Fostair Pink Inhaler

What is Fostair?

Fostair is a pressurised inhalation solution containing two active substances which work together to treat respiratory conditions:

Active Ingredients and Drug Class

• Beclometasone dipropionate (100 mcg per actuation): A corticosteroid that reduces inflammation and swelling in the airways
• Formoterol fumarate dihydrate (6 mcg per actuation): A long-acting beta-2 agonist bronchodilator that relaxes airway muscles

Mechanism of Action

Think of Fostair as having two complementary actions: the corticosteroid component (beclometasone) acts like a fire extinguisher that puts out the inflammation in your airways, while the bronchodilator (formoterol) works like a key that unlocks and opens up your constricted breathing passages.

Biological Pathway Explanation

Beclometasone works by entering airway cells and binding to glucocorticoid receptors, which then reduces the production of inflammatory chemicals. Formoterol stimulates beta-2 receptors in the airway smooth muscles, causing relaxation and bronchodilation that lasts for about 12 hours.

What is Fostair Used For?

Approved Indications

Target Patient Populations

Fostair is specifically indicated for adult patients with:

• Moderate to severe asthma requiring combination therapy
• Asthma not controlled on inhaled corticosteroids alone
• Severe COPD (primarily caused by smoking)

Before Using Fostair

Medical History Assessment Checklist

Inform your doctor if you have any of the following conditions:

• Heart problems (angina, recent heart attack, heart failure, coronary heart disease, valvular heart disease, hyperthick obstructive cardiomyopathy)
• Narrowing of arteries (arteriosclerosis), high blood pressure, or aneurysm
• Heart rhythm disorders (increased or irregular heart rate, palpitations)
• Overactive thyroid gland
• Low blood potassium levels
• Liver or kidney disease
• Diabetes
• Tumour of the adrenal gland (phaeochromocytoma)
• History of tuberculosis (TB) or chest infections
• Planned surgery requiring anaesthesia

Required Baseline Tests

Your doctor may recommend:

• Blood tests to check potassium levels (especially if taking diuretics or if you have severe asthma)
• Blood glucose monitoring if you have diabetes
• Electrocardiogram (ECG) if you have heart rhythm concerns

Fostair Contraindications

Absolute Contraindications

• Hypersensitivity to beclometasone dipropionate, formoterol fumarate dihydrate, or any excipients
• Children and adolescents under 18 years of age

Relative Contraindications (Use With Caution)

• Severe cardiovascular disorders
• Uncontrolled diabetes
• Severe hepatic or renal impairment
• Pregnancy and breastfeeding

Risk Stratification Table

Special Population Considerations

Elderly Patients

No dose adjustment necessary for older people, but increased monitoring may be required for those with age-related cardiac, hepatic or renal impairment.

Renal/Hepatic Impairment

No specific information available regarding use in people with liver or kidney problems. Use with caution and monitor for potential increased systemic exposure.

Pediatric/Adolescent Restrictions

Fostair is contraindicated in children and adolescents under 18 years until further safety and efficacy data become available.

Fostair and Other Medicines

High-Risk Medication Combinations

• Beta-blockers: Avoid concurrent use (atenolol, propranolol, sotalol, timolol eye drops) as they may reduce Fostair's effectiveness
• Antiarrhythmics: Quinidine, disopyramide, procainamide may increase risk of heart rhythm disturbances
• MAOIs and tricyclic antidepressants: May cause changes in heart rhythm and blood pressure
• Diuretics: May worsen potassium-lowering effects
• Other bronchodilators: Theophylline, aminophylline may increase risk of side effects
• HIV medications: Ritonavir, cobicistat may increase Fostair effects requiring careful monitoring

Timing Recommendations

If you need to use eye drops containing beta-blockers for glaucoma, administer them at least 10-15 minutes before using Fostair to minimize interaction.

Pregnancy & Breastfeeding

Pregnancy

Fostair is not recommended during pregnancy unless clearly necessary and only under strict medical supervision. There are no adequate clinical data on use during pregnancy.

Breastfeeding

Avoid using Fostair while breastfeeding unless advised by your doctor, as it is unknown whether the components are excreted in human milk.

Contraception Requirements

Women of childbearing potential should use effective contraception while taking Fostair. Discuss appropriate contraceptive methods with your doctor.

Driving & Machine Operation

Fostair is unlikely to affect your ability to drive and use machines. However, if you experience side effects such as dizziness, trembling, or visual disturbances, you should avoid driving or operating machinery until these symptoms resolve.

Warning Signs to Watch For

• Dizziness or lightheadedness
• Trembling or shakiness
• Blurred vision
• Palpitations or irregular heartbeat

Fostair Ingredients

Active Ingredients

• Beclometasone dipropionate: 100 micrograms per actuation
• Formoterol fumarate dihydrate: 6 micrograms per actuation

Other Ingredients (Excipients)

• Ethanol anhydrous (alcohol): 7mg per actuation
• Hydrochloric acid (for pH adjustment)
• Norflurane (HFC-134a): CFC-free propellant

Allergen Warnings

Fostair contains alcohol (ethanol) - 7mg per actuation. The amount in two puffs is equivalent to less than 1ml of wine or beer and is unlikely to have noticeable effects.

How to Use Fostair

Fostair is for inhalation use only. Always use exactly as prescribed by your doctor.

