Comprehensive medication guide to Perforomist including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$100 copay depending on plan tier; generic formoterol fumarate is often Tier 1–2 on commercial plans. Brand Perforomist may be Tier 3–4 with prior authorization required on some plans.
Estimated Cash Pricing
$865–$1,484 retail for brand Perforomist; as low as $92–$99 per month for generic formoterol fumarate with a GoodRx coupon for a 30-day supply (60 vials).
Medfinder Findability Score
45/100
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Perforomist is the brand name for formoterol fumarate inhalation solution — a long-acting beta-2 adrenergic agonist (LABA) delivered through a standard jet nebulizer. It is FDA-approved for the long-term, twice-daily maintenance treatment of bronchoconstriction in adults with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.
Perforomist is available as 20 mcg/2 mL unit-dose vials. Each vial contains a sterile, clear, colorless solution that is administered by inhaling the nebulized mist through a mouthpiece twice daily — morning and evening. A generic formoterol fumarate inhalation solution is also available.
Important: Perforomist is not a rescue medication. It does not work fast enough to relieve sudden breathing attacks. Always keep a short-acting bronchodilator (like albuterol) on hand for acute symptoms.
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Perforomist belongs to the class of drugs known as long-acting beta-2 adrenergic agonists (LABAs). Formoterol works by selectively binding to beta-2 adrenergic receptors located on the smooth muscle cells surrounding the airways in the lungs. This binding triggers a cellular cascade — via adenylyl cyclase activation and increased cyclic AMP — that causes the smooth muscle to relax.
When airway smooth muscle relaxes, the airways widen (bronchodilation), allowing air to flow more freely in and out of the lungs. This reduces the symptoms of COPD: shortness of breath, wheezing, chest tightness, and coughing. Perforomist begins working within 5–15 minutes of nebulization and provides bronchodilation for approximately 12 hours per dose — which is why it is taken twice daily.
Unlike inhaled corticosteroids, Perforomist does not reduce airway inflammation. It is a bronchodilator that works mechanically by relaxing muscle. For patients with significant airway inflammation, their doctor may prescribe an inhaled corticosteroid in addition to a LABA like Perforomist.
20 mcg/2 mL — inhalation solution (unit-dose vial)
One 20 mcg unit-dose vial inhaled via standard jet nebulizer twice daily (morning and evening). Maximum daily dose: 40 mcg (2 vials).
Perforomist is moderately difficult to find at retail pharmacies. While it is not on the FDA's official Drug Shortage List in 2026, many retail pharmacies do not stock it regularly. The reasons are structural: Perforomist requires refrigeration, serves a smaller patient population than most medications, and carries a high list price ($865–$1,484 per month) that drives insurance formulary steering toward alternatives.
Specialty pharmacies, hospital outpatient pharmacies, and mail-order pharmacies are the most reliable sources for Perforomist. Generic formoterol fumarate inhalation solution is also available from multiple manufacturers and is more widely stocked.
If you're struggling to find Perforomist at your local pharmacy,
medfinder calls pharmacies near you to find which ones have it in stock and texts you the results — saving you hours of phone calls.
Perforomist is not a controlled substance and has no DEA scheduling restrictions. Any licensed prescriber can write a prescription for Perforomist in the context of COPD management. The most common prescribers include:
Telehealth options are available for COPD management and Perforomist prescription renewal in most states. Platforms like Teladoc and MDLive can connect patients with licensed providers. Some telehealth services may require a prior COPD diagnosis or spirometry results before prescribing nebulized maintenance therapy.
No. Perforomist (formoterol fumarate) is not a controlled substance. It has no DEA schedule, meaning there are no special DEA-related prescribing restrictions, no limits on the number of refills beyond standard state laws, and no requirement for written prescriptions in states that allow electronic prescribing.
Any licensed prescriber — including physicians, nurse practitioners, and physician assistants — can prescribe Perforomist without DEA-specific additional authorization. Prescriptions can be called in, faxed, or sent electronically. Standard prescription rules apply, including the requirement for a valid patient-prescriber relationship and appropriate clinical indication (COPD).
The following are common side effects reported in clinical trials (occurring in ≥2% of patients):
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Brovana (arformoterol)
Closest nebulized LABA alternative; arformoterol 15 mcg twice daily via nebulizer. Arformoterol is the purified active enantiomer of formoterol. Generic arformoterol available.
Yupelri (revefenacin)
Once-daily nebulized LAMA (different mechanism). Revefenacin 175 mcg/3 mL once daily. Provides ~24 hours of bronchodilation.
Serevent Diskus (salmeterol)
Twice-daily dry powder inhaler LABA. Requires adequate inspiratory flow. Generic salmeterol available.
Striverdi Respimat (olodaterol)
Once-daily soft mist inhaler LABA. Easier to use than DPIs — no high inspiratory flow needed.
Spiriva (tiotropium)
Once-daily LAMA inhaler. Different mechanism (anticholinergic). Often combined with a LABA for dual bronchodilation.
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MAO Inhibitors (phenelzine, tranylcypromine, selegiline)
majorCan dramatically potentiate cardiovascular effects of formoterol. Avoid concurrent use; allow ≥14 days washout.
Tricyclic Antidepressants (amitriptyline, nortriptyline, imipramine)
majorPotentiate cardiovascular effects and prolong QTc interval. Use with extreme caution; cardiac monitoring may be warranted.
QTc-Prolonging Drugs (amiodarone, azithromycin, haloperidol, methadone)
majorCombined QTc prolongation increases risk of torsades de pointes and fatal arrhythmias. Avoid or monitor closely.
Beta-Blockers (metoprolol, atenolol, propranolol, carvedilol)
majorDirectly antagonize bronchodilating effects and can cause severe bronchospasm in COPD. Generally contraindicated; use cardioselective agents with caution if medically necessary.
Loop and Thiazide Diuretics (furosemide, hydrochlorothiazide)
moderateCompound hypokalemia risk from formoterol. Monitor potassium levels.
Other LABAs (arformoterol, salmeterol, olodaterol)
majorDo not combine. Using two LABAs provides no benefit and significantly increases cardiovascular risk.
Sympathomimetics (pseudoephedrine, amphetamines)
moderateAdditive cardiovascular stimulant effects. Use with caution; avoid OTC decongestants with sympathomimetic agents.
Perforomist (formoterol fumarate inhalation solution) is a clinically effective, FDA-approved nebulized LABA for COPD maintenance. For patients who cannot use handheld inhalers effectively — due to severe COPD, poor coordination, or other factors — it provides a reliable twice-daily delivery method that keeps airways open and reduces exacerbation risk.
Its main challenges are cost (up to $1,484/month brand retail) and pharmacy availability. Both are manageable: generic formoterol fumarate costs as little as $92–$99/month with coupons, and patient assistance programs are available through Viatris and the PAN Foundation. For pharmacy access, specialty and mail-order pharmacies are the most reliable sources.
If you're struggling to find Perforomist at your pharmacy,
medfinder calls pharmacies near you to check which ones have it in stock and texts you the results — so you can focus on your health, not your pharmacy search.
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