Moclobemide
Severe
Textbook
Increased risk of adverse cardiovascular effects.
At least 2 weeks should elapse between the use of MAO inhibitors and administration of β2 agonists or other sympathomimetics.
Source: G&G 14e · p264
Drug reference
Formoterol
Long-acting beta-2 agonist (LABA) · Bronchodilator
Also known as Formoterol Fumarate, Foradil, Oxis
START
Always prescribe with ICS for asthma; 4.5-12 mcg BD via inhaler; check baseline heart rate, BP, K+; provide asthma action plan
TYPICAL MAX
24 mcg BD; 40 mcg/day total
STOP IF
Paradoxical bronchospasm, significant arrhythmia, inadequate asthma control (step up therapy), severe hypokalemia
WATCH
Asthma control (ACT score), heart rate, BP, K+ (if on diuretics), inhaler technique, ensure concurrent ICS use
CDSCO approvedSchedule HATC R03AC13
KDIGO 2024 + manufacturer label
- ONSET
- 3min · 1-3 minutes (rapid for LABA)
- PEAK
- 45min · 0.5-1 hour
- t½
- 9h · 8-10 hours
- DURATION
- 12h · 12-hour bronchodilation
EXCRETION
Renal (metabolites)
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Compatible with pregnancy; asthma control benefits outweigh risks; use with ICS
FDA category + note
Top interactionssee all 12 →
- MoclobemideSevereTextbookG&G 14e · p264
- CarteololSevereDatabaseDDInter
- CarvedilolSevereDatabaseDDInter
- LabetalolSevereDatabaseDDInter
Available in India
3 branded formulations and 238 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Mechanism
Selective agonist at beta-2 adrenergic receptors on airway smooth muscle, activating adenylate cyclase and increasing intracellular cAMP, leading to smooth muscle relaxation and bronchodilation. Rapid onset of action with sustained 12-hour duration. Also inhibits mast cell mediator release and increases mucociliary clearance.
Indications
Asthma - maintenance treatment (in combination with ICS, NEVER monotherapy)COPD - maintenance bronchodilation (as monotherapy or combination)Exercise-induced bronchospasm preventionChronic bronchitis, emphysema
Dosing
- Adult
- Inhalation: 4.5-24 mcg BD (depending on device). DPI (Foradil): 12 mcg BD. MDI (Atimos): 12 mcg BD. Neb: 20 mcg BD
- Pediatric
- 6-17 years: 4.5-12 mcg BD (asthma, with ICS). <6 years: limited data
- Renal adjustment
- No adjustment needed
- Hepatic adjustment
- No adjustment needed; minimal hepatic metabolism
- Geriatric
- Standard dosing; monitor for cardiovascular effects
- Max dose
- 24 mcg BD (inhalation); 40 mcg/day total
Pharmacokinetics
Onset
1-3 minutes (rapid onset for LABA)
Peak effect
Inhalation: 0.5-1 hour
Duration
12 hours
Half-life
8-10 hours
Bioavailability
Inhalation: ~8% (systemic from lung); Oral swallowed: ~65% (extensive first-pass)
Protein binding
46-58%
Metabolism
Hepatic CYP2D6 and CYP2C19 (O-demethylation and glucuronidation)
Excretion
Renal (majority, as metabolites); fecal (~10%)
Contraindications
- Hypersensitivity to formoterol
- Asthma monotherapy without ICS (black box warning - increased mortality risk)
- Severe cardiovascular disease (unstable angina, recent MI)
- Tachyarrhythmias
- Untreated hypokalemia
Side effects
Common
TremorPalpitationsTachycardiaHeadacheMuscle crampsHypokalemiaThroat irritation
Serious
- Paradoxical bronchospasm
- Cardiovascular events (arrhythmias, angina, MI)
- Hypokalemia (potentially severe)
- Hyperglycemia
- Anaphylaxis (rare)
Pregnancy & lactation
Pregnancy
Compatible with pregnancy; asthma control benefits outweigh risks; use with ICS
Lactation
Excretion in breast milk unknown; likely compatible at standard doses
Drug interactions
Carteolol
Severe
Database
Drug interaction classified as: antagonism
Source: DDInter
Carvedilol
Severe
Database
Drug interaction classified as: antagonism.
Source: DDInter
Labetalol
Severe
Database
Clinical effect not specified
Source: DDInter
Levobunolol
Severe
Database
Clinical effect not specified
Source: DDInter
Macimorelin
Severe
Database
Clinical effect not specified
Source: DDInter
Metipranolol
Severe
Database
Clinical effect not specified
Source: DDInter
Nadolol
Severe
Database
Clinical effect not specified
Source: DDInter
Ozanimod
Severe
Database
Clinical effect not specified
Source: DDInter
Penbutolol
Severe
Database
Clinical effect not specified
Source: DDInter
Pindolol
Severe
Database
Clinical effect not specified
Source: DDInter
Propranolol
Severe
Database
.
Source: DDInter
Related guidelines
Ask House about Formoterol
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19