Description
How it works
Fostair combines two medicines in one inhaler:
- Beclometasone dipropionate – an inhaled corticosteroid (ICS) that:
- Reduces inflammation and swelling in the airways
- Decreases mucus production
- Makes the airways less sensitive to triggers like pollen, cold air, exercise or infections
- Formoterol fumarate – a long-acting beta₂ agonist (LABA) that:
- Relaxes the muscles around the airways
- Opens up the breathing tubes (bronchodilation) for around 12 hours
- Makes it easier to breathe and helps prevent symptoms coming back
Because it contains both an anti-inflammatory steroid and a long-acting bronchodilator, Fostair:
- Improves day-to-day control of asthma or COPD symptoms
- Reduces wheezing, shortness of breath, chest tightness and cough
- Lowers the risk of flare-ups / exacerbations
It is used regularly every day, and in some patients it can also be used as a reliever inhaler (maintenance and reliever therapy). It does not replace a fast-acting bronchodilator in all patients – follow the plan agreed with your prescriber.
Who it may be suitable for
Fostair 100/6 can be used in adults (18+ years) for:
Asthma
Regular treatment of asthma in adults when a combination inhaler (ICS + LABA) is appropriate, for example:
- Asthma not adequately controlled with an inhaled steroid plus a separate “as-needed” short-acting reliever, or
- Asthma already controlled on separate inhaled steroid and long-acting bronchodilator and switching to a single combination inhaler is preferred
It can be prescribed as:
- Maintenance therapy – taken every day with a separate reliever inhaler
- Maintenance and reliever therapy (MART) – taken every day and as needed for symptoms, using the same inhaler for both roles
COPD (Chronic Obstructive Pulmonary Disease)
Fostair may be used for the symptomatic treatment of adults with severe COPD who:
- Have FEV₁ < 50% predicted
- Have a history of repeated exacerbations
- Still have significant symptoms despite regular long-acting bronchodilators
Who should not use Fostair
Do not use Fostair if you:
- Are allergic to beclometasone, formoterol or any of the other ingredients
- Have had a serious allergic reaction to a similar inhaler in the past
Use with extra care – speak to a doctor first if you have:
- Heart problems, including heart disease, previous heart attack, heart failure or
- Irregular heartbeats, fast or abnormal pulse, or known abnormal ECG
- High blood pressure or narrowed arteries (arteriosclerosis)
- An aneurysm (bulging blood vessel)
- Overactive thyroid (hyperthyroidism)
- Low potassium levels (hypokalaemia) or take medicines that can lower potassium
- Liver or kidney disease
- Diabetes – formoterol may raise blood sugar; extra monitoring may be needed
- Tumour of the adrenal gland (phaeochromocytoma)
- Tuberculosis (TB), current or past, or other chronic lung infections
- A history of pneumonia or frequent chest infections (especially in COPD)
- Been using steroid tablets long term and are now switching to Fostair
Fostair is not intended for children or adolescents under 18 years.
Pregnancy and breastfeeding:
- Use only if a clinician decides that the benefits outweigh potential risks.
- Always mention if you are pregnant, planning pregnancy or breastfeeding.
Side Effects
Not everyone gets side effects. Many are mild and improve as your body adjusts.
Common local side effects:
- Thrush (oral candidiasis) in the mouth or throat – white patches, soreness
- Hoarse voice, voice changes, throat irritation
- Cough or throat discomfort after inhaling
- Mild headache
These are more likely at higher doses or if you do not rinse your mouth after using the inhaler.
Other common or recognised side effects:
- Palpitations, awareness of heartbeat
- Fast heart rate (tachycardia)
- Tremor (shakiness)
- Nervousness or restlessness
- Muscle cramps
- Mild chest tightness
- Raised blood sugar (especially in people with diabetes)
- Sinusitis, sore throat or chest infections – particularly in COPD
Less common or rare side effects (see a doctor promptly):
- Marked fall in blood potassium levels – may cause muscle weakness, cramps or irregular heartbeat
- Dizziness, fainting, or blood pressure changes
- Allergic reactions – rash, itching, redness, swelling of the face, lips or eyelids
Serious side effects – stop Fostair and seek urgent medical help if:
- You develop sudden worsening wheeze or breathlessness immediately after using the inhaler (possible paradoxical bronchospasm)
- You have chest pain, severe shortness of breath, or irregular / very fast heartbeat
- You notice swelling of the face, lips, tongue or throat, difficulty breathing or swallowing
- You develop signs of pneumonia (more common in COPD): increased cough, change in sputum colour, fever, or difficulty breathing
- You experience symptoms of adrenal suppression or steroid effects at high dose / long-term use, such as:
- Severe tiredness, weakness, low blood pressure
- Weight gain, rounded face, or Cushing-like appearance
- Mood or behaviour changes, depression or agitation
- Eye problems (blurred vision, cataracts, glaucoma)
If you have any unusual or persistent symptoms, speak to a clinician.
