Beclomethasone/Formoterol (Inhaler)

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

[edit] MECHANISM OF ACTION

Beclometasone dipropionate is an inhaled glucocorticoid, it works in the air passages of the lungs by reducing inflammation and keeping the airways open, making it easier to breathe. Glucocorticoids have multiple antiinflammatory effects, inhibiting both inflammatory cells and release of inflammatory mediators.


Formoterol is a long acting Beta2 agonist with a fast onset of action. Beta2 receptors are the predominant adrenergic receptors in bronchial smooth muscle. The binding of Formoterol to Beta2 adrenergic receptors in bronchial smooth muscle, activates the intracellular adenylate cyclase, an enzyme which catalyzes the conversion of adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP). The increase of cAMP determines:

  • Bronchodilation
  • Inhibition of the release of mast cell mediators
  • Increased mucociliary clearance

[edit] INDICATIONS

  • Regular treatment of asthma (Maintenance treatment) in adult patients (18 years and over), where use of a combination product (inhaled corticosteroid and long-acting beta2-agonist) is appropriate:
    • patients not adequately controlled with inhaled corticosteroids and ‘as needed’ inhaled rapid-acting beta2 agonist
    • patients already adequately controlled on both inhaled corticosteroids and long-acting beta2-agonists

Beclomethasone/Formoterol (Inhaler) is not appropriate for the treatment of acute asthma attacks, for such use a separate rapid-acting bronchodilator (Salbutamol) should be considered .

[edit] DOSAGE

  • Beclometasone dipropionate 100mcg/Formoterol fumarate 6mcg: One or two puffs twice daily (maximum 4 puffs daily)

[edit] CONTRAINDICATIONS

  • Hypersensitivity to any of the components
  • Acute episodes of asthma requiring intensive measures

[edit] PRECAUTIONS

  • Monitor blood glucose periodically (Formoterol may cause a rise in blood glucose levels)
  • Use with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension.
  • If anaesthesia with halogenated anaesthetics is planned, it should be ensured that Beclomethasone/Formoterol (Inhaler) is not administered for at least 12 hours before the start of anaesthesia as there is a risk of cardiac arrhythmias.
  • Deterioration of Disease and Acute Episodes: Beclomethasone/Formoterol (Inhaler) should not be initiated in patients during rapidly deteriorating or potentially life-threatening episodes of asthma. An inhaled, short-acting beta2-agonist (e.g. Salbutamol), should be used to relieve acute symptoms such as shortness of breath.
  • Paradoxical bronchospasm may occur. Treat bronchospasm immediately with a fast-acting inhaled bronchodilator (Salbutamol) and discontinue Beclomethasone/Formoterol (Inhaler).
  • Decreases in bone mineral density (BMD) have been observed with long-term administration of products containing inhaled corticosteroids
  • Glaucoma, increased intraocular pressure, and cataracts have been reported following the long-term administration of inhaled corticosteroids.
  • Potential worsening of existing tuberculosis; fungal, bacterial, viral, parasitic infection or ocular herpes simplex. Use caution in patients with the above because of the potential for worsening of these infections
  • Candida albicans infection of the mouth and pharynx. Monitor patients periodically for signs of adverse effects in the mouth and pharynx. Advise patients to rinse mouth after inhalation.

[edit] INTERACTIONS

[edit] PREGNANCY AND LACTATION

Should only be used during pregnancy or lactation if then expected benefits outweigh the potential risks

[edit] SIDE EFFECTS

May cause infection of the mouth and throat (rinsing your mouth and gargling with water after using the inhaler may avoid such inconvenience), headache, dysphonia, dry irritated throat, cough and pharyngitis.

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

Fostair Prescribing Information

[edit] REFERENCES

Asthma / Chronic obstructive pulmonary disease (COPD)
Adrenergics, inhalants Short acting β2-agonists Fenoterol (Berotec)   Levosalbutamol (Xopenex)   Salbutamol (Ventolin)   Terbutaline (Bricanyl)
Long acting β2-agonists (LABA) Arformoterol (Brovana)   Clenbuterol (Spiropent)   Formoterol (Foradil)   Salmeterol (Serevent)
Ultra long acting β2-agonists Indacaterol   Olodaterol   Vilanterol
Inhaled corticosteroids Beclomethasone (Inhaler)   Budesonide (Inhaler)   Ciclesonide (Inhaler)   Flunisolide (Inhalation suspension)   Fluticasone (Inhaler)   Mometasone (Inhaler)
Anticholinergics (Muscarinic antagonists) Aclidinium bromide   Glycopyrronium bromide   Ipratropium bromide   Oxitropium bromide (Inhalation suspension)   Tiotropium bromide
Mast cell stabilizers Cromoglicate   Nedocromil
Monoclonal anti-IgE antibody Omalizumab
Xanthine derivatives Aminophylline   Bamifylline   Doxofylline   Dyphylline   Theophylline
Eicosanoid inhibition Leukotriene antagonists Montelukast   Pranlukast   Zafirlukast
Thromboxane receptor antagonists Ramatroban   Seratrodast
Non-xanthine PDE4 inhibitors Ibudilast   Roflumilast
Combination products Corticosteroid + Long acting Beta2 agonist Beclomethasone/Formoterol (Inhaler)   Fluticasone/Salmeterol (Inhaler)   Fluticasone/Vilanterol   Mometasone/Formoterol
Corticosteroid + Short acting Beta2 agonist Beclomethasone/Salbutamol   Salbutamol/Flunisolide (Inhalation suspension)   Salbutamol/Flunisolide (Inhaler)
Short acting Beta2 agonist + Muscarinic antagonist Fenoterol/Ipratropium bromide (Inhaler)   Levosalbutamol/Ipratropium   Salbutamol/Ipratropium bromide