Formoterol

Benjamin Clanner-Engelshofen is a freelance writer in the medical department. He studied biochemistry and pharmacy in Munich and Cambridge / Boston (USA) and noticed early on that he particularly enjoyed the interface between medicine and science. That is why he went on to study human medicine.

More about the experts All content is checked by medical journalists.

The active ingredient formoterol is a beta-2 sympathomimetic and is used against asthma and chronic obstructive pulmonary disease (COPD). Formoterol works quickly and lasts about twelve hours. Here you can read everything interesting about the effect, application and side effects of formoterol.

This is how formoterol works

The active ingredient formoterol mimics the effects of the "stress hormones" adrenaline and noradrenaline in the body. These are released by the body in stressful situations or when the body has to perform (as in sport) and ensure that the necessary organs are optimally supplied with oxygen and nutrients: the heart beats faster, blood pressure rises, the bronchi of the lungs widen, the The muscles are better supplied with blood. At the same time, energy-consuming processes such as digestion are throttled.

Since the active ingredient formoterol is absorbed by inhalation, it mainly works in the lungs, where it widens the bronchi, which is supposed to ensure better gas exchange. This is particularly important if the bronchi are permanently narrowed or tend to narrow due to inflammatory or general pathological processes (as in COPD and asthma).

Formoterol absorption, breakdown and excretion

When inhaled, part of the active ingredient formoterol reaches the lungs, while most of it sticks to the mucous membrane of the mouth and throat and is swallowed. Formoterol enters the bloodstream via both the lungs and the intestines, and some of it (again) reaches the lungs. After inhalation, the highest blood levels are measured after five minutes, after ingestion within half an hour to an hour. Formoterol works quickly, after about 30 seconds, and lasts for about twelve hours.

Formoterol is largely broken down in the liver and then excreted through the kidneys. A small part (less than ten percent) is eliminated unchanged. Excretion occurs very quickly at high blood levels - half of the active ingredient is excreted within two to three hours. It happens more slowly when the blood levels are low: it takes up to 14 hours for half of the amount of active ingredient to leave the body.

When is formoterol used?

The active ingredient formoterol is used for:

• Treatment of moderate to severe asthma (in combination with a "cortisone" - a glucocorticoid)
• Treatment of chronic bronchitis

Formoterol is mainly used as a long-term preventative - either continuously, as in chronic illnesses, or in phases, as in seasonal allergy-related asthma. Since the drug works for about twelve hours, it is usually used twice a day.

In combination with a cortisone (budesonide), however, more recent studies have shown that formoterol is also very effective as a reliever medication for mild asthma. The guidelines recommend this fixed combination as reliever medication for asthmatics, even if their long-term therapy consists of these active ingredients.

This is how formoterol is used

Formoterol is used by inhalation, as this achieves the highest concentration of active substances in the lungs. It is used as a pressurized gas inhaler (the classic asthma spray) or in the form of capsules with powder for inhalation (with a suitable inhaler). The capsules are individually inserted into the inhaler and pierced. The powder is then transported into the lungs by the air suction when inhaling.

A single dose (spray or inhalation capsule) contains four and a half to twelve micrograms of formoterol and is given twice a day. In severe cases, the dosage can be doubled, which corresponds to a maximum daily dose of 48 micrograms of formoterol.

What side effects does formoterol have?

Side effects of treatment with formoterol usually occur more frequently at the beginning of therapy and then improve continuously. If symptoms persist, it should be checked whether the inhalation is being carried out correctly.

One in ten to one hundred people treated experience formoterol side effects such as headache, tremors, palpitations and shortness of breath.

Occasionally (in one in a hundred to a thousand patients), adverse drug effects such as restlessness, restlessness, sleep disorders, anxiety, nervousness, rapid heartbeat, irritation of the oropharynx, muscle cramps and pain, and further narrowing of the bronchi - in this case the use of formoterol should be stopped immediately and a doctor should be called.

If the preparation also contains a glucocorticoid (colloquially “cortisone”), as is customary in asthma treatment, something must be eaten or drunk after inhalation to rinse the mouth - otherwise it can lead to fungal infections in the mouth.

What should be considered when using formoterol?

If other sympathomimetics ("stimulating" active ingredients such as ephedrine) are taken during treatment with formoterol, the side effects may increase.

The simultaneous intake of formoterol and dehydrating agents (diuretics such as hydrochlorothiazide / HCT, furosemide), steroids and xanthines (e.g. caffeine, theophylline) can lead to low blood potassium levels (hypokalaemia).

Other drugs that affect the heart rhythm and in particular lengthen the so-called QT segment can, in combination with formoterol, lead to severe cardiac arrhythmias. Examples include antibiotics (e.g. erythromycin), anti-allergy drugs (terfenadine, astemizole, phenothiazine), certain anti-depression drugs (tricyclic antidepressants), and even anti-arrhythmic drugs (quinidine, procainamide).

The effect of formoterol can be weakened or canceled if it is combined with beta-blockers (active ingredients for lowering the heartbeat and thereby also the blood pressure), also in the form of eye drops (for the treatment of glaucoma).

Formoterol should not be used during pregnancy and breastfeeding if it can be avoided. However, it can be used in urgent cases where the benefit and risk have been carefully weighed up by a doctor.

Treatment with formoterol is approved for children and adolescents aged six years and over.

How to get formoterol medication

Preparations with the active ingredient formoterol require pharmacy and prescription only.

Since when has formoterol been known?

As early as 1903, the scientists Bullowa and Kaplan discovered that adrenaline dilates the bronchi and helps with acute asthma attacks. Later attempts were made to optimize the short duration of action and the many side effects of adrenaline by changing its chemical structure. Formoterol was first produced in 1977; However, its full potential was only discovered in 1986. In 1997, Formoterol came onto the market in Germany.

Tags:  teeth vaccinations foot care