Patient Information Leaflet
Please see HERE for the Patient Information Leaflet
Additional Info
Key points about Fostair 100/6:
- Active ingredients:
- Beclometasone dipropionate 100 micrograms
- Formoterol fumarate dihydrate 6 micrograms
per actuation (metered dose; delivered dose slightly lower at the mouthpiece)
- Type of medicine: Combination inhaled corticosteroid + long-acting beta₂ agonist (ICS/LABA)
- Use: Regular treatment of asthma in adults and symptomatic treatment of severe COPD in adults
- Age group: Adults 18 years and over
- Particle size: Beclometasone is in an extrafine formulation, so 100 micrograms in Fostair ≈ 250 micrograms of standard non-extrafine beclometasone; doses are therefore lower than some older ICS inhalers for similar effect
- Not for initial asthma management or acute attacks – a reliever plan is still needed
- Not a rescue option for everyone – MART must only be used if specifically prescribed
Important interactions / cautions (not a full list):
Tell your doctor or pharmacist if you take:
- Other beta₂ agonists or anticholinergic bronchodilators
- Beta-blockers (including eye drops for glaucoma) – may reduce effect of formoterol
- Medicines that can lower potassium (e.g. some diuretics, xanthines like theophylline, high-dose steroids) – together with formoterol these can increase risk of hypokalaemia
- MAOIs, tricyclic antidepressants or other drugs that can affect the heart rhythm or prolong the QT interval
- Certain antiviral / antifungal / HIV medicines that affect liver enzymes (e.g. ritonavir, cobicistat, ketoconazole) – may increase steroid or LABA levels
- Other steroid medicines (tablets, injections, creams, nasal sprays)
Always show your inhaler to any healthcare professional who is treating you.
Directions
Use exactly as prescribed. Your doctor or nurse should give you a clear plan – including whether you:
- Use Fostair as maintenance only (with a separate reliever), or
- Use it for maintenance and reliever therapy (MART)
Fostair is for inhalation through the mouth only.
Usual adult doses – Asthma
There are two approaches:
1. Maintenance therapy (plus separate reliever inhaler)
- Dose:
- 1 or 2 inhalations twice daily (morning and evening)
- Maximum daily dose:
- 4 inhalations per day
You must carry your separate fast-acting reliever inhaler (usually a blue inhaler) for sudden symptoms.
2. Maintenance and reliever therapy (MART)
In this approach, you use Fostair both as your daily preventer and as your reliever.
- Maintenance dose:
- 1 inhalation twice daily (morning and evening)
- Reliever dose:
- 1 additional inhalation as needed in response to symptoms
- If symptoms return or persist after a few minutes, you may take a second inhalation
- Maximum daily dose:
- 8 inhalations per day in total (maintenance + reliever)
If you need frequent extra doses (e.g. most days), you should see a doctor – your asthma may not be well controlled and your treatment may need adjusting.
Adult doses – COPD
For severe COPD in adults:
- 2 inhalations twice daily (morning and evening)
No MART regimen is used in COPD – this is maintenance therapy only, and you may still need a separate reliever inhaler.
How to use Fostair NEXThaler (dry powder inhaler)
NEXThaler is a breath-operated inhaler – it releases a dose when you breathe in quickly and deeply through the mouthpiece.
Basic steps:
- Open
- Hold the inhaler upright
- Open the cover fully until you hear a click – this loads a dose
- Breathe out
- Breathe out gently, away from the inhaler
- Do not breathe into the device
- Inhale
- Place the mouthpiece between your lips and close your lips firmly around it
- Breathe in strongly and deeply through your mouth
- You may feel or taste the powder – this is normal
- Hold your breath
- Remove the inhaler and hold your breath for about 5–10 seconds, then breathe out slowly
- Close
- Close the cover fully after each inhalation
Dose counter:
- The window shows how many doses are left; it counts down as you inhale doses.
- If you open then close the device without inhaling, the dose is returned to the reservoir and not lost.
After each dose, rinse your mouth, gargle with water and spit out, or brush your teeth to reduce the risk of thrush and hoarseness.
