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Medically reviewed by
Dr Alexandra Cristina Cowell
Writer & Clinical Content Reviewer
on November 29, 2023.
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What is formoterol?

Formoterol is the active ingredient found in many long-acting bronchodilators. It controls wheezing and shortness of breath for up to 12 hours, making it suitable for people with moderate-to-severe asthma or chronic obstructive pulmonary disease (COPD). Although you can use formoterol on its own, it’s usually combined with another drug like budesonide.

It can also come in a few different forms, such as a solution, dry powder or suspension for inhalation.

How does formoterol work?

Asthma is caused by the abnormal contraction of smooth muscles in your airways. This makes it harder to breathe, leading to shortness of breath and wheezing. Formoterol is in the class of drugs called long-acting agonists of beta2-adrenergic receptors (or LABA, for short). LABA drugs bind to beta-2 receptors, which are found on the smooth muscles in your airways. When activated, they cause these smooth muscles to relax, which opens up your airways and makes it easier for you to breathe.

Formoterol is a long-acting medication that remains effective for up to 12 hours a day. This makes it suitable for preventive use, as taking it in the morning helps keep your airways open throughout the day.

What types of formoterol are there?

Formoterol fumarate dihydrate is formoterol in salt form, and it’s the most common form of formoterol available. Although you can get formoterol fumarate dihydrate as a monotherapy (on its own), it’s not typically recommended. It’s usually only people with COPD that use it as a standalone, and aside from that it tends to be paired with corticosteroids.

This is because treatment with formoterol alone can cause some serious side effects (although it’s rare). Pairing it with a corticosteroid, though, can help reduce side effects like inflammation. Drugs commonly paired with formoterol include:

  • beclometasone dipropionate;
  • fluticasone propionate; and:
  • budesonide (all corticosteroids).

Another popular companion to formoterol is aclidinium bromide, a long‐acting anticholinergic. It blocks acetylcholine (a neurotransmitter responsible for muscle contractions) from binding to certain smooth muscles to prevent inflammation.

What forms of formoterol are there?

It can also come in a few different forms, such as a solution, dry powder or suspension for inhalation. These are available in several devices used to enable inhalation:

  1. Metered dose inhaler (MDI) – this is probably the most recognised form of asthma treatment. Some brand names include Symbicort. 
  2. Dry powder inhaler (DPI) – as suggested by the name it’s in a powdered form, and the way you use it differs from standard inhalers. Examples include Duaklir Genuair and Fobumix Easyhaler. 
  3. Nebuliser – unlike the other two, this requires an electric machine and a mouthpiece to deliver the medicine straight to your lungs.
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What doses of formoterol are available?

Most Formoterol treatments come in various concentrations. DuoResp Spiromax, for instance, is available in two concentrations: the 160 mcg budesonide/4.5 mcg formoterol dose is used for moderate COPD and asthma, and the 320 mcg budesonide/ 9 mcg formoterol is for severe cases.

After your clinician prescribes you a chosen concentration, they will then determine your dosage on how severe your condition is. Below is a list of common inhalers and their doses:

  • Fostair is commonly used to control asthma symptoms. The amount of puffs you take depends on how badly it’s affecting you.
  • Fobumix Easyhaler is a prevention and relief inhaler. Usually, you’ll take between one and four puffs, once or twice a day.
  • DuoResp Spiromax is another preventative and relief treatment. Taking just one puff a day will provide you with 12 hours of relief.
  • Flutiform inhaler is a preventor. The most common dose is four puffs a day: twice in the morning and twice in the evening.
  • Symbicort is another preventative and reliever inhaler. The typical dose is 1-4 puffs a day.

If you’re feeling a bit overwhelmed by all the available forms and doses, don’t worry. A clinician will advise you on the most suitable formoterol dose for you once you’ve talked to them about your health and symptoms.

Is formoterol similar to any other treatments?

Yes, salmeterol and salbutamol are two popular ingredients that help prevent asthma attacks (and they’re both pretty similar to formoterol). They work by opening your airways to make breathing more comfortable. And like formoterol, they can be combined with different steroids. Salbutamol is also a widely-recognised teal blue inhaler.

What is Formoterol easyhaler?

Easyhaler is a type of dry powder inhaler (DPI). Unlike the MDI and other DPI inhalers, which require accurate timing for hand-breath coordination, Easyhaler is much simpler to use. You just need to push down on the coloured button till you hear a click and breathe in.

Fobumix Easyhaler is the brand name of the inhaler containing budesonide and formoterol. It comes in three different doses: 80 mcg/4.5 mcg, 160 mcg/4.5 mcg and 320 mcg/9 mcg.

What are the side effects of Formoterol

In the same way that any treatment can cause side effects, asthma treatments containing formoterol can too. The most common side effects include oral thrush, sore throat, headaches and cough. But there are some ways you can avoid getting these side effects, like washing your mouth after using your inhaler to prevent thrush and a sore throat. A volumatic spacer can also help, as this makes sure the medicine reaches your lungs and doesn’t sit in your throat.

In rare cases, you might get an allergic reaction or find it hard to breathe right after inhalation. In these cases, you should go to your local hospital immediately.

Each inhaler will have different side effects depending on the active ingredients, so it’s best you read the ingredient list and patient information leaflet before using them.

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This page was medically reviewed by Dr Alexandra Cristina Cowell, Writer & Clinical Content Reviewer on November 29, 2023. Next review due on November 29, 2025.

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