Dosing & Uses
Dosage Forms & Strengths
aclidinium bromide/formoterol fumarate
powder for inhalation
- (400mcg/12mcg)/actuation by breath-actuated dry powder metered-dose inhaler
Chronic Obstructive Pulmonary Disease
Indicated for maintenance treatment of chronic obstructive pulmonary disease (COPD)
1 inhalation PO BID
Not to exceed 1 inhalation BID
Dosage Modifications
Renal or hepatic impairment: Formal pharmacokinetic studies not conducted; however, based on available data, no dosage adjustment required
Dosing Considerations
Limitations of use: Not indicated for treatment of acute bronchospasm or asthma
Safety and efficacy not established
No overall differences in safety or effectiveness were observed between adults aged ≥60 yr compared with younger adults
See adult dosing
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (1)
- umeclidinium bromide/vilanterol inhaled
aclidinium, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Duplicate therapy.
Serious - Use Alternative (67)
- adagrasib
adagrasib, formoterol. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- amisulpride
amisulpride and formoterol both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- amitriptyline
amitriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
amitriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - amoxapine
amoxapine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
amoxapine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - arformoterol
arformoterol and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
formoterol and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- chlorpromazine
chlorpromazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- clarithromycin
clarithromycin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- clomipramine
clomipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
clomipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - desipramine
desipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
desipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - disopyramide
disopyramide and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- dofetilide
dofetilide and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- doxepin
doxepin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
doxepin, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - dronedarone
dronedarone and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- droperidol
droperidol and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
formoterol and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- epinephrine
epinephrine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- epinephrine racemic
epinephrine racemic and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin base
erythromycin base and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
erythromycin lactobionate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
erythromycin stearate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fluconazole
fluconazole and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- fluphenazine
fluphenazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- glasdegib
formoterol and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- glucagon
glucagon increases toxicity of aclidinium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .
- glucagon intranasal
glucagon intranasal increases toxicity of aclidinium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .
- haloperidol
formoterol and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
formoterol and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- imipramine
imipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
imipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - indapamide
formoterol and indapamide both increase QTc interval. Avoid or Use Alternate Drug.
- inotuzumab
inotuzumab and formoterol both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.
- isocarboxazid
isocarboxazid increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- ivosidenib
ivosidenib and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
- ketoconazole
formoterol and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- levoketoconazole
formoterol and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- linezolid
linezolid increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- lofepramine
lofepramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
lofepramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - lumefantrine
formoterol and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
macimorelin and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- maprotiline
maprotiline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
maprotiline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - mobocertinib
mobocertinib and formoterol both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.
- moxifloxacin
formoterol and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- nilotinib
formoterol and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- nortriptyline
nortriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
nortriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - octreotide
formoterol and octreotide both increase QTc interval. Avoid or Use Alternate Drug.
- octreotide (Antidote)
formoterol and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.
- ondansetron
formoterol and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
- panobinostat
formoterol and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.
- pentamidine
formoterol and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- perphenazine
perphenazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- phenelzine
phenelzine increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- pimozide
formoterol and pimozide both increase QTc interval. Avoid or Use Alternate Drug.
- pitolisant
formoterol and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- pramlintide
pramlintide, aclidinium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- primaquine
primaquine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- procainamide
formoterol and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- prochlorperazine
prochlorperazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- promazine
promazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- promethazine
promethazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- protriptyline
protriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
protriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - quinidine
quinidine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
- revefenacin
revefenacin and aclidinium both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.
- sotalol
formoterol and sotalol both increase QTc interval. Avoid or Use Alternate Drug. Drugs known to prolong the QTc interval may potentiate the cardiovascular effects of formoterol.
sotalol and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Drugs known to prolong the QTc interval may potentiate the cardiovascular effects of formoterol.
Monitor Closely (350)
- abobotulinumtoxinA
abobotulinumtoxinA increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .
