Formoterol Explained

Formoterol should not be confused with Fenoterol.

Verifiedrevid:461113044
Width:230
Chirality:Racemic mixture
Tradename:Oxeze, Foradil, Symbicort, others
Pregnancy Au:B3
Licence Eu:yes
Inn Ema:formoterol fumarate dihydrate
Legal Au:S4
Legal Nz:Prescription only
Legal Uk:POM
Legal Us:Rx-only
Legal Eu:Rx-only
Legal Eu Comment:[1]
Legal Status:Rx-only
Routes Of Administration:Inhalation (capsules for oral inhalation, DPI, MDI)
Protein Bound:61% to 64%
Metabolism:Liver demethylation and glucuronidation (CYP2D6, CYP2C19, CYP2C9 and CYP2A6 involved)
Elimination Half-Life:10 h
Excretion:Kidney and fecal
Cas Number:73573-87-2
Atc Prefix:R03
Atc Suffix:AC13
Pubchem:3083544
Pubchem2:3034756
Iuphar Ligand:3465
Drugbank:DB00983
Chemspiderid:2340731
Unii:5ZZ84GCW8B
Kegg:D07990
Chebi:408174
Chembl:1363
Iupac Name:(RR,SS)-N-[2-hydroxy-5-[1-hydroxy-2-[1-(4-methoxyphenyl) propan-2-ylamino]ethyl] phenyl]formamide
C:19
H:24
N:2
O:4
Smiles:O=CNc1cc(ccc1O)[C@@H](O)CN[C@H](C)Cc2ccc(OC)cc2
Stdinchi: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
Stdinchikey:BPZSYCZIITTYBL-YJYMSZOUSA-N

Formoterol, also known as eformoterol, is a long-acting β2 agonist (LABA) used as a bronchodilator in the management of asthma and chronic obstructive pulmonary disease (COPD). Formoterol has an extended duration of action (up to 12 h) compared to short-acting β2 agonists such as salbutamol (albuterol), which are effective for 4 h to 6 h. Formoterol has a relatively rapid onset of action compared to other LABAs, and is effective within 2-3 minutes.[2] The 2022 Global Initiative for Asthma report [3] recommends a combination formoterol/inhaled corticosteroid inhaler as both a preventer and reliever treatment for asthma in adults. In children, a short-acting β2 adrenergic agonist (e.g., salbutamol) is still recommended.

It was patented in 1972 and came into medical use in 1998.[4] It is available as a generic medication.[5] It is also marketed in the combination formulations budesonide/formoterol and mometasone/formoterol.

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 patients.[6]

Nowadays, available long-acting β2 agonists include salmeterol, formoterol, bambuterol, and sustained-release oral salbutamol.

Combinations of inhaled steroids and long-acting bronchodilators are becoming more widespread – combination preparations include fluticasone/salmeterol and budesonide/formoterol.

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

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, Fostair, Oxeze/Oxis, Perforomist and Symbicort.

In some countries, Perforomist is marketed by Viatris after Upjohn merged with Mylan to create Viatris.[7] [8]

Uses and combinations

Notes and References

  1. Web site: List of nationally authorised medicinal products. ema.europa.eu. 17 June 2023.
  2. Anderson GP. Formoterol: pharmacology, molecular basis of agonism, and mechanism of long duration of a highly potent and selective beta 2-adrenoceptor agonist bronchodilator. . Life Sci . 1993 . 52 . 26 . 2145–60 . 8099696 . 10.1016/0024-3205(93)90729-m .
  3. Global Initiative for Asthma. 2022 . Global Strategy for Asthma Prevention and Management (Updated 2022) .
  4. Book: Fischer J, Ganellin CR . Analogue-based Drug Discovery . 2006 . John Wiley & Sons . 9783527607495 . 543 . en.
  5. Web site: Competitive Generic Therapy Approvals . U.S. Food and Drug Administration (FDA) . 29 June 2023 . 29 June 2023 . 29 June 2023 . https://web.archive.org/web/20230629233651/https://www.fda.gov/drugs/generic-drugs/competitive-generic-therapy-approvals . live .
  6. Web site: U.S. Food and Drug Administration (FDA) . Advair Diskus, Advair HFA, Brovana, Foradil, Perforomist, Serevent Diskus, and Symbicort Information (Long Acting Beta Agonists) . 16 December 2019 . 1 November 2017 . https://web.archive.org/web/20171101115959/https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm108111.htm . dead .
  7. Web site: Pfizer Completes Transaction to Combine Its Upjohn Business with Mylan . Pfizer . Business Wire . 16 November 2020 . 17 June 2024.
  8. Web site: Brands . Viatris . 16 November 2020 . 17 June 2024.