
What is Trelegy Ellipta?
Trelegy Ellipta is a prescription medication used for the long-term maintenance treatment of chronic obstructive pulmonary disease (COPD) and asthma in adults aged 18 and older who are not adequately controlled on other controller medications.
Trelegy Ellipta combines three active ingredients to help improve lung function and control symptoms.
Trelegy Ellipta is not a rescue inhaler and should not be used to relieve sudden breathing problems.
Trelegy Ellipta is not for children under 18, and studies have not established its safety in children. However, it provides an important treatment option for managing COPD and asthma effectively.
How Does Trelegy Ellipta Work?
Trelegy Ellipta combines three active ingredients: fluticasone furoate, umeclidinium, and vilanterol.
Each ingredient plays a unique role in treating COPD and asthma symptoms.
- Fluticasone Furoate is a corticosteroid that reduces inflammation in the airways. It helps prevent inflammation by blocking certain chemicals in the body, which can reduce swelling and irritation in the lungs. This action helps improve breathing and manage symptoms of COPD and asthma.
- Umeclidinium is an anticholinergic, which helps relax the muscles around the airways. By blocking specific receptors in the lungs, umeclidinium helps open the airways, making breathing easier.
- Vilanterol is a long-acting beta-agonist (LABA) that relaxes the muscles in the airways, allowing them to open up and improve airflow. This ingredient helps with breathing over a long period.
These ingredients control symptoms, reduce inflammation, and make breathing easier for individuals with COPD and asthma. However, Trelegy Ellipta does not relieve sudden breathing problems and should not replace a rescue inhaler.
Dosage Information and Usage
Dosage Form and Strengths of Trelegy Ellipta
Trelegy Ellipta is available in two strengths:
- 100/62.5/25 mcg per actuation: For some patients’ COPD treatment and asthma management.
- 200/62.5/25 mcg per actuation: For more severe asthma cases or patients requiring an increased dose.
Each inhaler contains 30 once-daily doses, each delivering a combination of fluticasone furoate, umeclidinium, and vilanterol.
Recommended Dosage for Maintenance Treatment of Chronic Obstructive Pulmonary Disease (COPD)
The recommended dosage of Trelegy Ellipta for the maintenance treatment of COPD is one inhalation of 100/62.5/25 mcg once daily.
It is important to take Trelegy Ellipta at the same time every day. If you experience shortness of breath between doses, use a short-acting beta2-agonist (like albuterol) for immediate relief.
Recommended Dosage for Maintenance Treatment of Asthma
For the maintenance treatment of asthma, the starting dosage of Trelegy Ellipta depends on the severity of your asthma and other factors like previous treatments:
- The starting dosage is Trelegy Ellipta 100/62.5/25 mcg once daily or 200/62.5/25 mcg once daily, as your healthcare provider prescribes.
- The highest recommended dosage is one inhalation of 200/62.5/25 mcg once daily. This strength is not approved for COPD.
- If you do not experience adequate relief with the 100/62.5/25 mcg dosage, your doctor may increase it to 200/62.5/25 mcg once daily. If this dosage does not adequately control your asthma, your doctor will evaluate your treatment plan and consider other options.
How to Use Trelegy Ellipta?
To use Trelegy Ellipta, follow these steps:
- Open the cover to prepare the dose. You should hear a click, signaling that the inhaler is ready. Do not open the inhaler until you are prepared to use it.
- Breathe out fully, away from the mouthpiece.
- Place the mouthpiece between your lips, ensuring a firm seal, and take a long, deep breath in. Do not block the air vent with your fingers.
- After inhaling, hold your breath for 3 to 4 seconds, then breathe out slowly.
- Slide the cover back over the mouthpiece.
- Rinse your mouth with water and spit it out to reduce the risk of side effects like thrush.
Storage Information
Store Trelegy Ellipta at room temperature, away from moisture and heat.
To protect the inhaler from humidity, keep it in its original packaging until you are ready to use it. Do not store the inhaler in the bathroom or any high-moisture areas.
Keep the inhaler out of children’s reach. Dispose of the inhaler after use, as each inhaler contains 30 blisters (or 14 for the institutional pack).
Check the expiration date on the package and avoid using the inhaler past that date.
Side Effects
Common side effects of Trelegy Ellipta include headaches, sore throats, and coughs. Severe side effects may involve serious reactions like pneumonia, eye problems, and allergies.
It is essential to monitor for any symptoms and consult with your doctor if they occur.