- acebutolol
acebutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - aceclofenac
aceclofenac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- acemetacin
acemetacin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- albuterol
albuterol and formoterol both decrease serum potassium. Use Caution/Monitor.
albuterol and formoterol both decrease sedation. Use Caution/Monitor.
albuterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - alfentanil
alfentanil increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfuzosin
formoterol and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and formoterol both increase QTc interval. Use Caution/Monitor. - alprazolam
alprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- amantadine
aclidinium, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.
- amiloride
amiloride increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- amiodarone
amiodarone and formoterol both increase QTc interval. Use Caution/Monitor.
- amitriptyline
aclidinium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
amitriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - amobarbital
amobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- amoxapine
aclidinium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amoxapine
amoxapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- apomorphine
apomorphine and formoterol both increase QTc interval. Use Caution/Monitor.
- arformoterol
arformoterol and formoterol both decrease serum potassium. Use Caution/Monitor.
arformoterol and formoterol both decrease sedation. Use Caution/Monitor.
arformoterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - aripiprazole
aclidinium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
aripiprazole and formoterol both increase QTc interval. Use Caution/Monitor.
aripiprazole increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - armodafinil
formoterol and armodafinil both decrease sedation. Use Caution/Monitor.
- atracurium
atracurium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- arsenic trioxide
arsenic trioxide and formoterol both increase QTc interval. Use Caution/Monitor.
- artemether
artemether and formoterol both increase QTc interval. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and formoterol both increase QTc interval. Use Caution/Monitor.
- aspirin
aspirin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aspirin rectal
aspirin rectal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atenolol
atenolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
atenolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - atomoxetine
formoterol, atomoxetine. Other (see comment). Use Caution/Monitor. Comment: Exercise caution if beta-agonists and atomoxetine are coadministered. Interaction may be less likely with inhaled beta-agonists versus those given systemically. .
atomoxetine and formoterol both increase QTc interval. Use Caution/Monitor. - atropine
atropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- azelastine
azelastine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- azithromycin
azithromycin and formoterol both increase QTc interval. Use Caution/Monitor.
- bedaquiline
formoterol and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belladonna alkaloids
belladonna alkaloids and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - bendroflumethiazide
formoterol and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.
- benperidol
aclidinium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
benperidol increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - benperidol
benperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benzphetamine
formoterol and benzphetamine both decrease sedation. Use Caution/Monitor.
formoterol and benzphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - benztropine
benztropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- betaxolol
betaxolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
betaxolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - bethanechol
bethanechol increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bisoprolol
bisoprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - brompheniramine
brompheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bumetanide
formoterol and bumetanide both decrease serum potassium. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- butabarbital
butabarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- butalbital
butalbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- butorphanol
butorphanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- caffeine
formoterol and caffeine both decrease sedation. Use Caution/Monitor.
- carbachol
carbachol increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbenoxolone
formoterol and carbenoxolone both decrease serum potassium. Use Caution/Monitor.
- carbinoxamine
carbinoxamine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carvedilol
carvedilol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - celecoxib
celecoxib increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celiprolol
celiprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
celiprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - ceritinib
ceritinib and formoterol both increase QTc interval. Use Caution/Monitor.
- cevimeline
cevimeline increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chloral hydrate
chloral hydrate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorothiazide
formoterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpromazine
chlorpromazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.
chlorpromazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - chlorthalidone
formoterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- cisatracurium
cisatracurium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- cinnarizine
cinnarizine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clemastine
clemastine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clomipramine
clomipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. - clonazepam
clonazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clozapine
aclidinium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - clorazepate
clorazepate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clozapine
clozapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- codeine
codeine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclizine
cyclizine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
cyclizine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor. - cyclobenzaprine
cyclobenzaprine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- cyclopenthiazide
formoterol and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.
- cyproheptadine
cyproheptadine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- darifenacin
darifenacin and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- dasatinib
dasatinib and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.
- deflazacort
formoterol and deflazacort both decrease serum potassium. Use Caution/Monitor.
- degarelix
degarelix and formoterol both increase QTc interval. Use Caution/Monitor.
