Oxis Turbohaler 6 (Formoterol Fumarate Dihydrate)

Formoterol fumarate dihydrate is a bronchodilator that acts on the β2‑adrenergic pathway to relax airway smooth muscle.

• Asthma: improves control of symptoms and reduces the frequency of exacerbations.
• Chronic obstructive pulmonary disease (COPD): provides sustained bronchodilation and helps decrease dyspnoea during daily activities.
• Exercise‑induced bronchoconstriction: prevents airway narrowing that can occur with physical exertion.

• Formoterol binds selectively to β2‑adrenergic receptors on airway smooth‑muscle cells, activating adenylate cyclase and increasing intracellular cyclic AMP. The rise in cAMP leads to relaxation of smooth‑muscle fibers, producing a rapid and prolonged bronchodilatory effect that improves airflow in obstructive airway diseases.

Formoterol may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Throat irritation: mild discomfort or dryness in the throat after inhalation.
• Cough: transient coughing immediately after use of the inhaler.
• Headache: mild to moderate headache not related to other causes.
• Tremor: fine shaking of the hands, especially at higher doses.
• Palpitations: sensation of rapid or irregular heartbeat.

Serious or Rare Side Effects

• Paradoxical bronchospasm: sudden worsening of airway obstruction after inhalation.
• Cardiac arrhythmia: irregular heart rhythm that may require medical attention.
• Hypokalaemia: low blood potassium levels, potentially leading to muscle weakness.
• Severe allergic reaction: rash, itching, swelling, or difficulty breathing.
• Hyperglycaemia: elevated blood glucose, particularly in patients with diabetes.

When using Formoterol inhalation therapy, patients and clinicians should observe several safety measures.

• Assess severity: evaluate the patient’s baseline lung function before initiating therapy.
• Monitor response: regularly review symptom control and rescue‑inhaler use.
• Avoid overuse: do not exceed the prescribed number of inhalations per day.
• Caution in cardiac disease: patients with known arrhythmias or coronary disease should be monitored closely.
• Pregnancy and lactation: use only if the potential benefit outweighs any risk to the fetus or infant.
• Store at ambient temperature: keep below 25°C, in the original packaging, protected from moisture and direct sunlight.

Formoterol may interact with several other medicines, altering its safety or effectiveness. Major Interactions (Avoid):\n- Non‑selective β‑blockers: may diminish bronchodilator response and precipitate bronchospasm.

• Monoamine oxidase inhibitors (MAOIs): can increase the risk of cardiovascular side effects.

Moderate Interactions (Monitor Closely)

• Diuretics: may exacerbate hypokalaemia when combined with β2‑agonists.
• Theophylline: concurrent use can increase the likelihood of tremor and tachycardia.
• Corticosteroids: may enhance systemic β2‑agonist effects, requiring dose adjustment.
• Anticholinergics: additive bronchodilation may increase the risk of dry mouth.
• Certain antidepressants (e.g., SSRIs): may potentiate tachycardia, requiring observation.