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Formoterol

Long-acting bronchiodilator


Long-acting bronchiodilator

FieldValue
verifiedrevid461113044
caption2Above (R,R)-(−)-formoterol
Below (S,S)-(+)-formoterol
imageFormoterol.svg
image_classskin-invert-image
width230
image2Formoterol ball-and-stick model.png
image_class2bg-transparent
captionFormoterol molecular structure
chiralityRacemic mixture
<!-- Clinical data -->tradenameOxeze, Foradil, Symbicort, others
Drugs.com
pregnancy_AUB3
licence_EUyes
INN_EMAformoterol fumarate dihydrate
legal_AUS4
legal_NZPrescription only
legal_UKPOM
legal_USRx-only
legal_EURx-only
legal_EU_comment
legal_statusRx-only
routes_of_administrationInhalation (capsules for oral inhalation, DPI, MDI)
protein_bound61% to 64%
metabolismLiver demethylation and glucuronidation (CYP2D6, CYP2C19, CYP2C9 and CYP2A6 involved)
elimination_half-life10 h
excretionKidney and fecal
CAS_number_Ref
CAS_number73573-87-2
ATC_prefixR03
ATC_suffixAC13
ATC_supplemental
PubChem3083544
PubChem23034756
IUPHAR_ligand3465
DrugBank_Ref
DrugBankDB00983
ChemSpiderID_Ref
ChemSpiderID2340731
UNII_Ref
UNII5ZZ84GCW8B
KEGG_Ref
KEGGD07990
ChEBI_Ref
ChEBI408174
ChEMBL_Ref
ChEMBL1363
<!-- Chemical data -->IUPAC_name(RR,SS)-N-[2-hydroxy-5-[1-hydroxy-2-[1-(4-methoxyphenyl) propan-2-ylamino]ethyl] phenyl]formamide
C19
H24
N2
O4
smilesO=CNc1cc(ccc1O)C@@HCNC@HCc2ccc(OC)cc2
StdInChI_Ref
StdInChI1S/C19H24N2O4/c1-13(9-14-3-6-16(25-2)7-4-14)20-11-19(24)15-5-8-18(23)17(10-15)21-12-22/h3-8,10,12-13,19-20,23-24H,9,11H2,1-2H3,(H,21,22)/t13-,19+/m1/s1
StdInChIKey_Ref
StdInChIKeyBPZSYCZIITTYBL-YJYMSZOUSA-N

Below (S,S)-(+)-formoterol

| Drugs.com =

| elimination_half-life = 10 h

Formoterol, also known as eformoterol, is a long-acting β2 agonist (LABA) used as a bronchodilator in the management of asthma and chronic obstructive pulmonary disease (COPD). Formoterol has an extended duration of action (up to 12 h) compared to short-acting β2 agonists such as salbutamol (albuterol), which are effective for 4 h to 6 h. Formoterol has a relatively rapid onset of action compared to other LABAs, and is effective within 2-3 minutes. The 2022 Global Initiative for Asthma report recommends a combination formoterol/inhaled corticosteroid inhaler as both a preventer and reliever treatment for asthma in adults. In children, a short-acting β2 adrenergic agonist (e.g., salbutamol) is still recommended.

It was patented in 1972 and came into medical use in 1998. It is available as a generic medication. It is also marketed in the combination formulations budesonide/formoterol and mometasone/formoterol.

Side effects

In November 2005, the US Food and Drug Administration (FDA) released a health advisory alerting the public to findings that show the use of long-acting β2 agonists could lead to a worsening of wheezing symptoms in some patients.

Nowadays, available long-acting β2 agonists include salmeterol, formoterol, bambuterol, and sustained-release oral salbutamol.

Combinations of inhaled steroids and long-acting bronchodilators are becoming more widespread – combination preparations include fluticasone/salmeterol and budesonide/formoterol.

Mechanism of action

Inhaled formoterol works like other β2 agonists, causing bronchodilation by relaxing the smooth muscle in the airway so as to treat the exacerbation of asthma. It has also been reported to target tubulin, favorizing its polymerization.

Society and culture

Brand names

Formoterol is marketed in three forms: a dry-powder inhaler (DPI), a metered-dose inhaler (MDI) and an inhalation solution, under various brand names including Atock, Atimos/Atimos Modulite, Foradil/Foradile, Fostair, Oxeze/Oxis, Perforomist and Symbicort.

  • Foradil/Foradile capsules for oral inhalation (Schering-Plough in the U.S., Novartis rest of world)
  • Oxeze/Oxis Turbuhaler dry-powder inhaler (DPI) (AstraZeneca)
  • Atock (Astellas)
  • Atimos/Atimos Modulite metered-dose inhaler (MDI) (Chiesi)
  • Perforomist inhalation solution (Mylan N.V.)
  • Symbicort Turbuhaler dry-powder inhaler (DPI) (AstraZeneca)

In some countries, Perforomist is marketed by Viatris after Upjohn merged with Mylan to create Viatris.

Uses and combinations

  • Arformoterol ((R,R)-(−)-formoterol) — an enantiopure compound used in the management of COPD
  • Combination drugs:
    • Aclidinium bromide/formoterol
    • Beclometasone/formoterol
    • Budesonide/formoterol
    • Mometasone furoate/formoterol

References

pnb:آمو دریا

References

  1. "List of nationally authorised medicinal products".
  2. Anderson GP. (1993). "Formoterol: pharmacology, molecular basis of agonism, and mechanism of long duration of a highly potent and selective beta 2-adrenoceptor agonist bronchodilator.". Life Sci.
  3. Global Initiative for Asthma. (2022). "Global Strategy for Asthma Prevention and Management (Updated 2022)".
  4. (2006). "Analogue-based Drug Discovery". John Wiley & Sons.
  5. (29 June 2023). "Competitive Generic Therapy Approvals".
  6. "Advair Diskus, Advair HFA, Brovana, Foradil, Perforomist, Serevent Diskus, and Symbicort Information (Long Acting Beta Agonists)". U.S. [[Food and Drug Administration]] (FDA).
  7. (2025). "NanoDSF Screening for Anti-tubulin Agents Uncovers New Structure–Activity Insights". Journal of Medicinal Chemistry.
  8. (16 November 2020). "Pfizer Completes Transaction to Combine Its Upjohn Business with Mylan". Pfizer.
  9. (16 November 2020). "Brands".
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