- desipramine
aclidinium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
desipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - dexchlorpheniramine
dexchlorpheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dicyclomine
dicyclomine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- dexfenfluramine
formoterol and dexfenfluramine both decrease sedation. Use Caution/Monitor.
formoterol and dexfenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dexmedetomidine
dexmedetomidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmethylphenidate
formoterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.
formoterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dextroamphetamine
formoterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.
formoterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dextromoramide
dextromoramide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diamorphine
diamorphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and formoterol both decrease serum potassium. Use Caution/Monitor.
dichlorphenamide, formoterol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis. - diclofenac
diclofenac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diethylpropion
formoterol and diethylpropion both decrease sedation. Use Caution/Monitor.
formoterol and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - difenoxin hcl
difenoxin hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diflunisal
diflunisal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- digoxin
digoxin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dimenhydrinate
dimenhydrinate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diphenhydramine
diphenhydramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
diphenhydramine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor. - diphenoxylate hcl
diphenoxylate hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil
donepezil increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dipipanone
dipipanone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dobutamine
dobutamine and formoterol both decrease serum potassium. Use Caution/Monitor.
dobutamine and formoterol both decrease sedation. Use Caution/Monitor.
dobutamine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dolasetron
dolasetron and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.
- donepezil
donepezil and formoterol both increase QTc interval. Use Caution/Monitor.
- donepezil transdermal
donepezil transdermal, aclidinium. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.
- dopamine
formoterol and dopamine both decrease sedation. Use Caution/Monitor.
formoterol and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dopexamine
dopexamine and formoterol both decrease serum potassium. Use Caution/Monitor.
dopexamine and formoterol both decrease sedation. Use Caution/Monitor.
dopexamine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
dopexamine, formoterol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. - dosulepin
aclidinium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- doxepin
aclidinium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
doxepin increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - droperidol
aclidinium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
droperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - drospirenone
drospirenone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- echothiophate iodide
echothiophate iodide increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- efavirenz
efavirenz and formoterol both increase QTc interval. Use Caution/Monitor.
- encorafenib
encorafenib and formoterol both increase QTc interval. Use Caution/Monitor.
- ephedrine
ephedrine and formoterol both decrease serum potassium. Use Caution/Monitor.
ephedrine and formoterol both decrease sedation. Use Caution/Monitor.
ephedrine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - epinephrine
epinephrine and formoterol both decrease serum potassium. Use Caution/Monitor.
epinephrine and formoterol both decrease sedation. Use Caution/Monitor.
epinephrine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - epinephrine racemic
formoterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.
formoterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.
formoterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - eribulin
eribulin and formoterol both increase QTc interval. Use Caution/Monitor.
- escitalopram
escitalopram increases toxicity of formoterol by QTc interval. Use Caution/Monitor.
- esmolol
esmolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
esmolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - estazolam
estazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ethacrynic acid
formoterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.
- ethanol
ethanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- etodolac
etodolac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fenfluramine
formoterol and fenfluramine both decrease sedation. Use Caution/Monitor.
formoterol and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - fenoprofen
fenoprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fesoterodine
fesoterodine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fingolimod
fingolimod and formoterol both increase QTc interval. Use Caution/Monitor.
- flavoxate
flavoxate and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flecainide
flecainide and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.
- fluoxetine
fluoxetine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely. Fluoxetine prolongs the QT interval; the prescribing information for fluoxetine recommends avoiding concurrent use of other drugs that may prolong the QT interval; risk may be increased with higher doses and/or when associated with hypokalemia; drugs that prolong the QTc interval may potentiate the effects of beta2 agonists on the cardiovascular system
- fluphenazine
aclidinium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
fluphenazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - flurazepam
flurazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- galantamine
galantamine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- flurbiprofen
flurbiprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fluvoxamine
fluvoxamine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.
- foscarnet
formoterol and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.
- fostemsavir
formoterol and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- furosemide
formoterol and furosemide both decrease serum potassium. Use Caution/Monitor.
- gemifloxacin
gemifloxacin and formoterol both increase QTc interval. Use Caution/Monitor.
