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| AHFS/Drugs.com | Micromedex Detailed Consumer Information |
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| Routes of administration | Inhalation |
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| Eliminationhalf-life | ~6.5 hours[1][2][3][4] |
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| ECHA InfoCard | 100.205.960 |
| Chemical and physical data | |
| Formula | C17H21NO4 |
| Molar mass | 303.358 g·mol−1 |
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Fenoterol is aβ2-adrenergic receptor agonist andbronchodilator medication used in the treatment ofasthma.
Fenoterol is produced and sold byBoehringer Ingelheim as Berotec N and in combination withipratropium as Berodual N.
It was patented in 1962 and came into medical use in 1971,[5] but in the 1980s concerns emerged about its safety and its use being associated with an increased risk of death.
Fenoterol is a short-actingβ2 agonist that also stimulatesβ1 receptors. Fenoterol has more cardiovascular toxicity than isoprenaline or salbutamol.[6][7] Fenoterol was widely used inNew Zealand in the late 1970s and the 1980s until it was removed from the New Zealand drug tariff in 1989 because its introduction and widespread use was associated with an epidemic of asthma deaths.[8] A series of case-control studies demonstrated that asthmatics using fenoterol were more likely to die of asthma compared with controls treated with alternative beta agonists; this risk of asthma deaths was particularly high in severe asthmatics.[9][10] The mortality rate declined following withdrawal of fenoterol[11] without evidence supporting an alternative explanation for the abrupt rise and fall in asthma deaths.[12] Data did not supportconfounding by severity as the explanation for theexcess mortality.[13] There are alternative short-acting beta agonists that have not been associated with increased mortality (e.g.salbutamol [albuterol]).[citation needed]
5-(1-Hydroxy-2-{[2-(4-hydroxyphenyl)-1-methylethyl]amino}ethyl)benzene-1,3-diol is a molecule with two different stereogenic centers. Thus, fourstereoisomers may exist, the (R,R)-, (R,S)-, (S,R)- and (S,S)-stereoisomers (see the figure below). Fenoterol is aracemate of the (R,R)- and the (S,S)-enantiomers. This racemate is 9 to 20 times more effective, as compared to the racemate of the (R,S)- and (S,R)-enantiomers.[14]
