[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Beta-2 adrenergic agonists](https://durgical.com/en/pharmacology/classes/beta-2-adrenergic-agonists/) › Formoterol

[Pharmacology](https://durgical.com/en/pharmacology/) · [Beta-2 adrenergic agonists](https://durgical.com/en/pharmacology/classes/beta-2-adrenergic-agonists/)

# Formoterol

A long-acting beta-2 agonist that also works within minutes. Maintenance bronchodilator in COPD; in asthma only with an inhaled steroid.

Updated 2026-11-01

- Class: [Beta-2 adrenergic agonists](https://durgical.com/en/pharmacology/classes/beta-2-adrenergic-agonists/)
- Receptor: Beta-2 adrenergic receptor
- ATC code: R03AC13

Also called: Eformoterol

◎**Beta-2 adrenergic receptor**Formoterol

ⓘ The figure shows formoterol bound to the human beta-2 adrenergic receptor coupled to its Gs protein (cryo-EM).

**Target in 3D:** Beta-2 adrenergic receptor. PDB structure 7BZ2 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7BZ2) · Drag to rotate · pinch to zoom

## Mechanism of action

Formoterol is a selective, full agonist of the beta-2 receptor. Like salbutamol it raises cyclic AMP and relaxes airway smooth muscle, so its effect starts within minutes; but its moderate lipophilicity lets it stay in the cell membrane near the receptor, so bronchodilation lasts about twelve hours.

- Formoterol binds the beta-2 receptor as a full agonist
- Cyclic AMP rises and airway muscle relaxes within minutes
- The drug lingers in the membrane next to the receptor
- Bronchodilation lasts about twelve hours

## Pharmacokinetics

**Absorption**
Acts in the lung; part is absorbed into the blood

**Metabolism**
Glucuronidation and O-demethylation

**Elimination**
Mostly in urine, the rest in faeces

**Half-life**
About 7 hours after nebulisation

**Onset and duration**
Within minutes; peak effect after about 2 hours

## Indications

- Maintenance treatment of bronchoconstriction in COPD [Chronic obstructive pulmonary disease (COPD) →](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/)
- Asthma, only combined with an inhaled corticosteroid (for example budesonide + formoterol) [Asthma →](https://durgical.com/en/conditions/asthma/)

## Adverse effects

### Common

- Tremor and palpitations
- Nausea, diarrhoea and dry mouth
- Dizziness and insomnia
- Nasopharyngitis

### Serious (rare, important)

- Serious asthma-related events, including death, when used without an inhaled corticosteroid in asthma
- Paradoxical bronchospasm
- Arrhythmia, QT prolongation and hypokalaemia with excessive use
- Hyperglycaemia

## Contraindications

- Use without an inhaled corticosteroid in asthma
- Hypersensitivity to formoterol
- Not started in acutely deteriorating COPD; caution in heart disease, seizure disorders and hyperthyroidism

## Key interactions

**Beta blockers**
Reduce its effect and may cause bronchospasm

**Theophylline, corticosteroids or non-potassium-sparing diuretics**
Additive hypokalaemia and ECG changes

**Monoamine oxidase inhibitors, tricyclic antidepressants or QT-prolonging drugs**
Stronger cardiovascular effects

**Other LABA-containing inhalers**
Overdose risk; not combined

## What is monitored

- Heart rate and rhythm
- Potassium and glucose in high-risk patients
- Symptom control and reliever use

## Administration and safety

- Oral inhalation by nebuliser (single-use vials), dry powder inhaler or combination inhaler
- Nebuliser vials are kept in their foil pouch and used only by inhalation
- In asthma it is used only in a product or plan that includes an inhaled corticosteroid
- Not given with another LABA product

## Nursing care

- Check heart rate and ask about palpitations and tremor
- In asthma, check that an inhaled corticosteroid is part of the treatment
- Teach that it is a maintenance medicine; a short-acting reliever is kept for sudden symptoms unless the plan uses a budesonide + formoterol inhaler for relief
- Teach to report worsening breathing right after use (paradoxical bronchospasm)

## Pregnancy and breastfeeding

Human data are limited; asthma control is the priority, because poorly controlled asthma harms mother and fetus.

## Memory aid

FORMoterol is FAST and LONG: FORMula 1 start, marathon finish.

## Test yourself

Think of the answer, then tap the question to see it.

## What distinguishes formoterol from salmeterol in onset?

Formoterol starts working within minutes (full agonist), while salmeterol has a slower onset.

## When is formoterol contraindicated in asthma?

When used without an inhaled corticosteroid, because LABA monotherapy raises serious asthma-related events.

## Which electrolyte is watched when formoterol is combined with diuretics or theophylline?

Potassium, because their hypokalaemic effects add up.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/formoterol/)

## Related drugs

- [Salmeterol](https://durgical.com/en/pharmacology/salmeterol/)
- [Salbutamol](https://durgical.com/en/pharmacology/salbutamol/)
- [Budesonide + formoterol](https://durgical.com/en/pharmacology/budesonide-formoterol/)

## Related conditions

- [Chronic obstructive pulmonary disease (COPD)](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/)
- [Asthma](https://durgical.com/en/conditions/asthma/)

[← Back to the class: Beta-2 adrenergic agonists](https://durgical.com/en/pharmacology/classes/beta-2-adrenergic-agonists/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - FORMOTEROL FUMARATE solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=07afdf7e-c480-4806-b469-a6a460522bc0) (DailyMed (U.S. National Library of Medicine), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=R03AC13) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 44 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/formoterol/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/formoterol/