Formoterol

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Formoterol
Formoterol.svg
Formoterol ball-and-stick model.png
Formoterol (top),
(R,R)-(−)-formoterol (center) and
(S,S)-(+)-formoterol (bottom)
Names
Trade namesOxeze, Perforomist, others
  • (RR,SS)-N-[2-hydroxy-5-[1-hydroxy-2-[1-(4-methoxyphenyl) propan-2-ylamino]ethyl] phenyl]formamide
Clinical data
Drug classLABA[1]
Main usesAsthma, COPD[2]
Side effectsDry mouth, trouble sleeping, nausea, throat inflammation[1]
Pregnancy
category
  • AU: B3
Routes of
use
Inhalation (capsules for oral inhalation, DPI, MDI)
Onset of actionUp to 3 hr for max. effect[1]
Duration of action12 h[1]
External links
AHFS/Drugs.comMonograph
US NLMFormoterol
Legal
License data
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • US: ℞-only
  • EU: Rx-only [3]
  • In general: ℞ (Prescription only)
Pharmacokinetics
Protein binding61% to 64%
MetabolismLiver demethylation and glucuronidation (CYP2D6, CYP2C19, CYP2C9 and CYP2A6 involved)
Elimination half-life10 h
ExcretionKidney and fecal
Chemical and physical data
FormulaC19H24N2O4
Molar mass344.411 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
  • O=CNc1cc(ccc1O)[C@@H](O)CN[C@H](C)Cc2ccc(OC)cc2
  • InChI=1S/C19H24N2O4/c1-13(9-14-3-6-16(25-2)7-4-14)20-11-19(24)15-5-8-18(23)17(10-15)21-12-22/h3-8,10,12-13,19-20,23-24H,9,11H2,1-2H3,(H,21,22)/t13-,19+/m1/s1 checkY
  • Key:BPZSYCZIITTYBL-YJYMSZOUSA-N checkY
  (verify)

Formoterol, also known as eformoterol, is a used in the long term management of asthma and chronic obstructive pulmonary disease (COPD).[2] It is used by breathing it into the lungs.[2] Full effects take about 2 hours and last about 12 h.[1]

Common side effects include dry mouth, trouble sleeping, nausea, and throat inflammation.[1] Other side effects may include bronchospasm, anaphylaxis, and QT prolongation.[1] In asthma, it may increase the risk of death if used without an inhaled steroid.[1] Use in pregnancy is of unclear safety.[1] It is a long-acting β2 agonist (LABA).[1]

Formoterol was patented in 1972 and came into medical use in 1998.[4] It is available as a generic medication.[5] In the United Kingdom it costs the NHS about £12 per month as of 2021.[2] In the United States this amount costs about 285 USD.[5] It is also available in combination as budesonide/formoterol and mometasone/formoterol.[2][1]

Medical uses

Dosage

It is often used at a dose of 12 micrograms twice per day.[2]

Combinations

Side effects

In November 2005, the US Food and Drug Administration (FDA) released a health advisory alerting the public to findings that show the use of long-acting β2 agonists could lead to a worsening of wheezing symptoms in some.[6]

Mechanism of action

Inhaled formoterol works like other β2 agonists, causing bronchodilation by relaxing the smooth muscle in the airway so as to treat the exacerbation of asthma.

Society and culture

Brand names

Inhaler for a powder based in budesonide and formoterol

It is marketed in three forms: a dry-powder inhaler (DPI), a metered-dose inhaler (MDI) and an inhalation solution, under various brand names including Atock, Atimos/Atimos Modulite, Foradil/Foradile, Oxeze/Oxis, and Perforomist.

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 "Formoterol Monograph for Professionals". Drugs.com. Retrieved 13 December 2021.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 267. ISBN 978-0857114105.
  3. https://www.ema.europa.eu/documents/psusa/formoterol-list-nationally-authorised-medicinal-products-psusa/00001469/202005_en.pdf
  4. Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 543. ISBN 9783527607495.
  5. 5.0 5.1 "Formoterol Prices, Coupons & Savings Tips - GoodRx". GoodRx. Retrieved 13 December 2021.
  6. "Advair Diskus, Advair HFA, Brovana, Foradil, Perforomist, Serevent Diskus, and Symbicort Information (Long Acting Beta Agonists)". U.S. Food and Drug Administration (FDA).[dead link]

External links

External sites:
Identifiers: