FOSTER 100/6/MCG INHALER 120/DOSE @

Indications

Approved Uses

Asthma: regular (maintenance) treatment in adults and adolescents (≥12 years) where use of a combination (ICS/LABA) is appropriate (e.g., not adequately controlled on ICS alone or already stabilized on ICS+LABA). COPD: symptomatic treatment of severe COPD (typically FEV1 <50% predicted) with frequent exacerbations despite bronchodilator therapy.

Dosage & Administration

Dosing by Condition

Asthma (maintenance, adults/adolescents ≥12): typically 1 inhalation twice daily; some patients may require 2 inhalations twice daily (max 4 inhalations/day for maintenance-only regimens). COPD (adults): 2 inhalations twice daily (max 4 inhalations/day). MART/SMART: may be used only if specifically prescribed and supported by local labeling/guidelines; if used, follow the prescriber’s plan with a defined maximum total daily inhalations (commonly up to 8/day in some labels).

Initial Dose

1-2 inhalations (100/6 mcg per actuation) twice daily

Maintenance Dose

1-2 inhalations (100/6 mcg per actuation) twice daily

How to Take

Pressurised metered-dose inhaler (solution): Remove cap and check mouthpiece; shake well before each actuation. Breathe out gently away from the inhaler. Place mouthpiece in mouth with a good seal. Start to breathe in slowly and deeply through the mouth and press the canister once; continue inhaling to full inspiration. Hold breath about 5-10 seconds (or as long as comfortable), then breathe out slowly. If another puff is prescribed, wait ~30 seconds, shake again, and repeat. Replace cap. Rinse mouth/gargle and spit after use (especially with maintenance dosing) to reduce oral candidiasis/hoarseness. Use a spacer if coordination is difficult.

Side Effects

Common Side Effects

Common: oral candidiasis, dysphonia/hoarseness, throat irritation, cough, headache, nasopharyngitis. LABA-related: tremor, palpitations/tachycardia, muscle cramps; hypokalemia can occur especially with high doses or interacting drugs. In COPD patients: increased risk of pneumonia is a recognized class effect with ICS-containing regimens.

Safety & Warnings

Contraindications

Hypersensitivity to beclomethasone dipropionate, formoterol fumarate, or any excipients.

Age Restriction

Approved for adults and adolescents ≥12 years for asthma; adults for COPD.

Drug Interactions

Drug Interactions

Beta-blockers (may antagonize bronchodilation/trigger bronchospasm); strong CYP3A inhibitors (e.g., ritonavir/cobicistat/ketoconazole) may increase systemic corticosteroid effects; MAOIs/TCAs and other QT-prolonging drugs (additive arrhythmia risk); other sympathomimetics (additive cardiovascular effects); xanthines/diuretics/systemic steroids (additive hypokalemia risk).

Special Populations

Pregnancy

Consult Doctor

Breastfeeding

Consult Doctor

Liver Impairment

No specific dose adjustment recommended; use with caution as data are limited.

Storage & Patient Advice

Missed Dose

If you miss a dose, take it as soon as you remember unless it is close to the time of the next dose; then skip the missed dose and continue as scheduled. Do not take a double dose.

Patient Counseling

Use regularly as prescribed; it is not a substitute for a rapid-acting reliever for sudden severe symptoms unless you have been specifically instructed to use a MART/SMART regimen. Demonstrate correct pMDI technique (shake, slow deep inhalation with actuation, breath-hold) and consider a spacer if needed. Rinse/gargle and spit after use. Seek review if symptoms worsen, reliever use increases, or you develop paradoxical bronchospasm. Store per SFDA: refrigerated 2-8°C; follow local labeling for any allowed room-temperature period after dispensing.

Pharmacology

Mechanism of Action

Beclometasone dipropionate (ICS) reduces airway inflammation via glucocorticoid receptor-mediated suppression of inflammatory gene transcription and mediator release; formoterol fumarate (LABA) stimulates beta2-receptors in bronchial smooth muscle to increase cAMP and produce bronchodilation with rapid onset and long duration.

Onset of Action

Bronchodilation from formoterol begins within ~1-3 minutes; the full anti-inflammatory benefit of beclometasone develops over days to weeks (often ~2-4 weeks for maximal effect).

Duration of Effect

Approximately 12 hours per dose

Bioavailability

Not reliably stated as a single 'bioavailability' percentage for this product; systemic exposure depends on lung deposition and swallowed fraction with extensive first-pass metabolism (beclometasone is converted to active B-17-MP). Use qualitative description rather than fixed percentages unless citing the specific SmPC/label values.

Excretion

Beclometasone dipropionate (via active metabolite) is eliminated mainly in feces via biliary excretion after hepatic metabolism, with a smaller renal component. Formoterol is eliminated via metabolism with excretion of drug/metabolites in both urine and feces (urinary excretion is a major route).

Protein Binding

Beclomethasone-17-monopropionate: approximately 94-96%. Formoterol fumarate: approximately 61-64%

Product Information

Available Dosage Forms

Pressurised inhalation, solution (pMDI). (Other markets may also have an inhalation powder device such as NEXThaler, but the SFDA-verified product here is the pressurised solution.)

Composition per Dose

Each actuation delivers: 100mcg beclomethasone dipropionate and 6mcg formoterol fumarate dihydrate.

Symptom Target

Wheeze, Dyspnea, Bronchoconstriction

Sedating

No

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 23-08-2026