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formoterol and glycopyrronium bromide

R03AL07

Forms & Strengths

Inhalation powder, 12 µg formoterol + 18 µg glycopyrronium per actuation
Two inhalations (24 µg/36 µg total) administered twice daily
Delivered via dry‑powder inhaler (DPI) device

Adult Dosing

COPD maintenance: 2 inhalations BID (total 24 µg formoterol, 36 µg glycopyrronium per day)
Do not use for acute symptom relief
Administer each dose with a full inhalation and hold breath 5‑10 seconds

Pediatric Dosing

Not approved for patients <18 years of age
Safety and efficacy not established in children

Indications

Long‑term maintenance treatment of airflow obstruction in COPD
Reduces exacerbations in moderate to severe COPD

Mechanism of Action

Formoterol: selective β2‑adrenergic agonist → ↑cAMP → bronchial smooth‑muscle relaxation
Glycopyrronium: competitive muscarinic M3 antagonist → blocks ACh‑mediated bronchoconstriction
Combined LABA/LAMA provides additive bronchodilation

Contraindications

Hypersensitivity to formoterol, glycopyrronium or any excipients
Severe acute bronchospasm (use rapid‑acting bronchodilator instead)
Narrow‑angle glaucoma or urinary retention (anticholinergic contraindication)
Use with caution in uncontrolled cardiovascular disease

Adverse Reactions

Headache, dizziness, dry mouth, cough, throat irritation
Tremor, palpitations, tachycardia, arrhythmias (β2‑agonist effect)
Urinary retention, constipation (anticholinergic effect)
Paradoxical bronchospasm, angina, myocardial infarction (rare but serious)

Drug Interactions

β‑blockers may attenuate formoterol bronchodilator response
Concomitant anticholinergics can increase anticholinergic side‑effects
CYP3A4 inhibitors (e.g., ketoconazole) may raise formoterol plasma levels
Other sympathomimetics (e.g., epinephrine) may cause additive cardiovascular effects
QT‑prolonging drugs – monitor for arrhythmia risk

Curated Content: Needs Vetting Before Put to Clinical Use