LABA·Respiratory - Asthma & COPD

Formoterol

Asthma maintenance and reliever (when combined with ICS), COPD maintenance

Authority requiredPBSLABAOxis, Foradile, Symbicort (with Budesonide)Dry powder inhalers, typical…+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

48 mcg/day

Onset

1-3 mins

High risk: Asthma Mono

CONTRAIND.

Caution: Tremor

RISK

Cautions

Avoid / Cautions

Asthma monotherapy without an ICS. Pregnancy Category B3.

Where it stands

Rapid Summary

Overview

Long-Acting Beta-2 Agonist (LABA) with a uniquely *fast* onset. Used as both maintenance and reliever therapy in asthma (MART regimen).

Clinical Focus

Never prescribe a LABA as monotherapy in asthma (black box warning for asthma-related death). MUST be combined with an inhaled corticosteroid (ICS).

Bottom Line

Formoterol is a fast-onset LABA uniquely suitable for both maintenance and reliever therapy (MART with ICS), but must never be used without an ICS due to increased asthma mortality risk.

Formulation & Access

Brand Names

Oxis, Foradile, Symbicort (with Budesonide)

Oral Routes

Dry powder inhalers, typically 6 mcg or 12 mcg per dose.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Asthma maintenance and reliever (when combined with ICS), COPD maintenance.

Clinical Place

Because it works as fast as salbutamol but lasts 12 hours, it is the only LABA approved for 'Maintenance And Reliever Therapy' (MART).

Quick reference

Class & Role

LABA — Long-Acting Beta-2 Agonist (LABA) with a uniquely *fast* onset.

Route / Formulation

Dry powder inhalers, typically 6 mcg or 12 mcg per dose. (Oxis, Foradile, Symbicort (with Budesonide))

Usual Dose & Max

Inhaled Combo with ICS (e.g., Symbicort). Typically 1-2 puffs BD maintenance, plus 1 puff PRN for relief. Max 12 puffs/day.

Key Indication Doses

Asthma (MART Regimen): Inhaled Combo with ICS (e.g., Symbicort). Typically 1-2 puffs BD maintenance, plus 1 puff PRN for relief. Max 12 puffs/day. COPD Maintenance: Inhaled 12 mcg BD.

Best Uses

Formoterol is a fast-onset LABA uniquely suitable for both maintenance and reliever therapy (MART with ICS), but must never be used without an ICS due to increased asthma mortality risk.

Key Risks

Neurological: Tremor, headache, anxiety. Cardiovascular: Palpitations, tachycardia, mild QTc prolongation at high doses. Metabolic: Hypokalemia (usually only significant if overusing the inhaler).

Key Interactions

Non-selective beta-blockers antagonise the effect. Additive hypokalemia with loop/thiazide diuretics and high-dose corticosteroids.

Monitoring

Ensure patient understands the MART regimen (that their 'preventer' is now also their 'reliever'). Check U&E (potassium) if the patient is taking frequent PRN doses.

Clinical Pearl

Symbicort (Budesonide/Formoterol) is taken BD for prevention, but also used PRN for breathlessness. This ensures that every time a patient uses their reliever, they get a dose of steroid to treat the underlying inflammation.

Access

Authority requiredOxis, Foradile, Symbicort (with Budesonide)Dry powder inhalers, typical…

Brand: Oxis, Foradile, Symbicort (with Budesonide)
PBS status: Authority required
Formulation: Dry powder inhalers, typically 6 mcg or 12 mcg per dose.

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

LABA·Respiratory - Asthma & COPD

Formoterol

Asthma maintenance and reliever (when combined with ICS), COPD maintenance

Authority requiredPBSLABAOxis, Foradile, Symbicort (with Budesonide)Dry powder inhalers, typical…+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

48 mcg/day

Onset

1-3 mins

High risk: Asthma Mono

CONTRAIND.

Caution: Tremor

RISK

Cautions

Avoid / Cautions

Asthma monotherapy without an ICS. Pregnancy Category B3.

Where it stands

Rapid Summary

Overview

Long-Acting Beta-2 Agonist (LABA) with a uniquely *fast* onset. Used as both maintenance and reliever therapy in asthma (MART regimen).

Clinical Focus

Never prescribe a LABA as monotherapy in asthma (black box warning for asthma-related death). MUST be combined with an inhaled corticosteroid (ICS).

Bottom Line

Formoterol is a fast-onset LABA uniquely suitable for both maintenance and reliever therapy (MART with ICS), but must never be used without an ICS due to increased asthma mortality risk.

Formulation & Access

Brand Names

Oxis, Foradile, Symbicort (with Budesonide)

Oral Routes

Dry powder inhalers, typically 6 mcg or 12 mcg per dose.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Asthma maintenance and reliever (when combined with ICS), COPD maintenance.

Clinical Place

Because it works as fast as salbutamol but lasts 12 hours, it is the only LABA approved for 'Maintenance And Reliever Therapy' (MART).

Quick reference

Class & Role

LABA — Long-Acting Beta-2 Agonist (LABA) with a uniquely *fast* onset.

Route / Formulation

Dry powder inhalers, typically 6 mcg or 12 mcg per dose. (Oxis, Foradile, Symbicort (with Budesonide))

Usual Dose & Max

Inhaled Combo with ICS (e.g., Symbicort). Typically 1-2 puffs BD maintenance, plus 1 puff PRN for relief. Max 12 puffs/day.

Key Indication Doses

Asthma (MART Regimen): Inhaled Combo with ICS (e.g., Symbicort). Typically 1-2 puffs BD maintenance, plus 1 puff PRN for relief. Max 12 puffs/day. COPD Maintenance: Inhaled 12 mcg BD.

Best Uses

Formoterol is a fast-onset LABA uniquely suitable for both maintenance and reliever therapy (MART with ICS), but must never be used without an ICS due to increased asthma mortality risk.

Key Risks

Neurological: Tremor, headache, anxiety. Cardiovascular: Palpitations, tachycardia, mild QTc prolongation at high doses. Metabolic: Hypokalemia (usually only significant if overusing the inhaler).

Key Interactions

Non-selective beta-blockers antagonise the effect. Additive hypokalemia with loop/thiazide diuretics and high-dose corticosteroids.

Monitoring

Ensure patient understands the MART regimen (that their 'preventer' is now also their 'reliever'). Check U&E (potassium) if the patient is taking frequent PRN doses.

Clinical Pearl

Access

Authority requiredOxis, Foradile, Symbicort (with Budesonide)Dry powder inhalers, typical…

Brand: Oxis, Foradile, Symbicort (with Budesonide)
PBS status: Authority required
Formulation: Dry powder inhalers, typically 6 mcg or 12 mcg per dose.

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.