- gentamicin
formoterol and gentamicin both decrease serum potassium. Use Caution/Monitor.
- gilteritinib
gilteritinib and formoterol both increase QTc interval. Use Caution/Monitor.
- glycopyrrolate
glycopyrrolate and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate inhaled
glycopyrrolate inhaled and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrronium tosylate topical
glycopyrronium tosylate topical, aclidinium. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.
- goserelin
goserelin increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- haloperidol
haloperidol increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
haloperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor. - henbane
henbane and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- histrelin
histrelin increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- homatropine
homatropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrochlorothiazide
formoterol and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.
- hydromorphone
hydromorphone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydroxyzine
hydroxyzine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hyoscyamine
hyoscyamine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ibuprofen
ibuprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen IV
ibuprofen IV increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- iloperidone
iloperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
iloperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
formoterol and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely. - imipramine
aclidinium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
imipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - indapamide
formoterol and indapamide both decrease serum potassium. Use Caution/Monitor.
- ipratropium
ipratropium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- indomethacin
indomethacin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- isoproterenol
formoterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.
formoterol and isoproterenol both decrease sedation. Use Caution/Monitor.
formoterol and isoproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - itraconazole
itraconazole and formoterol both increase QTc interval. Use Caution/Monitor.
- ketoprofen
ketoprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac
ketorolac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac intranasal
ketorolac intranasal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- ketotifen, ophthalmic
ketotifen, ophthalmic increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- labetalol
labetalol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
labetalol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - lapatinib
formoterol and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- lenvatinib
formoterol and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.
- leuprolide
leuprolide increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- levalbuterol
formoterol and levalbuterol both decrease serum potassium. Use Caution/Monitor.
formoterol and levalbuterol both decrease sedation. Use Caution/Monitor.
formoterol and levalbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - levodopa
aclidinium, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .
- levofloxacin
formoterol and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- levorphanol
levorphanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lisdexamfetamine
formoterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.
formoterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - lofepramine
aclidinium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
lofepramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - lofexidine
lofexidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- loxapine
aclidinium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
aclidinium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loprazolam
loprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lorazepam
lorazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lormetazepam
lormetazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lornoxicam
lornoxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- loxapine
loxapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
aclidinium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine inhaled increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - maprotiline
aclidinium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
maprotiline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - marijuana
marijuana increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meclizine
meclizine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- meclofenamate
meclofenamate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mefenamic acid
mefenamic acid increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- melatonin
melatonin increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meloxicam
meloxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meperidine
meperidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meprobamate
meprobamate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaproterenol
formoterol and metaproterenol both decrease serum potassium. Use Caution/Monitor.
formoterol and metaproterenol both decrease sedation. Use Caution/Monitor.
formoterol and metaproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - methadone
formoterol and methadone both increase QTc interval. Modify Therapy/Monitor Closely.
methadone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - methamphetamine
formoterol and methamphetamine both decrease sedation. Use Caution/Monitor.
formoterol and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - methscopolamine
methscopolamine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methyclothiazide
formoterol and methyclothiazide both decrease serum potassium. Use Caution/Monitor.
- methylenedioxymethamphetamine
formoterol and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.
formoterol and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - methylphenidate
formoterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- metolazone
formoterol and metolazone both decrease serum potassium. Use Caution/Monitor.
- metoprolol
metoprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
metoprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - midazolam
midazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midodrine
formoterol and midodrine both decrease sedation. Use Caution/Monitor.
formoterol and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - mifepristone
mifepristone, formoterol. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- mirtazapine
mirtazapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- modafinil
formoterol and modafinil both decrease sedation. Use Caution/Monitor.
- morphine
morphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- motherwort
motherwort increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- moxonidine
moxonidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nabilone
nabilone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nabumetone
nabumetone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nadolol
nadolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - nalbuphine
nalbuphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- naproxen
naproxen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nebivolol
nebivolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nebivolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - neostigmine
neostigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- norepinephrine
formoterol and norepinephrine both decrease serum potassium. Use Caution/Monitor.
formoterol and norepinephrine both decrease sedation. Use Caution/Monitor.
formoterol and norepinephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - nortriptyline
aclidinium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
nortriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - ofloxacin
formoterol and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- olanzapine
aclidinium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
aclidinium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - olanzapine
olanzapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oliceridine
aclidinium increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.
- olodaterol inhaled
formoterol and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects
- onabotulinumtoxinA
onabotulinumtoxinA and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- opium tincture
opium tincture increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- orphenadrine
aclidinium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- osilodrostat
osilodrostat and formoterol both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and formoterol both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- oxaliplatin
oxaliplatin will increase the level or effect of formoterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- oxaprozin
oxaprozin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxazepam
oxazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin
oxybutynin and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
oxybutynin topical and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
oxybutynin transdermal and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
oxycodone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxymorphone
oxymorphone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ozanimod
ozanimod and formoterol both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paliperidone
paliperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
formoterol and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.
paliperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pancuronium
pancuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- papaveretum
papaveretum increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
parecoxib increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- paroxetine
formoterol and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- pasireotide
formoterol and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- pazopanib
formoterol and pazopanib both increase QTc interval. Use Caution/Monitor.
- penbutolol
penbutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
penbutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - pentazocine
pentazocine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pentobarbital
pentobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- perphenazine
aclidinium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
perphenazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
perphenazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - phendimetrazine
formoterol and phendimetrazine both decrease sedation. Use Caution/Monitor.
formoterol and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - physostigmine
physostigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
phenobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenoxybenzamine
phenoxybenzamine, formoterol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.
- phentermine
formoterol and phentermine both decrease sedation. Use Caution/Monitor.
formoterol and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - phenylephrine
formoterol and phenylephrine both decrease sedation. Use Caution/Monitor.
formoterol and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - phenylephrine PO
formoterol and phenylephrine PO both decrease sedation. Use Caution/Monitor.
formoterol and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - pholcodine
pholcodine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
aclidinium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
pimozide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
pimozide increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pindolol
pindolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
pindolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - pralidoxime
pralidoxime and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pirbuterol
formoterol and pirbuterol both decrease serum potassium. Use Caution/Monitor.
formoterol and pirbuterol both decrease sedation. Use Caution/Monitor.
formoterol and pirbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - piroxicam
piroxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- posaconazole
formoterol and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- potassium acid phosphate
potassium acid phosphate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium chloride
potassium chloride increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium citrate
potassium citrate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- primidone
primidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- procarbazine
procarbazine increases effects of formoterol by pharmacodynamic synergism. Use Caution/Monitor.
- prochlorperazine
aclidinium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
prochlorperazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - promethazine
promethazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
promethazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
aclidinium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor. - propantheline
propantheline and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- propranolol
propranolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
propranolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - propylhexedrine
formoterol and propylhexedrine both decrease sedation. Use Caution/Monitor.
formoterol and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - protriptyline
protriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. - pseudoephedrine
formoterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- pyridostigmine
pyridostigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quazepam
quazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quetiapine
aclidinium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
quetiapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
quetiapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - quinine
formoterol and quinine both increase QTc interval. Use Caution/Monitor.
- rapacuronium
rapacuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ranolazine
formoterol and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.
- ribociclib
ribociclib increases toxicity of formoterol by QTc interval. Use Caution/Monitor.
- rimantadine
aclidinium, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.
- risperidone
risperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
formoterol and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
aclidinium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - rivastigmine
rivastigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sacubitril/valsartan
sacubitril/valsartan increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- rocuronium
rocuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- salicylates (non-asa)
salicylates (non-asa) increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salmeterol
formoterol and salmeterol both decrease serum potassium. Use Caution/Monitor.
formoterol and salmeterol both decrease sedation. Use Caution/Monitor.
formoterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - salsalate
salsalate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scopolamine
scopolamine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scullcap
scullcap increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- secobarbital
secobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- selpercatinib
selpercatinib increases toxicity of formoterol by QTc interval. Use Caution/Monitor.
