This product is taken via Aerolizer®.
Why is it prescribed?
Foradil® is indicated as long-term, twice-daily administration in the maintenance treatment of asthma in patients 6 years of age and older with reversible obstructive airways disease, including patients with symptoms of nocturnal asthma, who are using optimal corticosteroid treatment and experiencing regular or frequent breakthrough symptoms requiring use of a short-acting bronchodilator. Foradil® should not be used in patients whose asthma can be managed by occasional use of short-acting inhaled β2-agonists.
Foradil® is indicated as long-term, twice-daily administration in the treatment of adults with chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.
- The contents of Foradil® capsules should be inhaled using the inhaler provided with each prescription. Do not take the capsules by mouth.
- It is important that you understand how to operate the inhaler before using Foradil® for the first time. Your doctor or pharmacist will demonstrate how to load and use the inhaler but you should also read and keep the package insert which comes with the inhaler device. To be sure that you are getting the maximum effect from the medication, ask your pharmacist to assess your technique.
Instructions for Use:
- 1. Pull off cap
- 2. To open, hold base of the inhaler firmly and turn the mouthpiece in the direction of the arrow.
- 3. Remove the capsule from the blister pack. It is important to keep the capsule in the blister pack until you are ready to use it. Place the capsule in the capsule shaped compartment in the base of the inhaler.
- 4. Return the mouthpiece to the closed position.
- 5.Keeping the inhaler upright, firmly squeeze the two blue buttons fully only once. This will pierce the capsule. Release the buttons. Although the capsule is now pierced, the powder will not be released until you inhale it.Please note that the capsule might splinter at this step and small fragments of gelatin might reach your mouth and throat. This gelatin is edible and is therefore not harmful. You can minimize the tendency of the capsule splintering by:
- piercing the capsule only once
- keeping the capsules stored in a dry place at room temperature
- keeping the capsule in the blister pack until you are ready to use it.
- 6. Breathe out fully.
- 7. Place the mouthpiece in your mouth and tilt your head slightly backward. Close your lips around the mouthpiece and breathe in steadily as deeply as you can. As you breathe in, you will inhale the medication into your lungs. You should hear a whirring noise as you breathe in because inhalation causes the capsule to spin around in the inhaler. Please note if you do not hear the whirring noise, the capsule may be stuck in the capsule-shaped compartment. If this occurs, re-open the inhaler carefully and pry the capsule out. You cannot loosen the capsule by repeatedly pressing the buttons.
- 8. If you have heard the whirring noise, hold your breath for as long as you comfortably can while removing the inhaler from your mouth. Then breathe out.
- 9. After use, open the inhaler. Check that the capsule is empty. If it is not close the inhaler and re-inhale following steps 6, 7 and 8. Remove the empty capsule. Close the mouthpiece. Replace the cap.
- Foradil® should not be used more often than twice a day. If your forget a dose, take it as soon as possible. But, if it is almost time for your next dose, do not take the missed one, just resume your regular schedule. Doubling up on your regular dosage could increase the chance of serious unwanted effects.
Keep Foradil® capsules at room temperature in a dry place. The capsules should be removed from the blister pack just before use.
Clean and care for the inhaler device according to the manufacturer's instructions.
Foradil® capsules should not be used to treat acute symptoms. Use your rescue inhaler instead.
Adults: One capsule (12 mcg of formoterol fumarate) is inhaled using the Aerolizer* inhaler twice daily, in the morning and evening. In severe cases, adults may require two capsules twice daily. The maximum recommended daily dose is 48 mcg.
Children (6 - 16 years) : One capsule (12 mcg of formoterol fumarate) is inhaled using the Aerolizer* inhaler twice daily, in the morning and evening. The maximum recommended daily dose is 24 mcg.
Formoterol is a long-acting bronchodilator that acts at specific receptors called beta2-adrenergic receptors. Stimulating these receptors makes breathing easier by opening the small air passages in the lungs. Formoterol starts to improve breathing within 1 to 3 minutes. This fast onset of action is similar to that seen with short-acting bronchodilators. The bronchodilating effect of formoterol typically lasts for 12 hours. This duration is similar to that seen with other long-acting beta2-agonists.
Along with its needed effects, formoterol may cause some unwanted or undesirable effects. Often, formoterol users who use their medication properly, never experience any unwanted effects. The severity and duration of these effects are dependant on many factors including duration of therapy, dose, route of administration and individual response. Common:
- dry mouth
- slight palpitations (awareness of heart beat)
- muscle cramps and pain
- feeling nervous or tired
- difficulties in sleeping
- allergic reaction (rash, swelling of face and throat)
- cardiac arrythmias (e.g., atrial fibrillation, supraventricular tachycardia, estrasystoles)
- worsening of asthma symptoms
Check with your pharmacist or doctor if mild effects persist and become bothersome or if more severe effects occur.
Long-acting beta2-adrenergic agonists (LABA), such as formoterol may increase the risk of asthma-related death. This increased risk was determined based on the evidence from a large study done in the United States with another LABA called salmeterol. Because of this risk, LABAs like formoterol must never be used alone to treat asthma. They should be used as add-on therapy for patients with asthma who continue to have poor asthma control despite an optimal dose of inhaled corticosteroids (ICS). In asthma, formoterol must be used together with an appropriate dose of inhaled corticosteroid .
- Maximum benefit cannot be achieved unless the inhalation device is used correctly. Even if you have used this device before, you should have your technique reassessed by your pharmacist and read the patient instructions that are provided with each inhaler.
- Formoterol should be used as an additional therapy to low-to-medium dose inhaled corticosteroids. Do not use Formoterol as monotherapy in asthma patients or as a substitute for oral or inhaled corticosteroids. Corticosteroids should not be stopped when Formoterol is initiated.
- Formoterol can be used to treat acute symptoms (Oxeze® only; NOT Foradil®), however, medical attention should be sought if patients find that relief bronchodilator treatment becomes less effective or that they need more inhalations than usual.
Do not use formoterol:
- If you are allergic to it or to other bronchodilators such as salbutamol
Caution is advised in:
- heart disease
- high blood pressure
- overactive thyroid
- history of seizures
- low blood levels of potassium or magnesium
Drug interactions: Make sure your doctor and pharmacist know that you are on the following:
- diuretics or water pills
- any medications that affect heart rhythm such as: amiodarone, quinidine, sotalol
- some antibiotics, such as: erythromycin, clarithromycin
Use in pregnancy: Human data is limited. If you suspect that you might be pregnant, consult your doctor.
Use in breastfeeding: Human data is limited. It is unlikely that the amount in breast milk would present problems to the infant, but always check with doctor or pharmacist before use.