Degrees of COPD

Facts you should know

Doctors often discuss COPD in 3 different degrees of illness:

MILD

Mild airflow limitation in your lungs (which may not be noticeable)¹⁰
Breathlessness⁹
Chronic cough and mucus production^9,10
Fatigue⁹

MILD TO MODERATE

Narrowing of airways to the lungs; difficulty breathing¹⁰
Shortness of breath develops with brisk activity such as working hard or walking fast¹⁰

SEVERE

Extremely narrowed airways to the lungs⁷
Shortness of breath even with very little activity⁷
Wheezing and chest tightness⁷
Heart complications may develop¹⁰
Quality of life is negatively affected¹⁰
Worsening symptoms may be life threatening¹⁰

Seek emergency help¹¹

If your usual medications aren't working and...

You find that it is unusually hard to walk or talk (difficulty in completing a sentence)
Your heart is beating very fast or irregularly
Your lips or fingernails are turning gray or blue
Your breathing is fast and hard, even though you are using your medicine

Are there other conditions with some signs and symptoms of COPD?¹²

Yes. Asthma shares some signs and symptoms with COPD.

Please consult your physician for your diagnosis.

PERFOROMIST™ Solution is not indicated for asthma.

Congestive heart failure (CHF) can also have many of the same signs and symptoms of COPD. Doctors take steps to rule out CHF, including x-rays and spirometry.⁷

Please see full Prescribing Information, including Boxed Warning.

Approved Use

Maintenance Treatment of COPD. PERFOROMIST Inhalation Solution is approved for the long-term, twice-daily (morning and evening) use in the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.

Important Safety Information

WARNING: INCREASED RISK OF ASTHMA-RELATED DEATH

PERFOROMIST Inhalation Solution belongs to a class of medications known as long-acting beta₂-adrenergic agonists or LABAs. Long-acting beta₂-adrenergic agonists may increase the risk of asthma-related death. Data from a large placebo-controlled US study comparing the safety of another long-acting beta₂-adrenergic agonist (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol may apply to formoterol (a long-acting beta₂-adrenergic agonist), the active ingredient in PERFOROMIST Inhalation Solution. [See WARNINGS AND PRECAUTIONS.]

Important Limitations of Use

Deteriorating COPD

PERFOROMIST Inhalation Solution should not be used in patients with rapidly worsening COPD, which may be a life-threatening condition.

Asthma

PERFOROMIST Inhalation Solution is not indicated to treat asthma.

Warnings and Precautions

PERFOROMIST Inhalation Solution should not used for the relief of sudden symptoms, i.e., as rescue therapy for bronchospasm (wheezing or coughing). Sudden symptoms should be treated with a fast-acting rescue inhaler.

Excessive Use of PERFOROMIST Inhalation Solution and Use With Other Long-Acting Beta-Agonists PERFOROMIST Inhalation Solution should not be used more often, or at higher doses than recommended, or with other inhaled, long-acting beta₂-agonists, at the same time because of the risk of an overdose. Serious heart effects and fatalities have been reported with too high doses of inhaled adrenaline-like drugs.

Paradoxical Bronchospasm

As with other inhaled beta₂-agonists, PERFOROMIST Inhalation Solution can produce paradoxical bronchospasm (unexpected tightening of breathing tubes) that may be life threatening. If paradoxical bronchospasm occurs, PERFOROMIST Inhalation Solution should be immediately stopped and a different therapy started.

Cardiovascular Effects

PERFOROMIST Inhalation Solution, like other beta₂-agonists, can produce serious heart-related effects in some patients as measured by higher pulse rate and higher blood pressure.

PERFOROMIST Inhalation Solution should be used with caution in patients with heart disease, especially coronary insufficiency, cardiac arrhythmias, and high blood pressure; in patients with convulsive disorders or thyrotoxicosis; and in patients who are unusually responsive to adrenaline-like drugs.

Coexisting Conditions

PERFOROMIST Inhalation Solution, like other adrenaline-like drugs, should be used with caution in patients with convulsive disorders or thyrotoxicosis, and in patients who are unusually responsive to adrenaline-like drugs. Doses of the related beta₂-agonist albuterol, when administered intravenously, have been reported to worsen preexisting diabetes.

Drug Interactions

MAO Inhibitors, Tricyclic Antidepressants and QTc Prolonging Drugs

PERFOROMIST Inhalation Solution, like other beta₂-agonists, should be used with extreme caution in patients being treated with certain antidepressants (monoamine oxidase inhibitors, tricyclic antidepressants), or drugs known to prolong the QTc interval because the action of adrenergic agonists on the cardiovascular system may be increased by these agents.

Adverse Events

PERFOROMIST Inhalation Solution was studied in a 12-week, double-blind, placebo- and active-controlled trial (123 subjects treated with PERFOROMIST Inhalation Solution) and a 52-week, active-controlled trial (463 subjects treated with PERFOROMIST Inhalation Solution). The most common adverse events reported in patients taking PERFOROMIST Inhalation Solution, and occurring more frequently than in patients taking placebo, were diarrhea (5%), nausea (5%), nasopharyngitis (3%), dry mouth (3%), dizziness (2%), and insomnia (2%).

This Web site provides useful information about chronic obstructive pulmonary disease (COPD) and the maintenance treatment of COPD with PERFOROMIST (formoterol fumarate) Inhalation Solution. Please consult with your healthcare practitioner, who is your best source for diagnosing COPD and recommending appropriate treatment.

PERFOROMIST is a registered trademark of Dey, L.P. DEY^® is a registered trademark of Dey, L.P. U.S. Patent Nos. 6,814,953 and 6,667,344.