- serdexmethylphenidate/dexmethylphenidate
formoterol and serdexmethylphenidate/dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- shepherd's purse
shepherd's purse increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
formoterol and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- solifenacin
solifenacin and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- solriamfetol
formoterol and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- sorafenib
sorafenib and formoterol both increase QTc interval. Use Caution/Monitor.
- sotalol
sotalol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
sotalol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - spironolactone
spironolactone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- succinylcholine
succinylcholine increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
succinylcholine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. - sufentanil
sufentanil increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
aclidinium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
thioridazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - sulfamethoxazole
sulfamethoxazole and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.
- sulfasalazine
sulfasalazine increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sulindac
sulindac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tapentadol
tapentadol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- telavancin
formoterol and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.
- temazepam
temazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- terbutaline
formoterol and terbutaline both decrease serum potassium. Use Caution/Monitor.
formoterol and terbutaline both decrease sedation. Use Caution/Monitor.
formoterol and terbutaline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - thioridazine
thioridazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thiothixene
thiothixene increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
thiothixene increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
aclidinium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor. - timolol
timolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
timolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - tolterodine
aclidinium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tolfenamic acid
tolfenamic acid increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolmetin
tolmetin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolvaptan
tolvaptan increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- topiramate
topiramate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- torsemide
formoterol and torsemide both decrease serum potassium. Use Caution/Monitor.
- tramadol
tramadol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trazodone
trazodone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor. - triamterene
triamterene increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- trifluoperazine
aclidinium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
trifluoperazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - triazolam
triazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- triclofos
triclofos increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trifluoperazine
trifluoperazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trihexyphenidyl
aclidinium and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trimethoprim
formoterol and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.
- trimipramine
trimipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aclidinium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. - triprolidine
triprolidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trospium chloride
aclidinium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- triptorelin
triptorelin increases levels of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- tropisetron
formoterol and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.
- umeclidinium bromide
umeclidinium bromide and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents
- vecuronium
aclidinium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- venlafaxine
formoterol and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.
- voriconazole
formoterol and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- xylometazoline
formoterol and xylometazoline both decrease sedation. Use Caution/Monitor.
formoterol and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - yohimbine
formoterol and yohimbine both decrease sedation. Use Caution/Monitor.
formoterol and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - ziconotide
ziconotide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziprasidone
aclidinium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
ziprasidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - zotepine
aclidinium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (20)
- bendroflumethiazide
formoterol, bendroflumethiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- bumetanide
formoterol, bumetanide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- chloroquine
chloroquine increases toxicity of formoterol by QTc interval. Minor/Significance Unknown.
- chlorothiazide
formoterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- chlorthalidone
formoterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- cyclopenthiazide
formoterol, cyclopenthiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- dimenhydrinate
dimenhydrinate increases toxicity of aclidinium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of aclidinium by pharmacodynamic antagonism. Minor/Significance Unknown.
- ethacrynic acid
formoterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- eucalyptus
eucalyptus increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- furosemide
formoterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- galantamine
galantamine decreases effects of aclidinium by pharmacodynamic antagonism. Minor/Significance Unknown.
- green tea
green tea increases effects of formoterol by pharmacodynamic synergism. Minor/Significance Unknown. Due to caffeine content. Combination may increase CNS stimulatory effects due to caffeine in green tea.
- hydrochlorothiazide
formoterol, hydrochlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- indapamide
formoterol, indapamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- methyclothiazide
formoterol, methyclothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- metolazone
formoterol, metolazone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- noni juice
noni juice increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- rimantadine
rimantadine increases effects of aclidinium by pharmacodynamic synergism. Minor/Significance Unknown.