Common Side Effects
- Upper respiratory tract infections
- Sore throat and runny nose
- Bronchitis
- Constipation
- Headache
- Painful and frequent urination (signs of a urinary tract infection)
- Nausea, vomiting, and diarrhea
- Back pain
- Mouth and throat pain
- Hoarseness
- Flu-like symptoms
- Inflammation of the sinuses
- Taste disturbances
Severe Side Effects
- Fungal infection in mouth or throat (thrush)
- Increased mucus production or change in color
- Chills, fever, or coughing with increased breathing problems (signs of pneumonia)
- Sudden breathing problems immediately after inhalation
- Serious allergic reactions (rash, swelling, trouble breathing)
- Increased blood pressure, chest pain, fast or irregular heartbeat
- Eye problems, including glaucoma or cataracts
- Bone thinning or weakness (osteoporosis)
- Urinary retention (difficulty or painful urination)
- Adrenal insufficiency (fatigue, weakness, low blood pressure)
- Changes in blood values (high blood sugar, low potassium levels)
- Slowed growth in children
Warnings and Precautions
Trelegy Ellipta can cause serious health risks in some individuals, so it is important to be aware of specific warnings and precautions when using this medication.
It may increase the risk of asthma-related deaths, pneumonia, and other complications, such as eye problems and bone thinning.
Always follow your healthcare provider’s advice and monitor for any side effects.
- Increased Risk of Asthma-Related Deaths: Trelegy Ellipta contains vilanterol, which can increase the risk of asthma-related deaths, especially in children and adolescents.
- Deterioration in COPD: Do not use Trelegy Ellipta for sudden worsening of chronic obstructive pulmonary disease (COPD). It is not for acute bronchospasm.
- Interactions with Other Beta2-Agonists: Do not combine Trelegy Ellipta with other long-acting beta2-agonists like salmeterol or formoterol.
- Oral Candida Infection: Rinse your mouth after using Trelegy Ellipta to reduce the risk of mouth and throat infections (thrush).
- Acute Asthmatic Deterioration: Trelegy Ellipta should not be used for acute asthma attacks as it does not have immediate bronchodilator effects.
- Immunosuppression: Trelegy Ellipta can weaken the immune system, increasing the risk of infections like tuberculosis or chickenpox.
- Increased Risk of Pneumonia: People with COPD are at a higher risk of developing pneumonia while using Trelegy Ellipta.
- Adrenal Insufficiency: Switching from oral steroids to Trelegy Ellipta may cause adrenal insufficiency, a condition where your body can not produce enough steroid hormones.
- Bone Mineral Density Reduction: Long-term use may reduce bone density, raising the risk of fractures.
- Paradoxical Bronchospasm: Trelegy Ellipta can rarely cause sudden breathing problems. If this occurs, use a fast-acting inhaler and stop the Trelegy Ellipta.
- Eye Problems: Inhaled steroids can increase eye pressure, leading to conditions like glaucoma or cataracts.
- Eosinophilia and Churg-Strauss Syndrome: In rare cases, long-term use can increase a type of white blood cell (eosinophils) and trigger Churg-Strauss Syndrome, an inflammatory condition.
- Cardiovascular Risk: Trelegy Ellipta may affect heart rate and blood pressure, especially in people with heart disease.
- Urinary Retention: The anticholinergic effect of Trelegy Ellipta can cause difficulty urinating, especially in men.
- Special Populations: Use caution in pregnant or breastfeeding women and children under 18. Monitor patients with liver, kidney, or heart issues.
Drug Interactions With Other Medications
Trelegy Ellipta can interact with various medications, which may affect how the drug works or increase the risk of side effects.
It is important to be aware of potential drug interactions and discuss them with your healthcare provider before starting Trelegy Ellipta.
- Antifungals: Itraconazole, Ketoconazole, Voriconazole
- Antiretrovirals: Ritonavir, Atazanavir, Indinavir
- Antibiotics: Clarithromycin, Telithromycin
- Antidepressants: Nefazodone
- Other long-acting beta2-agonists
- Loop diuretics
- Non-selective beta-blockers (e.g., propranolol)
- Monoamine oxidase inhibitors
- Tricyclic antidepressants
- Anticholinergics
Alternative Medications
Suppose Trelegy Ellipta is unsuitable for you, or you are looking for other treatment options, several alternative medications may help manage chronic obstructive pulmonary disease (COPD) and asthma symptoms.
- Advair Diskus (fluticasone propionate, salmeterol)
- Dulera (mometasone furoate, formoterol fumarate)
- Breo Ellipta (fluticasone furoate, vilanterol)
- Anoro Ellipta (umeclidinium, vilanterol)
- Symbicort (budesonide, formoterol fumarate)
- Zenhale (Mometasone/formoterol)
Unlike Trelegy, most alternatives are dual-drug combinations (LABA/ICS or LABA/LAMA). Trelegy is the only once-daily triple therapy available as a single inhaler.
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