Managing respiratory conditions like chronic obstructive pulmonary disease (COPD) and asthma poses a substantial healthcare challenge in the US. In 2016 alone, asthma and COPD accounted for staggering costs of $35.5 billion and $34.3 billion, respectively.

This financial strain is exacerbated by the sheer number of individuals affected, with 11.7 million people reporting a diagnosis of COPD, chronic bronchitis, or emphysema in 2022.

In the face of these challenges, choosing the right treatment is crucial. Trelegy Ellipta and Advair stand out as top choices for COPD and asthma management. By understanding how they differ and how well they work, people can choose the best option for their health, gaining more control over their breathing.

Key Differences Between Advair and Trelegy Ellipta Medications

ParametersAdvairTrelegy Ellipta
Cost$165 to $255$700 to $870
Prescription RequirementPrescription-onlyPrescription-only
Generic AvailabilityAvailableNot available
Drug ClassInhaled corticosteroid (ICS) and long-acting beta2-adrenergic agonist (LABA) combinationInhaled corticosteroid (ICS), long-acting muscarinic antagonist (LAMA), and long-acting beta2-adrenergic agonist (LABA) combination
UsageMaintenance medicationMaintenance medication
FormsHFA inhaler and diskus inhalerDiskus inhaler
Route of AdministrationOrally inhaledOrally inhaled
Dosage1-2 inhalation twice daily1 inhalation once daily
IndicationsAsthma, COPDAsthma, COPD
Side effectsUpper respiratory tract infection, throat irritation, hoarseness and voice changes, headache, dizziness, nausea and vomitingPharyngitis/nasopharyngitis, upper respiratory tract infection/viral upper respiratory tract infection, bronchitis, sinusitis/acute sinusitis, urinary tract infection, rhinitis, influenza, headache, and back pain.
Duration of ActionLong-acting drugLong-acting drug

Approved Indications

What is Advair used for?

Advair is a prescription drug primarily used to manage chronic obstructive pulmonary disease (COPD), asthma, and other respiratory conditions, including chronic bronchitis and emphysema. It combines two active ingredients – fluticasone propionate and salmeterol. Additionally, Advair comes in two forms, the Advair Diskus Inhaler and the Advair HFA Inhaler.

Specifically, Advair is prescribed for the following:

Advair Diskus

  • treatment of asthma in patients aged four years and older
  • maintenance treatment of COPD in adults

Advair HFA

  • treatment of asthma in adults and children ages 12 years and older

Note that Advair HFA is not approved for the treatment of COPD.

Advair falls under the drug class of inhaled corticosteroid and long-acting beta2-adrenergic agonist (LABA) combination. This class of drugs is specifically designed to address both the inflammation and the airway constriction seen in conditions like bronchitis and asthma.

What is Trelegy Ellipta used for?

Trelegy Ellipta is a maintenance medication prescribed for COPD and asthma in patients aged 18 years and older. It’s a combination inhaler that contains three active ingredients – fluticasone furoate, umeclidinium, and vilanterol. It’s the first and only once-daily, 3-in-1 treatment for COPD, including chronic bronchitis, emphysema, or both.

Trelegy falls under the drug class of inhaled corticosteroid, long-acting muscarinic antagonist (LAMA), and long-acting beta2-adrenergic agonist (LABA) combination.

Mechanism of Action

How does Advair work?

Woman using an Advair Asthma Inhalor

Fluticasone, the corticosteroid component of Advair, reduces inflammation in the airways. In conditions like bronchitis and asthma, inflammation causes symptoms like wheezing, coughing, and shortness of breath. Fluticasone helps alleviate these symptoms and prevent flare-ups.

Salmeterol, the other component of Advair, is a bronchodilator. This means it helps to relax the muscles around the airways, making breathing easier. Unlike short-acting bronchodilators, which are used for quick relief during asthma attacks (commonly referred to as rescue inhalers), salmeterol provides long-lasting relief by keeping the airways open for an extended period of time.

So, is Advair a rescue inhaler? No, it’s not. While it contains a bronchodilator, it’s not intended for immediate relief during an asthma attack. Instead, it’s used as a maintenance medication to prevent symptoms and exacerbations over the long term.

How does Trelegy Ellipta work?

Is Trelegy a steroid? Yes, it contains a corticosteroid (fluticasone furoate) and functions similarly to fluticasone in Advair. It reduces inflammation in the airways, alleviating symptoms such as coughing, shortness of breath, and wheezing.

The unique component in Trelegy, umeclidinium, is an anticholinergic bronchodilator. It works by relaxing the muscles around the airways, which helps to open them up and make breathing easier. This component helps to reduce airway constriction and improve airflow in individuals with COPD.

Vilanterol is a long-acting beta2-adrenergic agonist bronchodilator, similar to salmeterol in Advair. It works by stimulating receptors in the airway muscles, leading to relaxation and widening of the airways. This helps to further improve airflow and relieve symptoms of COPD.

Like Advair, Trelegy Ellipta is not designed to relieve acute symptoms rapidly and should not be used as a rescue inhaler. However, unlike Advair, which combines a corticosteroid with a LABA, Trelegy combines a corticosteroid with an anticholinergic bronchodilator and a LABA.

Woman using an asthma inhalor

Dosage Forms and Administration

How to use Advair Inhaler?

Advair HFA is an aerosol inhaler utilizing a propellant to deliver medication to the lungs. In contrast, Advair Diskus is a powder inhaler that relies on the user’s inhalation to disperse the medication without a propellant.

1. Here’s a video on how to use Advair HFA inhaler:

2. Here’s a video on how to use Advair Diskus inhaler:

Advair Dosage

Advair is available in various strengths:

Advair HFA:

  • 45/21: 45 mcg fluticasone propionate/21 mcg salmeterol
  • 115/21: 115 mg fluticasone propionate/21 mcg salmeterol
  • 230/21: 230 mg fluticasone propionate/21 mcg salmeterol

Advair Diskus:

  • 100/50: 100 mcg fluticasone propionate/50 mcg salmeterol
  • 250/50: 250 mcg fluticasone propionate/50 mcg salmeterol
  • 500/50: 500 mcg fluticasone propionate/50 mcg salmeterol

Below are Advair’s general dosing recommendations.

Advair’s dosage for Asthma

FormPatient GroupStarting DosageRecommended DosageMaximum Dosage
Advair DiskusAdults and children aged 12 years and olderdepends on the patient’s asthma severity, previous therapy, symptom control, and risk of exacerbation1 inhalation twice daily (~12 hours apart)500/50 twice daily
Pediatric patients aged 4 to 11 years not controlled on an ICSN/A1 inhalation of 100/50 twice daily (~12 hours apart)N/A
Advair HFAAdults and children aged 12 years and olderdepends on the patient’s asthma severity, previous therapy, symptom control, and risk of exacerbation2 oral inhalation twice daily (~12 hours apart)230/21 twice daily

Advair’s dosage for COPD

Advair Diskus 250/50 is the only approved dosage for the treatment of COPD, including chronic bronchitis and emphysema. This is because an efficacy advantage of the Advair Diskus 500/50 has not been demonstrated.

The recommended dosage for patients with COPD is 1 inhalation of Advair Diskus 250/50 twice daily, approximately 12 hours apart.

How to use Trelegy Inhaler?

Trelegy Ellipta is a dry powder inhaler, similar to Advair Diskus. Here’s a video on how to use the Trelegy inhaler:

Trelegy Dosage

Trelegy is available in the following dosage strengths:

  • 100/62.5/25 mcg: 100 mcg fluticasone furoate, 62.5 mcg umeclidinium, and 25 mcg vilanterol
  • 200/62.5/25 mcg: 200 mcg fluticasone furoate, 62.5 mcg umeclidinium, and 25 mcg vilanterol

Below are Trelegy Ellipta’s general dosing recommendations.

