46°F (2°C and 8°C).
  • Keep it away from light and high temperatures. Protect the pouch from heat.
  • Don’t freeze formoterol.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

The brand-name drug Perforomist should only be used with a standard jet nebulizer (with a facemask or mouthpiece) connected to an air compressor. Follow the instructions that come with your nebulizer carefully. Your doctor or pharmacist will show you how to use your nebulizer properly.

Clinical monitoring

Your doctor will monitor how well your lungs are working. This will help make sure your lung function is within the range your doctor feels is best for you. It will also tell if your medication is working. 

This monitoring may be done using two tests:

  • Pulmonary function tests (PFTs). Your doctor will do PFTs to measure how well your lungs are working.
  • Peak flow results. Your doctor may have you monitor your lung function at home. You may need to record your symptoms or monitor how well your lungs are working with a peak flow meter.

Your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Blood. This medication can cause changes in some blood test values (sugar and potassium).

Hidden costs

You may need to purchase a peak flow meter to monitor your lung function at home.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by University of Illinois-Chicago, Drug Information Group on June 15, 2017

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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