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Formoterol
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{{Short description|Long-acting bronchiodilator}} {{distinguish|Fenoterol}} {{Use dmy dates|date=June 2024}} {{cs1 config |name-list-style=vanc |display-authors=6}} {{Infobox drug | verifiedrevid = 461113044 | image = Formoterol.svg | image_class = skin-invert-image | width = 230 | alt = | image2 = Formoterol ball-and-stick model.png | alt2 = | caption = Formoterol (top),<br />(''R'',''R'')-(β)-formoterol (center) and<br />(''S'',''S'')-(+)-formoterol (bottom) | chirality = [[Racemic mixture]] <!-- Clinical data --> | tradename = Oxeze, Foradil, Symbicort, others | Drugs.com = {{drugs.com|monograph|formoterol-fumarate}} | pregnancy_AU = B3 | licence_EU = yes | INN_EMA = formoterol fumarate dihydrate | legal_AU = S4 | legal_CA = | legal_NZ = Prescription only | legal_UK = POM | legal_US = Rx-only | legal_EU = Rx-only | legal_EU_comment = <ref>{{cite web|url=https://www.ema.europa.eu/documents/psusa/formoterol-list-nationally-authorised-medicinal-products-psusa/00001469/202005_en.pdf |title=List of nationally authorised medicinal products|website=ema.europa.eu|access-date=17 June 2023}}</ref> | legal_status = Rx-only | routes_of_administration = Inhalation ([[Capsule (pharmacy)|capsules]] for oral inhalation, [[Dry powder inhaler|DPI]], [[Metered-dose inhaler|MDI]]) <!-- Pharmacokinetic data --> | bioavailability = | protein_bound = 61% to 64% | metabolism = [[Liver]] [[demethylation]] and [[glucuronidation]] ([[CYP2D6]], [[CYP2C19]], [[CYP2C9]] and [[CYP2A6]] involved) | elimination_half-life = 10 h | excretion = [[Kidney]] and fecal <!-- Identifiers --> | index_label = | index2_label = | CAS_number_Ref = {{cascite|correct|??}} | CAS_number = 73573-87-2 | ATC_prefix = R03 | ATC_suffix = AC13 | ATC_supplemental = {{ATC|R03|CC15}} | PubChem = 3083544 | PubChem2 = 3034756 | IUPHAR_ligand = 3465 | DrugBank_Ref = {{drugbankcite|correct|drugbank}} | DrugBank = DB00983 | ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} | ChemSpiderID = 2340731 | UNII_Ref = {{fdacite|correct|FDA}} | UNII = 5ZZ84GCW8B | KEGG_Ref = {{keggcite|correct|kegg}} | KEGG = D07990 | ChEBI_Ref = {{ebicite|correct|EBI}} | ChEBI = 408174 | ChEMBL_Ref = {{ebicite|correct|EBI}} | ChEMBL = 1363 <!-- Chemical data --> | IUPAC_name = (''RR'',''SS'')-''N''-[2-hydroxy-5-[1-hydroxy-2-[1-(4-methoxyphenyl) propan-2-ylamino]ethyl] phenyl]formamide | C=19 | H=24 | N=2 | O=4 | smiles = O=CNc1cc(ccc1O)[C@@H](O)CN[C@H](C)Cc2ccc(OC)cc2 | StdInChI_Ref = {{stdinchicite|correct|chemspider}} | StdInChI = 1S/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 = {{stdinchicite|correct|chemspider}} | StdInChIKey = BPZSYCZIITTYBL-YJYMSZOUSA-N }} <!-- Definition and medical uses --> '''Formoterol''', also known as '''eformoterol''', is a [[Long-acting beta-adrenoceptor agonist|long-acting Ξ²<sub>2</sub> 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 Ξ²<sub>2</sub> 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.<ref name="pmid8099696">{{cite journal| author=Anderson GP| title=Formoterol: pharmacology, molecular basis of agonism, and mechanism of long duration of a highly potent and selective beta 2-adrenoceptor agonist bronchodilator. | journal=Life Sci | year= 1993 | volume= 52 | issue= 26 | pages= 2145β60 | pmid=8099696 | doi=10.1016/0024-3205(93)90729-m | pmc= | url=https://pubmed.ncbi.nlm.nih.gov/8099696 }}</ref> The 2022 [[Global Initiative for Asthma]] report <ref>{{cite report |author=Global Initiative for Asthma|date=2022 |title=Global Strategy for Asthma Prevention and Management (Updated 2022) |url=https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf}}</ref> recommends a combination formoterol/inhaled corticosteroid inhaler as both a preventer and reliever treatment for asthma in adults. In children, a short-acting Ξ²<sub>2</sub> adrenergic agonist (e.g., [[salbutamol]]) is still recommended. <!-- Society and culture --> It was patented in 1972 and came into medical use in 1998.<ref name=Fis2006>{{cite book | vauthors = Fischer J, Ganellin CR |title=Analogue-based Drug Discovery |date=2006 |publisher=John Wiley & Sons |isbn=9783527607495 |page=543 |url=https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA543 |language=en}}</ref> It is available as a [[generic medication]].<ref>{{cite web | title=Competitive Generic Therapy Approvals | website=U.S. [[Food and Drug Administration]] (FDA) | date=29 June 2023 | url=https://www.fda.gov/drugs/generic-drugs/competitive-generic-therapy-approvals | access-date=29 June 2023 | archive-date=29 June 2023 | archive-url=https://web.archive.org/web/20230629233651/https://www.fda.gov/drugs/generic-drugs/competitive-generic-therapy-approvals | url-status=dead }}</ref> It is also marketed in the combination formulations [[budesonide/formoterol]] and [[mometasone/formoterol]].
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