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formoterol (Rx)Brand and Other Names:Perforomist

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

solution for inhalation

  • 20mcg/2mL
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Chronic Obstructive Pulmonary Disease (COPD)

Indicated for long-term maintenance treatment of bronchoconstriction in patients with COPD

Perforomist: 20 mcg inhaled via nebulizer q12hr

Safety and efficacy not established

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Interactions

Interaction Checker

formoterol and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Viral infection (17.2%)

            1-10%

            Bronchitis (4.6%)

            Chest infection (2.7%)

            Dyspnea (2.1%)

            Chest pain (1.9%)

            Tremor (1.9%)

            Dizziness (1.6%)

            Frequency Not Defined

            Angina

            Arrhythmias

            Hypo/hypertension

            Tachycardia

            Hypokalemia

            Hyperglycemia

            Metabolic acidosis

            Headache

            Insomnia

            Paradoxical bronchospasm

            Severe asthma exacerbation

            Postmarketing Reports

            Immune system disorders: Rare reports of anaphylactic reactions, including severe hypotension and angioedema

            Metabolism and nutrition disorders: Hypokalemia, hyperglycemia

            Respiratory, thoracic and mediastinal disorders: Cough

            Skin and subcutaneous tissue disorders: Rash

            Cardiac disorders: Angina pectoris, cardiac arrhythmias (eg, atrial fibrillation, ventricular extrasystoles, tachyarrhythmia)

            Investigations: Electrocardiogram QT prolonged, blood pressure increased (including hypertension)

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            Warnings

            Black Box Warnings

            Long-acting beta2-adrenergic agonists (LABAs) increase the risk of asthma-related death

            A placebo-controlled study with another long-acting beta2-adrenergic agonist (salmeterol) showed an increase in asthma-related deaths in patients receiving salmeterol

            The finding of an increased risk of asthma-related death with salmeterol is considered a class effect of LABAs, including formoterol, the active ingredient in Perforomist

            The safety and efficacy of Perforomist in patients with asthma have not been established

            All LABAs, including Perforomist, are contraindicated in patients with asthma without use of a long-term asthma control medication

            Contraindications

            Hypersensitivity

            Tachycardia secondary to heart condition

            Cautions

            Coexisting conditions including cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, hypertension, aneurysm, and pheochromocytoma; convulsive disorders; thyrotoxicosis; patients who are unusually responsive to sympathomimetic amines

            Risk of transient hypokalemia

            May increase risk of severe, potentially fatal asthma attacks

            Do not use for relief of acute COPD symptoms

            Concomitant short-acting beta2-agonists can be used as needed for acute relief

            Life-threatening paradoxical bronchospasm can occur; discontinue immediately

            Immediate hypersensitivity reactions may occur (eg, anaphylactic reactions, urticaria, angioedema, rash, bronchospasm)

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Long-acting selective beta-2 agonist

            Bronchial smooth muscle relaxation

            Absorption

            Peak Plasma Time: 5 min

            Peak Plasma Concentration: 92 pg/mL

            Distribution

            Protein Bound: 61-64%

            Metabolism

            Metabolized by CYP2D6, CYP2C19, CYP2C9, CYP2A6

            Elimination

            Half-Life: 10 hr

            Clearance: 150 mL/min

            Excretion: Urine 66%; feces 33%

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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