Step-by-Step Administration

1. Remove the protective cap from the mouthpiece and check it's clean
2. Breathe out as slowly and deeply as possible
3. Hold the canister upright with the mouthpiece at the bottom
4. Place your lips tightly around the mouthpiece (don't bite it)
5. Breathe in slowly and deeply through your mouth
6. Just after starting to breathe in, press down firmly on the inhaler to release one puff
7. Continue breathing in deeply
8. Hold your breath for as long as possible (ideally 10 seconds)
9. Remove the inhaler from your mouth and breathe out slowly
10. If you need another puff, wait 30 seconds then repeat steps 2-9
11. After use, replace the protective cap

Inhaler Technique Tips

• If you have weak hands, use both hands: place both index fingers on top and both thumbs on the bottom
• Don't perform the steps too quickly - coordinate breathing and pressing carefully
• If you see "mist" coming from the top or sides of your mouth, repeat the dose
• Rinse your mouth or brush your teeth after each use to prevent oral thrush

Fostair Dosage Guidelines

Asthma Treatment Approaches

Fostair can be prescribed in two different ways for asthma:

Option A: With Separate Reliever Inhaler

• Recommended dose: 1-2 puffs twice daily
• Maximum daily dose: 4 puffs
• Always carry your quick-acting reliever inhaler for sudden symptoms

Option B: As Your Only Inhaler

• Maintenance dose: 1 puff morning and evening
• Reliever use: Take 1 puff for sudden symptoms, wait a few minutes, take another if needed
• Maximum daily dose: 8 puffs (including maintenance and reliever use)
• Do not exceed 6 reliever puffs per day

COPD Dosage

• Recommended dose: 2 puffs morning and evening

Titration Schedule

Administration Instructions

Testing Your Inhaler

Before first use or if unused for 14+ days:

1. Remove protective cap from mouthpiece
2. Hold inhaler upright with mouthpiece at bottom
3. Point mouthpiece away from yourself and press canister to release one puff
4. Check dose counter - should read 120 when new

Using a Spacer Device

If you find it difficult to coordinate breathing and pressing, ask your doctor about using an AeroChamber Plus™ spacer device. Always follow the spacer's specific instructions for use and cleaning.

Cleaning Instructions

Clean your inhaler once a week:

1. Remove protective cap by pulling away from inhaler
2. Wipe inside and outside of mouthpiece and actuator with clean, dry cloth
3. Replace mouthpiece cover
4. Do not remove canister from actuator
5. Do not use water or other liquids to clean

Dose Counter Information

The inhaler has a counter on the back that shows how many doses remain:

• Replace when counter shows 20
• Stop using when counter shows 0
• Take care not to drop the inhaler as this may affect the counter

Missed Dose Management

If you forget to use Fostair:

• Take it as soon as you remember
• If it's almost time for your next dose, skip the missed dose
• Continue with your regular dosing schedule
• Do not double the dose to make up for a forgotten one

Overdose Information

Formoterol Overdose Symptoms

• Nausea, vomiting
• Heart racing, palpitations
• Heart rhythm disturbances
• Headache, trembling
• Drowsiness
• Metabolic acidosis
• Low blood potassium
• High blood glucose

Beclometasone Overdose Effects

• Short-term adrenal gland problems
• May require blood tests to check cortisol levels

Management Protocol

If overdose is suspected:

1. Seek immediate medical attention
2. Your doctor may perform blood tests for potassium and glucose
3. Adrenal function may need monitoring
4. Symptomatic and supportive treatment will be provided

Fostair Side Effects

Common (affects less than 1 in 10 people)

• Fungal infections of mouth and throat
• Headache
• Hoarseness
• Sore throat
• Pneumonia (in COPD patients) - watch for fever, chills, increased mucus, worsened cough

Uncommon (affects less than 1 in 100 people)

• Fast heartbeat, heart rhythm disorders
• ECG changes
• Asthma attack
• Trembling, restlessness
• Dizziness, palpitations
• Flu symptoms
• Vaginal fungal infections
• Sinusitis, ear inflammation
• Reduced blood cortisol (COPD patients)
• Irregular heartbeat (COPD patients)

Rare (affects less than 1 in 1,000 people)

• Chest tightness
• Sensation of missed heartbeat
• Increased or decreased blood pressure

Very Rare (affects less than 1 in 10,000 people)

• Worsening of asthma
• Shortness of breath
• Adrenal suppression (with long-term high doses)
• Increased eye pressure (glaucoma)

Unknown Frequency

• Sleeping problems, depression, anxiety
• Restlessness, nervousness, irritability
• Blurred vision

Reporting Side Effects

If you experience any side effects, talk to your doctor, pharmacist or nurse. You can also report directly via the Yellow Card Scheme: Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in app stores.

How to Store Fostair

Temperature Requirements

• Single pack (120 doses): Do not use beyond 3 months from date of collection from pharmacy
• Double pack (2x120 doses): Before use - store in refrigerator (2-8°C); After first use - use within 3 months and store below 25°C
• Do not store above 25°C
• Do not freeze
• If exposed to severe cold, warm with hands for a few minutes before use

Safety Precautions

• Canister contains pressurised liquid - do not expose to temperatures above 50°C
• Do not pierce the canister
• Keep out of sight and reach of children

Disposal Protocols

Do not dispose of via wastewater or household waste. Return all used, partially used and unused inhalers to your pharmacist for proper disposal to help protect the environment.

Fostair Pack Information

What's in the Pack

• Pressurised solution in aluminium-coated canister with metering valve
• Polypropylene plastic actuator with protective cap
• Dose counter showing remaining puffs
• Pack contains one canister providing 120 actuations

Marketing Authorisation

• Holder: Chiesi Limited, 333 Styal Road, Manchester, M22 5LG, UK
• Manufacturer: Chiesi Farmaceutici S.p.A., Via San Leonardo 96, 43122 Parma, Italy

Environmental Information

Fostair contains fluorinated greenhouse gases (norflurane HFC-134a). Each inhaler contains 8.147g corresponding to 0.012 tonne CO2 equivalent. The CFC-free propellant has less damaging effect on the ozone layer compared to older inhalers.

Where Can I Buy Fostair Online in the UK