Fenoterol and Death from Asthma in New Zealand

This article reviews the epidemiological evidence that the use of fenoterol leads to an increased risk of death compared with other commonly used β-agonist drugs such as salbutamol, and that fenoterol was a causative factor in the second epidemic of asthma deaths in New Zealand. One of the features of this evidence is the consistency of the findings. In addition to evidence from three case-control studies in New Zealand and a recent study in Canada, the fenoterol hypothesis is also consistent with data on time trends in mortality and drugs sales, and with a large body of experimental evidence that fenoterol has relatively greater cardiac side effects, and that these may be hazardous in the situation of hypoxia.