ConditionStarting DosageRecommended DosageMaximum Dosage
Asthmadepends on the patient’s asthma severity, previous therapy, symptom control, and risk of exacerbation1 inhalation of 100/62.5/25 mcg or 200/62.5/25 mcg once daily200/62.5/25 once daily
COPD1 inhalation of 100/62.5/25 mcg once daily is the only strength indicated for the treatment of COPD

Potential Side Effects

Advair Side Effects

Although effective in managing asthma symptoms, Advair can also present potential side effects. Below is an overview of both the common and severe side effects individuals should consider when using Advair.

Common side effects of Advair HFA for asthma

  • upper respiratory tract infection
  • throat irritation
  • hoarseness and voice changes
  • headache
  • dizziness
  • nausea and vomiting

Common side effects of Advair Diskus for asthma

  • upper respiratory tract infection
  • throat irritation
  • hoarseness and voice changes
  • thrush in mouth or throat
  • bronchitis
  • cough
  • headache
  • nausea and vomiting
  • infections in the ear, nose, and throat (in children with asthma)

Common side effects of Advair Diskus for COPD

  • thrush in mouth or throat
  • throat irritation
  • hoarseness and voice changes
  • viral respiratory infections
  • headache
  • muscle and bone pain

Serious side effects of Advair

  • Fungal infection in mouth or throat
  • Pneumonia
  • Weakened immune system and increased chance of getting infections (immunosuppression)
  • Reduced adrenal function
  • Sudden breathing problems immediately after inhaling the medicine
  • Serious allergic reactions
  • Effects on the heart (increased blood pressure, a fast or irregular heartbeat, chest pain)
  • Effects on the nervous system (tremor and nervousness)
  • Bone thinning or weakness (osteoporosis)
  • Slowed growth in children
  • Eye problems including glaucoma, increased pressure in your eye, cataracts, or other vision changes
  • Changes in laboratory blood levels (sugar, potassium, certain types of white blood cells)

Trelegy Ellipta Side Effects

Below are the common and serious side effects of Trelegy.

Common side effects of Trelegy for asthma

  • pharyngitis/nasopharyngitis
  • upper respiratory tract infection/viral upper respiratory tract infection
  • bronchitis
  • respiratory tract infection/viral respiratory tract infection
  • sinusitis/acute sinusitis
  • urinary tract infection
  • rhinitis
  • influenza
  • headache
  • back pain

Common side effects of Trelegy for COPD

  • upper respiratory tract infection
  • pneumonia
  • bronchitis
  • oral candidiasis
  • headache
  • back pain
  • arthralgia
  • influenza
  • sinusitis
  • pharyngitis
  • rhinitis,
  • dysgeusia
  • constipation
  • urinary tract infection
  • diarrhea
  • gastroenteritis
  • oropharyngeal pain
  • cough
  • dysphonia

Serious side effects of Trelegy

  • Fungal infection in mouth or throat
  • Weakened immune system and increased chance of getting infections (immunosuppression)
  • Reduced adrenal function
  • Sudden breathing problems immediately after inhaling the medicine
  • Serious allergic reactions
  • Effects on the heart (increased blood pressure, a fast or irregular heartbeat, awareness of heartbeat, chest pain)
  • Effects on the nervous system (tremor and nervousness)
  • Bone thinning or weakness (osteoporosis)
  • Eye problems including glaucoma, increased pressure in your eye, cataracts, blurred vision, worsening of narrow-angle glaucoma, or other changes in vision)
  • Urinary retention (difficulty urinating, painful urination, urinating frequently, urination in a weak stream or drips)
  • Changes in laboratory blood levels (high levels of blood sugar and low levels of potassium)
  • Slowed growth in children

Information on Cost and Alternative Asthma Drugs

Advair Cost

One common concern when considering Advair is how much it costs without insurance coverage. Advair, like many other prescription medications, can be expensive. One reason why Advair is so expensive is due to its patented status.

The price can vary depending on the dosage strength, the type of Advair (HFA or Diskus), and the pharmacy where it’s purchased. In the US, the price of Advair Diskus starts at $165, while the Advair HFA starts at $255.

Alternative to Advair

There are several drugs available that offer similar benefits in managing asthma and COPD symptoms. One option is Symbicort, which also combines an inhaled corticosteroid with a long-acting beta agonist.

