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Formoterol

Brand: Perforomist (nebulizer); also in Symbicort and Dulera

Long-acting beta-2 agonist (LABA)Used for: Asthma and COPD maintenanceRespiratory & Allergy

No boxed warning on the current FDA label.

Caution
Single-agent formoterol (Perforomist) is approved for COPD only; in asthma a LABA must be paired with an inhaled corticosteroid because LABA monotherapy raises asthma death risk. Perforomist's boxed warning was removed in 2019 because it is COPD-only.
Storage
Perforomist vials: refrigerate in the foil pouch; may be kept at room temperature for up to 3 months.

Common side effects

  • Tremor
  • Headache
  • Fast heartbeat
  • Muscle cramps

Key interactions

  • Additive cardiac effects with other stimulants
  • Beta blockers oppose its effect

Counseling points

  • Not a rescue inhaler
  • In asthma it must be paired with an inhaled corticosteroid
  • Rinse the mouth after combination inhalers containing a steroid
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