The Foracort Inhaler is a prescription-only combination inhaler designed for the maintenance treatment of asthma and chronic obstructive pulmonary disease (COPD) in patients requiring both bronchodilation and anti-inflammatory therapy. It contains a synergistic blend of Formoterol, a long-acting beta2-agonist (LABA) that relaxes airway muscles, and Budesonide, an inhaled corticosteroid (ICS) that reduces inflammation and swelling in the airways. This dual-mechanism approach provides comprehensive management of obstructive airway diseases, helping to prevent symptoms, improve lung function, and reduce the frequency of exacerbations. It is not intended for the relief of acute bronchospasm, for which a separate rescue inhaler is required.

Features

• Active Ingredients: Formoterol Fumarate Dihydrate and Budesonide.
• Mechanism of Action: Combines a long-acting bronchodilator (LABA) with an anti-inflammatory corticosteroid (ICS).
• Delivery System: Metered-dose inhaler (MDI) or dry powder inhaler (DPI), depending on the specific product variant.
• Dosage Strengths: Available in various strengths (e.g., Formoterol 6 mcg / Budesonide 100 mcg, 200 mcg, or 400 mcg per inhalation) to allow for individualized treatment plans.
• Prescription Status: Requires a prescription and regular medical supervision.

Benefits

• Provides superior symptom control compared to monotherapy by addressing both bronchoconstriction and underlying inflammation.
• Significantly reduces the frequency and severity of asthma attacks and COPD exacerbations.
• Improves overall lung function (FEV1) and exercise tolerance, enhancing quality of life.
• Helps achieve long-term disease control, potentially reducing the need for oral corticosteroids and associated systemic side effects.
• The convenient twice-daily dosing regimen supports treatment adherence.

Common use

Foracort Inhaler is indicated for the regular maintenance treatment of asthma where the use of a combination product is appropriate, i.e., for patients not adequately controlled on inhaled corticosteroids and “as needed” short-acting inhaled beta2-agonists, or for those already controlled on both inhaled corticosteroids and long-acting inhaled beta2-agonists. It is also indicated for the symptomatic treatment of patients with severe COPD (FEV1 < 50% predicted normal) and a history of repeated exacerbations, who have significant symptoms despite regular therapy with long-acting bronchodilators.

Dosage and direction

The dosage must be individualized based on disease severity and patient response. The usual recommended dose for asthma and COPD is one or two inhalations twice daily (morning and evening). The maximum recommended dose is four inhalations twice daily. It is crucial to administer the dose at approximately the same times each day. Patients must be instructed on the proper inhalation technique by a healthcare professional to ensure optimal drug delivery to the lungs. Rinsing the mouth with water without swallowing after each dose is advised to minimize the risk of oropharyngeal candidiasis (oral thrush) and systemic absorption.

Precautions

• Not for relief of acute symptoms. Patients must have a separate short-acting beta2-agonist (e.g., salbutamol) for acute rescue therapy.
• Paradoxical bronchospasm may occur immediately after dosing, requiring discontinuation and alternative therapy.
• Use with caution in patients with cardiovascular disorders (e.g., coronary artery disease, arrhythmias, hypertension), convulsive disorders, thyrotoxicosis, and diabetes mellitus.
• Systemic effects of corticosteroids may occur, particularly at high doses and over prolonged periods. These include adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract, and glaucoma.
• Patients should be monitored for signs of systemic corticosteroid effects. A gradual step-down of therapy is recommended when discontinuing treatment.
• Be alert to the potential development of pneumonia in patients with COPD.

Contraindications

Foracort Inhaler is contraindicated in patients with known hypersensitivity to Formoterol Fumarate, Budesonide, or any of the excipients (e.g., lactose monohydrate in DPIs). It is not indicated for the treatment of acute asthma attacks or status asthmaticus.

Possible side effect

Common side effects may include:

• Headache
• Tremor
• Palpitations
• Oropharyngeal candidiasis (oral thrush)
• Hoarseness or dysphonia
• Cough and throat irritation

Less common but serious side effects require immediate medical attention and may include:

• Severe allergic reactions (rash, hives, swelling, difficulty breathing)
• Increased blood pressure and heart rate
• Chest pain
• Significant nervousness or restlessness
• Signs of systemic corticosteroid effects (e.g., easy bruising, moon face, muscle weakness)
• Signs of infection (e.g., fever, chills)

Drug interaction

Concomitant use with other beta-adrenergic drugs (e.g., other LABAs, SABAs) will produce additive sympathomimetic effects. Use with caution with drugs known to prolong the QTc interval (e.g., certain antidepressants, antifungals, antibiotics) as this may potentiate the risk of ventricular arrhythmias. Ketoconazole, itraconazole, and other potent CYP3A4 inhibitors may increase plasma concentrations of budesonide, increasing the risk of systemic corticosteroid side effects. Beta-blockers (both non-selective and selective) may antagonize the bronchodilating effect of formoterol and may produce severe bronchospasm in asthmatic patients.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Do not double the dose to make up for a missed one.

Overdose

Overdosage with Formoterol may lead to exaggeration of its pharmacologic effects: tachycardia, arrhythmias, tremor, headache, muscle cramps, nausea, dizziness, and hypokalemia. Overdosage with Budesonide could potentially lead to systemic corticosteroid effects such as hypercorticism and adrenal suppression. Treatment involves discontinuation of the inhaler, supportive measures, and symptomatic therapy. Cardiac monitoring is recommended in cases of significant overdose. There is no specific antidote.

Storage

Store at room temperature (15°C to 30°C) in a dry place. Protect from frost, moisture, and direct sunlight. Keep the canister away from open flame or heat sources, as it may burst. Do not puncture or incinerate the canister, even when empty. Keep out of reach of children.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

• “As a pulmonologist, I find Foracort to be a cornerstone of therapy for many of my moderate-to-severe asthma patients. The combination provides excellent control and improves compliance.” – Dr. A. Sharma, MD.
• “Switching to Foracort significantly reduced my nighttime symptoms and the number of exacerbations I experienced each year. It has given me back a sense of normalcy.” – Patient with COPD, 10-year user.
• “The clinical trial data consistently shows its efficacy in improving FEV1 and reducing rescue medication use. It’s a well-established and reliable option in our treatment arsenal.” – Clinical Pharmacist.
• “It took some getting used to the routine, but the difference in my breathing capacity is night and day. I hardly need my rescue inhaler anymore.” – Patient with asthma.