Similar to Advair, Symbicort helps to reduce inflammation in the airways and improve airflow, making it effective for controlling symptoms and preventing exacerbations in asthma and COPD patients.

Other Advair alternatives include:

Trelegy Ellipta Cost

According to GoodRx, the price of Trelegy Ellipta (100/62.5/25 mcg) ranges from $700 to $870. It’s normal to wonder why Trelegy is so expensive. Trelegy is a combination inhaler containing three active ingredients, its unique formulation contributes to its higher price than single-agent medications.

Additionally, Trelegy is a brand-name medication, which means it’s protected by patents. This limits competition from generic alternatives and allows the manufacturer to set higher prices.

The cost of Trelegy per month can vary depending on factors such as insurance coverage, dosage strength, and pharmacy pricing. With insurance coverage, Trelegy’s out-of-pocket cost may be significantly reduced.

Alternative to Trelegy

So, is there a cheaper alternative to Trelegy? Yes. Several alternative inhalers are on the market that feature the same corticosteroid component (fluticasone) found in Trelegy Ellipta, along with inhalers combining umeclidinium and vilanterol in different combinations.

For those looking for Trelegy alternatives, here are some commonly recommended options:

  • Breo Ellipta (fluticasone furoate/vilanterol)
  • Anoro Ellipta (umeclidinium/vilanterol)
  • Combivent Respimat (ipratropium/albuterol)
  • Dulera (mometasone/ formoterol)

Tips to Save on Advair and Trelegy Ellipta

To save on Advair or Trelegy, consider the following strategies:

  1. Use generic versions: Generic versions of these medications may be less expensive than brand-name options.
  2. Shop around: Compare prices at different pharmacies and look for Trelegy coupons and Advair coupons.
  3. Consider Canadian pharmacies: Purchasing drugs from Canadian pharmacies may offer cost savings. One reputable option is Pharma Giant, which allows customers to save up to 90% on prescription medications. For example, the prices of Advair HFA start at $124.99 (125/25 mcg), Advair Diskus start at $149.95, and Trelegy Ellipta start at $189.95. Generic versions are also available, which can provide further savings.Additionally, customers can benefit from additional discounts and promotions, particularly when ordering larger quantities. New customers can take advantage of the coupon code FIRST10, which provides a 10% discount on their initial order. Pharma Giant also ensures convenient service with expedited delivery, typically within 3-5 business days.
  4. Ask about assistance programs: Some patients may have access to copay assistance programs offered by the manufacturer or savings cards to help offset the cost.
  5. Review your insurance coverage: Check with your provider to understand your coverage and potential out-of-pocket expenses.
  6. Discuss alternatives with your doctor: Your healthcare provider may be able to recommend alternative drugs or treatment options that are more affordable.

Wrap-Up

Both Advair and Trelegy Ellipta are valuable drugs in the management of respiratory conditions such as asthma and COPD. Advair, with its combination of fluticasone and salmeterol, provides effective control of symptoms and prevention of exacerbations.

On the other hand, Trelegy Ellipta offers the convenience of a triple therapy inhaler, containing fluticasone, umeclidinium, and vilanterol, which may simplify treatment regimens for some patients.

Consult your healthcare provider to determine the most suitable medication for you, considering factors such as the severity of your condition, treatment history, preferences, and cost.

Frequently Asked Questions

Can Trelegy cause hair loss?

No, hair loss wasn’t observed as a side effect among individuals who participated in Trelegy Ellipta clinical trials.

Can Advair or Trelegy cause thrush?

Yes. Both Advair and Trelegy contain corticosteroids, which can increase the risk of oral thrush, a fungal infection in the mouth. It’s important to rinse your mouth with water after using these medications to help reduce this risk. If you experience symptoms of oral thrush, such as white patches in your mouth or throat, consult your healthcare provider for appropriate management.

Can Trelegy or Advair cause high blood pressure?

Yes. According to their prescribing information, they may lead to heart-related issues, such as rapid heartbeat and elevated blood pressure. The likelihood of experiencing these complications increases if you have a history of heart problems, hypertension, or if you’re using this medication alongside other LABAs.

Which is better, Trelegy or Advair?

