Alternatives to Perforomist If You Can't Fill Your Prescription

Perforomist (formoterol fumarate inhalation solution) is a critical maintenance medication for many COPD patients. But when it's not available at your pharmacy, you need to know your options. This guide covers the most clinically appropriate alternatives to Perforomist — but always discuss any medication change with your doctor before switching.

Important: Never Switch COPD Medications Without Your Doctor

COPD medications are highly individualized. What works for one patient may not work for another. Stopping Perforomist abruptly without a plan can cause your symptoms to worsen. Always call your prescriber before making any change — they can often facilitate a rapid switch with a phone or telehealth visit.

Closest Alternative: Brovana (Arformoterol)

Brovana (arformoterol tartrate) inhalation solution is the closest alternative to Perforomist. Like Perforomist, it is a nebulized long-acting beta-2 agonist (LABA) for twice-daily COPD maintenance. Arformoterol is actually the purified active enantiomer of formoterol, making these drugs closely related pharmacologically. Key points:

• Same delivery method (nebulizer), same dosing frequency (twice daily)
• Generic arformoterol is available and may cost less than brand Brovana
• Best for: Patients who need to remain on a nebulized LABA

Nebulized LAMA: Yupelri (Revefenacin)

Yupelri (revefenacin) is a once-daily nebulized long-acting muscarinic antagonist (LAMA) — a different drug class from Perforomist but equally important for COPD management. If you need to stay on a nebulizer but want to switch medication class, Yupelri is a strong option. It provides approximately 24 hours of bronchodilation with a single daily treatment.

• Once-daily dosing (vs. twice daily for Perforomist)
• Different mechanism of action (muscarinic antagonist vs. beta agonist)
• Best for: Patients who want to reduce treatment to once daily or switch drug classes

Inhaler LABAs: Serevent Diskus, Striverdi Respimat

If you're able to transition from a nebulizer to a handheld inhaler, there are several LABA inhalers available:

• Serevent Diskus (salmeterol): A twice-daily dry powder inhaler LABA. Generic salmeterol is available. Requires adequate inspiratory flow rate.
• Striverdi Respimat (olodaterol): A once-daily soft mist inhaler LABA. Easier to use than dry powder inhalers; doesn't require a high inspiratory flow.

Note: Not all COPD patients can use inhalers effectively. Patients with severe COPD, arthritis, or coordination issues may not be good candidates for handheld inhalers without training and assessment.

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LAMA Inhalers: Spiriva, Incruse Ellipta

If your COPD management plan needs a different approach altogether, your doctor may switch you to a LAMA inhaler like Spiriva (tiotropium) or Incruse Ellipta (umeclidinium). LAMAs work differently from LABAs but are a cornerstone of COPD management. Your provider will assess whether a LAMA alone or a LABA+LAMA combination is best for your disease stage.

Comparison Summary

• Need to stay on nebulizer + same drug class: Brovana (arformoterol)
• Need nebulizer + once daily: Yupelri (revefenacin)
• Can use inhaler + LABA: Serevent Diskus (salmeterol) or Striverdi Respimat (olodaterol)
• Looking for different drug class: Spiriva (tiotropium) or Incruse Ellipta (umeclidinium)

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Don't Give Up on Finding Perforomist First

Before switching medications, it's worth exhausting your options to find Perforomist in stock. See our guide on

how to find Perforomist in stock near you, or use

medfinder to have pharmacies near you checked for availability.