Formoterol is a drug used to treat bronchial asthma, as one of the components of basic therapy. The main pharmacological effect of this drug is a bronchodilatory effect, which helps to eliminate shortness of breath and prevents the occurrence of asthma attacks. Unlike other bronchodilators used for symptomatic therapy, Formoterol has a prolonged effect.
The use of Formoterol is limited to a relatively narrow list of indications, which mainly include chronic diseases of the bronchopulmonary system with an obstructive component. In this case, the drug is usually used only for long-term continuous therapy.
Diseases in which the use of this drug is necessary:
- bronchial asthma (as a component of basic therapy);
- chronic obstructive pulmonary disease (COPD);
- chronic bronchitis with severe broncho-obstructive syndrome;
- emphysema of the lungs.
The use of the drug Formoterol is contraindicated and can be dangerous in the following cases:
- children under the age of five;
- if the patient has hypersensitivity (history of allergic reactions) to any components of the pharmacological agent;
- during pregnancy (especially in the first trimester) and lactation;
- patients with cardiac arrhythmias and conduction disorders (arrhythmias, blockade), since in some cases the medication can affect the functional activity of the cardiovascular system;
- people suffering from ischemic heart disease and uncorrectable arterial hypertension;
- patients with congenital and acquired lactose or galactose deficiency;
- patients with thyrotoxicosis.
Mechanism of action
The main active ingredient that realizes all the biological effects of this drug is formoterol fumarate . The mechanism of action of the drug consists in direct stimulation of specific adrenergic receptors, which are located in the mucous lining of the bronchi of various sizes.
- Getting on the mucous membrane of the bronchial tree, Formoterol selectively binds to beta-2-adrenergic receptors, causing their activation.
- Due to the stimulating effect on adrenaline receptors, the intracellular enzyme adenylate cyclase is activated , which realizes the conversion of adenosine triphosphate (ATP) into cyclic adenosine monophosphate ( cAMP ).
- An increase in the concentration of cyclic adenosine monophosphate in the cytoplasm of cells leads to relaxation of smooth muscles, which leads to an expansion of the bronchial lumen.
In addition to the main bronchodilator effect, Formoterol blocks the release of biologically active substances (histamine, leukotrienes , prostaglandins) from mast cells and eosinophils, which provoke the progression of the inflammatory reaction. This effect is also important, since allergic inflammation is the basis of the pathogenesis of bronchial asthma (such an effect leads to a slight decrease in the manifestations of edema and hyperreactivity).
Beta-2-adrenergic receptors, which are molecular targets of Formoterol , are present not only in the bronchi, but are found in small amounts in the muscle fibers of the heart. Therefore, in some cases, an undesirable effect on the cardiovascular system develops. The number of beta-2-adrenergic receptors in cardiomyocytes varies significantly from person to person, which is why cardiac effects develop only in a fraction of patients.
The main active ingredient that realizes all the biological effects of the drug is formoterol fumarate dihydrate.
In addition to the main pharmacological compound, the composition of the product includes an additional chemical substance – lactose monohydrate, which is necessary to give the drug the desired dosage form.
There are three dosage forms of Formoterol :
Powder for inhalation Formoterol-native
- metered aerosol;
- dosed powder in a bottle;
- powder in capsules.
It should be noted that any form of release is intended only for inhalation administration. However, before use, you should study in detail the recommendations for taking the drug in order to familiarize yourself with the peculiarities of using each individual dosage form.
All pharmacological forms of the drug, which are now offered on the official pharmaceutical market, are administered only by inhalation .
The frequency of application, dosage and duration of the course of therapy are selected by the attending physician individually after assessing the severity of the disease and the characteristics of the course. This remedy is not used “on demand” to relieve bronchospasm, but in combination with inhaled glucocorticosteroids, it is prescribed for a long time as a “basic therapy”.
To facilitate the delivery of the active substance to the pathological focus, it is recommended to use a special device – a spacer .
The spacer for inhalation is a special device that is a nozzle for the medicinal product bottles and allows you to improve the nebulization so that the pharmacological product is able to penetrate into hard-to-reach parts of the respiratory tract.
It is forbidden to do inhalation of the drug more often than indicated in the recommendations, since this can lead to the development of complications and undesirable effects.
Before starting treatment with Formoterol, the instructions for use of the drug must be studied without fail, since there are particularities in use for different dosage forms.
Medicines that can be used instead of Formoterol , because they have a similar effect:
Aerosol for inhalation Atimos
- Atimos ;
- Zafiron ;
- Oxis turbuhaler ;
- Foradil ;
- Fortulin ;
- Fortix ;
- Salmeterol .
Only the attending physician can change the original drug to an analogue; it is forbidden to do this on his own due to the fact that each pharmacological agent with a similar composition has dosing features.
Formoterol can have undesirable side effects on various organs and systems of the body. However, the most frequent complications arise from the cardiovascular system, because, despite the high selectivity (selectivity) of this medication, beta-2-adrenergic receptors located in the myocardium may be activated.
Side effects that may occur when taking Formoterol :
- from the side of the cardiovascular system, there are: angina pectoris, various types of arrhythmias (often tachysystole ), sudden palpitations, arterial hypertension or, conversely, a decrease in pressure;
- on the part of the nervous system, patients note the following symptoms: fatigue, generalized weakness, local convulsions, frequent dizziness, sleep disturbances;
- from the respiratory system may appear: bronchitis, dysphonia , dyspnea (these complications aggravate the course of the underlying respiratory disease);
- some patients develop allergy phenomena (rashes on the skin (exanthema) and mucous membranes (enanthema), itching, angioedema (Quincke’s edema), urticaria);
- in rare cases, an allergic reaction provokes an attack of suffocation (bronchospasm);
- development of severe life-threatening complications – anaphylactic shock is possible .
At the first manifestations of an allergic reaction, you must immediately stop taking this drug and seek medical help.
Adverse reactions when taking Formoterol develop in a small percentage of patients; in most patients, there is no worsening of the condition associated with drug treatment.
Formoterol is an effective drug that affects the pathogenetic mechanisms of the development of bronchial asthma and helps to eliminate the main symptoms of the disease. Most patients tolerate therapy with this drug without complications and note an improvement in their well-being after a course of regular use of Formoterol .