- sage
sage increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
Adverse Effects
1-10%
Upper respiratory tract infection (8.9%)
Headache (6.3%)
Back pain (3.8%)
Cough (1-3%)
Sinusitis (1-3%)
Influenza (1-3%)
Tooth abscess (1-3%)
Insomnia (1-3%)
Dizziness (1-3%)
Dry mouth (1-3%)
Oropharyngeal pain (1-3%)
Muscle spasms (1-3%)
Musculoskeletal pain (1-3%)
Arthralgia (1-3%)
Pain in extremity (1-3%)
Urinary tract infection (1-3%)
Blood creatine phosphokinase increased (1-3%)
Warnings
Contraindications
Severe hypersensitivity to milk proteins
Hypersensitivity to aclidinium bromide, formoterol fumarate, or any product component
Not indicated for asthma; use of long-acting beta2-adrenergic agonists (LABAs), including formoterol fumarate, without an inhaled corticosteroid is contraindicated in patients with asthma
Cautions
Safety and efficacy not established for patients with asthma; not indicated for asthma; use of LABA as monotherapy (without inhaled corticosteroids) for asthma associated with increase asthma-related deaths; available data do not suggest increased risk of death with LABAs in patients with COPD
Do not initiate in acutely deteriorating COPD, which may be a life-threatening condition; aclidinium/formoterol is intended as maintenance treatment and should not be used for relief of acute symptoms (ie, rescue therapy for acute bronchospasm)
Instruct patients who have been taking oral or inhaled, short-acting beta2-agonists on a regular basis (eg, 4x/day) to discontinue the regular use of these drugs and use them only for symptomatic relief of acute respiratory symptoms
As with other inhaled drugs containing beta-agonists, do not use more often than recommended, at higher doses than recommended, or in conjunction with other medications containing LABAs, as an overdose may result; clinically significant cardiovascular effects and fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs
May cause paradoxical bronchospasm, which may be life threatening; if paradoxical bronchospasm occurs, treat immediately with an inhaled short-acting bronchodilator; discontinue aclidinium/formoterol and institute alternant therapy
Immediate hypersensitivity reactions, including anaphylaxis, angioedema, urticaria, rash, bronchospasm, or itching, reported; discontinue aclidinium/formoterol and institute alternant therapy if this occurs
Beta-agonists can produce clinically significant cardiovascular effects as measured by increases in pulse rate, systolic or diastolic or blood pressure, or symptoms; additionally, may cause ECG changes (eg, flattening of the T wave, prolongation of the QTc interval, and ST-segment depression), although clinical significance is unknown
Caution with using sympathomimetic amines in patients with convulsive disorders, thyrotoxicosis, and in those who are unusually responsive to sympathomimetic amines; doses of the related beta-agonist albuterol, when administered IV, have been reported to aggravate preexisting diabetes mellitus and ketoacidosis
Caution with narrow-angle glaucoma; monitor for signs and symptoms of acute narrow-angle glaucoma (eg, eye pain or discomfort, blurred vision, visual halos, colored images in association with red eyes from conjunctival congestion and corneal edema)
May worsen urinary retention or bladder neck obstruction; monitor for signs and symptoms (eg, difficulty passing urine, painful urination)
Hypokalemia and hyperglycemia
- Beta-agonists may produce significant hypokalemia, possibly through intracellular shunting, which has the potential to produce adverse cardiovascular effects; this decrease is usually transient, not requiring potassium supplementation
- Beta-agonist medications may produce transient hyperglycemia
- Clinical trials of aclidinium/formoterol over 24-52 weeks' duration did not show evidence of an effect on serum glucose or potassium
Drug interaction overview
- Caution with coadministration with additional adrenergic drugs, by any administration route, because additive sympathetic effects
- Concomitant treatment with xanthine derivatives or steroids may potentiate any hypokalemic effect of beta-adrenergic agonists
- Caution if coadministered with other drugs that cause hypokalemia (eg, loop or thiazide diuretics)
- Caution if beta2-agonists are coadministered with MAO inhibitors, tricyclic antidepressants, or other drugs known to prolong the QTc interval, because the action of adrenergic agonists on the cardiovascular system may be potentiated by these agents
