How Does Anoro Ellipta Work?
ANORO ELLIPTA is a combination anticholinergic and long-acting beta2-adrenergic agonist that is breathed into the lungs using an inhaler. The anticholinergic, umeclidinium, blocks the action of acetylcholine on muscarinic receptors in the lung, causing the smooth muscle in the lung to relax and the bronchi to open. The long-acting beta2-adrenergic agonist, vilanterol, stimulates the beta2 receptors in the lung, causing prolonged dilatation of smooth muscle in the lung bronchi.
WHAT ARE THE INDICATIONS FOR ANORO ELLIPTA?
ANORO ELLIPTA is indicated for the long-term treatment of chronic obstructive pulmonary disease. It works to prevent and control shortness of breath and wheezing caused by chronic obstructive pulmonary disease and is used to regain disease control. It must be used regularly (for at least two weeks) before any effect is seen.
WHAT IS THE DOSE OF ANORO ELLIPTA?
The dose of ANORO ELLIPTA for the treatment of chronic obstructive pulmonary disease is one inhalation of the umeclidinium 62.5 mcg and vilanterol 25 mcg combination, taken once a day.
Warnings & Precautions
Increased risk of asthma-related deaths
ANORO ELLIPTA contains vilanterol, a long-acting beta2-agonist. Studies have shown that these agonists increase the risk of asthma-related deaths. Data suggest that the use of long-acting beta2-agonists in pediatrics and adolescents increases the risk of hospitalization.
Acute asthmatic/chronic obstructive pulmonary disease deterioration
ANORO ELLIPTA should not be used for the management of acute asthmatic deterioration. It has no intrinsic bronchodilatory effects. Therefore, using it during an acute asthmatic deterioration will not help relieve any symptoms. It should also not be used in patients having an acute exacerbation of their chronic obstructive pulmonary disease.
Risk of worsening airway obstruction
Some patients may experience a paradoxical worsening of their bronchospasm when starting ANORO ELLIPTA. Should this happen, treatment with ANORO ELLIPTA should be stopped, and an alternative therapy started.
ANORO ELLIPTA interacting with other long-acting beta2-agonists
ANORO ELLIPTA should not be used at higher doses or more often than recommended. Care should not be taken not to use ANORO ELLIPTA in conjunction with medicines containing other long-acting beta2-agonists (salmeterol, formoterol, fumarate, arformoterol tartrate, indacaterol) as this may result in an overdose.
Cardiovascular disease risk
Vilanterol may stimulate beta-adrenergic receptors in the heart and cause elevations in heart rate. In patients with heart disease, this may exacerbate their symptoms.
TRELEGY ELLIPTA should be used with care in patients with a history of seizures, diabetes mellitus, ketoacidosis, or thyrotoxicosis. Patients should also be monitored for the development of hyperglycemia and hypokalemia.
Exacerbation of urinary retention
In patients with a history of urinary retention, ANORO ELLIPTA should be used with caution. Monitor patients carefully for signs of retention, including painful urination or difficulty passing urine. This risk is significantly greater in patients with bladder-neck obstruction or prostatic hyperplasia.
ANORO ELLIPTA increases the risk of complications from narrow-angle glaucoma. Therefore, it should be used with caution in patients who have been or who are on treatment for glaucoma. Providers and patients should be vigilant for signs or symptoms of glaucoma. These include eye pain, eye discomfort, blurring of vision, visual halos, red eyes, corneal edema, and conjunctival congestion. If any of these signs or symptoms develop, the patient should urgently seek assistance from a healthcare provider.
ANORO ELLIPTA metabolism is not significantly affected by hepatic impairment.
There are no significant increases in umeclidinium or vilanterol blood levels in patients with severe renal dysfunction. No dose adjustments are therefore required in this population.
ANORO ELLIPTA has not been tested in persons under the age of 18 years. As a result, its use is not recommended in this age group.
ANORO ELLIPTA has not been extensively studied in pregnant women. However, some studies have shown that its use does not increase the risk of birth abnormalities.
The safety of ANORO ELLIPTA has not been tested in breastfeeding mothers. Therefore, the risk to the infant should be weighed up against the benefit for the mother. This should be discussed with a doctor.
Use in the elderly
Data suggest that no dosage adjustments are required when prescribing ANORO ELLIPTA for elderly patients.
ANORO ELLIPTA is contraindicated in patients with a hypersensitivity to milk proteins, umeclidinium, or vilanterol.
ANORO ELLIPTA is contraindicated in patients with status asthmaticus or acute exacerbations of chronic obstructive pulmonary disease who may be requiring intensive management measures.
Common side effects of ANORO ELLIPTA include:
- Sore throat
- Chest infections
- Joint pain
- Muscle pain
- Tooth pain
- Stomach pain
- Skin bruising
- Fast or irregular heartbeat
Less common side effects include:
- Difficulty passing urine
- Inability to pass urine
- Glaucoma (eye pain, visual changes, eye redness)
Certain drugs may interact with ANORO ELLIPTA. These include:
- Monoamine oxidase inhibitors
- Tricyclic antidepressants