How to use Fostair pressurised inhalation solution (pMDI)
This is a press-and-breathe metered-dose inhaler. Using a spacer may help if you struggle with timing or are prone to side effects in the mouth/throat.
Before first use, or if not used for several days:
- Remove the mouthpiece cover
- Shake gently if instructed
- Release two test sprays into the air
To take a dose (without spacer):
- Sit or stand upright. Remove the mouthpiece cover and check it’s clean.
- Breathe out gently as far as is comfortable.
- Place the mouthpiece between your lips and close your lips around it.
- Start to breathe in slowly and deeply through your mouth.
- As you begin to breathe in, press down once on the canister to release a puff.
- Continue to breathe in steadily to fully fill your lungs.
- Remove the inhaler and hold your breath for 5–10 seconds, then breathe out slowly.
- If a second puff is needed, wait around 30 seconds and repeat.
Using a spacer:
- Attach the inhaler to the spacer
- Spray one puff into the spacer
- Breathe in slowly and deeply, or take several normal breaths from the spacer mouthpiece as per the spacer instructions
After use, rinse your mouth and spit, or brush your teeth.
Missed a dose?
- If you forget a regular dose, take it as soon as you remember unless it’s almost time for your next scheduled dose
- If it’s nearly time for the next dose, skip the missed dose and take the next one at the usual time
- Do not take a double dose to make up for a forgotten dose
For MART (maintenance and reliever therapy):
- If you forget a scheduled maintenance dose, take it when you remember and continue as normal
- You can still use as-needed doses for symptoms within the maximum total of 8 inhalations per day
Do not stop using Fostair suddenly, especially if you have been on high doses or previous steroid tablets. Your doctor will normally reduce the dose gradually if treatment needs to be changed or stopped.
FAQs
What is Fostair used for?
Fostair is a combination preventer inhaler for adults with asthma or severe COPD. It helps control day-to-day symptoms (wheeze, breathlessness, cough, chest tightness) and reduce flare-ups. In some asthma patients, it may also be used as a reliever inhaler as part of a maintenance and reliever regimen.
Is Fostair a reliever or preventer inhaler?
It is mainly a preventer inhaler. For many people, it is used only as maintenance alongside a separate fast-acting reliever. Some adults may be prescribed Fostair under a MART plan, where it is used both daily and as-needed. Your asthma action plan should clearly state how to use it.
How quickly does Fostair work?
The formoterol component starts working within a few minutes, giving rapid bronchodilation. The steroid (beclometasone) works more slowly over days to weeks to reduce underlying inflammation. For asthma control, it is important to use Fostair every day, even when you feel well.
Can I use Fostair if I already use another steroid inhaler?
Usually Fostair replaces your previous steroid inhaler and long-acting bronchodilator. Do not use multiple preventer inhalers together unless specifically told to do so by a doctor, as this may increase the risk of side effects.
Why is my dose of beclometasone “lower” than my old inhaler?
The beclometasone in Fostair is extrafine, so it reaches deeper into the lungs and is more potent per microgram. Roughly, 100 micrograms in Fostair ≈ 250 micrograms in some older non-extrafine products, so your prescribed dose may look lower but give similar or better effect.
Do I still need a blue reliever inhaler?
If you are on maintenance therapy only, yes – you should carry your reliever inhaler at all times. If you are on a MART regimen, your doctor may tell you to use Fostair itself as both maintenance and reliever, you should follow your written asthma plan and ask if anything is unclear.
Can I drink alcohol while taking Fostair?
Both devices contain only tiny amounts of ethanol (alcohol), too small to have noticeable effects in most people. Moderate drinking is usually fine unless you’ve been advised otherwise for another medical reason.
Can I share my Fostair inhaler with someone else who has asthma?
No. Fostair is prescribed individually based on your condition and dose needs. Sharing inhalers is unsafe and unhygienic.
What should I do if my breathing gets worse while using Fostair?
Seek medical advice promptly if: you need your reliever (or MART extra doses) more often, your symptoms are worse at night or on waking, you notice you’re using more than the maximum allowed daily doses, your peak flow readings are falling. Get urgent help if your reliever is not helping, you are struggling to speak in full sentences, or you feel very breathless or sleepy – this may be a severe attack.
How long can I stay on Fostair?
Many adults use combination inhalers long term. The key is to: use the lowest effective dose, have regular reviews (at least once a year, more often if unstable), adjust treatment according to how well your asthma or COPD is controlled. Your clinician will review your symptoms, inhaler technique and side effects to decide whether to continue, reduce or change your therapy.
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