- Formoterol and beta-blockers may inhibit the effect of each other if coadministered; patients with COPD are not typically treated with beta-blockers; however, under certain circumstances (eg, prophylaxis after MI), there may be no acceptable alternatives to the use of beta-blockers in patients with COPD; if needed, consider cautious use of cardioselective beta-blockers
- Avoid coadministration of other anticholinergic medications with aclidinium, owing to additive effects
Pregnancy
Pregnancy
There are no adequate and well-controlled studies of aclidinium/formoterol or its individual components in pregnant women to assess drug-associated risks
Animal studies
- No adverse developmental effects were seen with inhalation administration of aclidinium bromide to pregnant rats and rabbits during organogenesis at 15 or 20 times, respectively, the maximum recommended human daily inhaled dose (MRHDID)
- Formoterol fumarate alone, administered by the oral route, was teratogenic in rats and rabbits at 1,200 and 49,000 times the MRHDID, respectively
- Formoterol fumarate was also embryocidal, increased pup loss at birth and during lactation, and decreased pup weight in rats at 85 times the MRHDID
Labor or delivery
- No well-controlled human studies
- Because of the potential for beta-agonist interference with uterine contractility, use of during labor should be restricted to those patients in whom the benefits clearly outweigh the risk
Lactation
There are no available data on the breastfed child or on milk production or presence in human milk
Both aclidinium bromide and formoterol fumarate are present in rat milk; when a drug is present in animal milk, it is likely that the drug will be present in human milk
Animal studies
- Aclidinium bromide reduced pup weights when pregnant rats continued inhalation administration through lactation at 5 times the MRHDID
- Formoterol fumarate increased pup loss at birth and during lactation, and decreased pup weight in rats at 85 times the MRHDID
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.Pharmacology
Mechanism of Action
Aclidinium: Long-acting muscarinic antagonist (LAMA), often referred to as an anticholinergic, has specificity for muscarinic receptors with affinity for the M3 (subscript) receptor in the airways; produces bronchodilation by inhibiting acetylcholine’s effect on muscarinic receptors in the airway smooth muscle
Formoterol: Long-acting selective beta-2 agonist (LABA); elicits bronchial smooth muscle relaxation by stimulation of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3', 5'-adenosine monophosphate (cyclic AMP); increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibit release of mediators of immediate hypersensitivity from cells, especially from mast cells
Absorption
Peak plasma time: Within 5 minutes after inhalation
Peak plasma concentration: 128 pg/mL (aclidinium); 17 pg/mL (formoterol)
Steady-state achieved within 5 days
Distribution
Vd (aclidinium; 400 mcg IV): 300 L
Protein bound (formoterol; 54 mcg inhaled): 46% (RR enantiomer); 58% (SS enantiomer)
Metabolism
Aclidinium
- Major metabolic route is hydrolysis, both chemically and enzymatically by esterases
- Rapidly and extensively hydrolyzed in plasma to alcohol and dithienylglycolic acid derivatives, neither of which binds to muscarinic receptors and are devoid of pharmacologic activity
- Owing to the low plasma levels achieved at the clinically relevant doses, aclidinium and its metabolites are not expected to alter the disposition of drugs metabolized by the human CYP450 enzymes
Formoterol
- Primarily by direct glucuronidation and by O-demethylation, followed by conjugation to inactive metabolites
- Secondary metabolic pathways include deformylation and sulfate conjugation; CYP2D6 and CYP2C identified as being primarily responsible for O-demethylation
Elimination
Half-life: ~12 hr (aclidinium)
Total clearance: ~170 L/hr (aclidinium IV)
Excretion
- Aclidinium: 54-65% urine; 20-33% feces; <1% excreted as unchanged drug
- Formoterol: 62% urine; 24% feces
Administration
Oral Inhalation Administration
Not for relief of acute symptoms; extra doses should not be used for that purpose
Do not use additional LABAs while taking this combination inhaler
Breath-actuated inhaler; counsel patients with instructions and images included with inhaler
Missed dose: Instruct patient to take the next dose at the usual time; do not take 2 doses at one time
Storage
Unopened: Store inside the sealed bag and only open immediately before use; discard bag and desiccant sachet
Opened: Store in dry place at 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F)
Do not store inhaler on a vibrating surface
Images
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- 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.