Perforomist (formoterol) dosing, indications, interactions, adverse effects, and more

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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

solution for inhalation

20mcg/2mL

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

Interaction Checker

Enter a drug name and formoterol

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No Interactions Found

Interactions Found

Contraindicated

Serious - Use Alternative

Significant - Monitor Closely

Minor

All Interactions Sort By:

>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)

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

Use of a LABA without an inhaled corticosteroid

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)

Safety and efficacy in patients with asthma not established; not indicated for asthma; monotherapy [without inhaled corticosteroids (ICS)] for asthma is associated with an increased risk of asthma-related death

Available data do not suggest an increased risk of death with use of LABA in patients with COPD

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.

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%

Images

Patient Handout

Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

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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.

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.

View explanations for tiers and restrictions

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.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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Sections formoterol
Dosing & Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology
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Patient Handout
Formulary

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