Advair is more favorable in terms of cost and availability of a generic version, as it is less expensive and has a generic option available. However, Trelegy offers the convenience of a single inhaler and a once-daily dosage regimen, which might be preferable for some individuals. The choice between the two drugs ultimately depends on factors such as cost, convenience, and individual response to treatment, which should be discussed with a healthcare provider.

How much is Trelegy at Walmart?

According to SingleCare, Trelegy Ellipta costs $774.49 at Walmart.

Can Advair or Trelegy cause weight gain?

Studies conducted on Advair or Trelegy Ellipta did not report weight gain. Weight gain is typically associated with corticosteroids taken orally rather than through inhalation.

Is Advair the same as Symbicort?

Advair and Symbicort work similarly in terms of their mechanism of action. However, they contain different active ingredients. Advair combines fluticasone with salmeterol, while Symbicort combines budesonide with formoterol. While they serve similar purposes, their specific formulations, side effects, and dosages may differ.

Can Trelegy or Advair cause hoarseness?

Yes. Hoarseness is a potential side effect associated with the use of both Trelegy and Advair. This side effect is primarily attributed to the corticosteroid component found in these inhalers.

Can Trelegy cause gastritis?

Trelegy Ellipta, like many drugs, can potentially cause gastrointestinal side effects, including gastritis, in some individuals. Gastritis is inflammation of the stomach lining, and while it’s not a commonly reported side effect of Trelegy, it’s important to monitor for symptoms such as abdominal pain, nausea, vomiting, or indigestion while using the medication.

Is Advair safe for long-term use?

Advair is generally considered safe for long-term use when used as prescribed by a healthcare professional. Regulatory agencies approve it for the treatment of asthma and chronic obstructive pulmonary disease (COPD), and many individuals use it as a maintenance medication for extended periods.

Can you use Trelegy and Advair together?

No. Using Trelegy and Advair together is not recommended. Both drugs contain corticosteroids and long-acting beta2-adrenergic agonists (LABAs), and combining them could potentially increase the risk of side effects associated with these asthma treatments. Additionally, using two combination inhalers together may lead to overuse of certain active ingredients, which could be harmful.

How much is Trelegy in Canada?

At Pharma Giant, an online Canadian pharmacy, Trelegy Ellipta costs $189.95 for 30 doses of 100/62.5/25 mcg and $157.27 for 30 doses of 200/62.5/25 mcg.

How long does Advair take to work?

Symptoms relief from Advair may start within 30 minutes of initiating treatment, but it may take one week or longer to achieve its full therapeutic effect.

Is Advair being discontinued?

No announcements were made about the discontinuation of Advair.

Who makes Trelegy?

Trelegy Ellipta is manufactured by GlaxoSmithKline (GSK), a global biopharma company known for developing and producing various medications.

Can you use Trelegy and Albuterol together?

Combining albuterol with vilanterol may heighten cardiovascular side effects, including increased heart rate, elevated blood pressure, or irregular heart rhythm. If you have any inquiries or apprehensions, especially if you have a history of high blood pressure, arrhythmia, or heart disease, consult your doctor.

Can you use Advair and Spiriva together?

According to experts at Health Central, combining Advair and Spiriva is typically considered safe for most individuals, and there are no additional side effects associated with their combined use beyond those that each drug may individually cause.

Sources

Advair Official Website. (NA). Retrieved from https://www.advair.com/

American Lung Association. (NA). How to Use a Diskus Asthma Inhaler. Retrieved from

https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/treatment/devices/diskus-inhaler

GSKPRO. (2023, Jul). Prescribing Information of Advair HFA. Retrieved from

https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Advair_HFA/pdf/ADVAIR-HFA-PI-PIL-IFU.PDF

GSKPRO. (2023, Jun). Prescribing Information of Advair Diskus. Retrieved from https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Advair_Diskus/pdf/ADVAIR-DISKUS-PI-PIL-IFU.PDF

GSKPRO. (2023, Jun). Prescribing Information of Trelegy Ellipta. Retrieved from https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Trelegy_Ellipta/pdf/TRELEGY-ELLIPTA-PI-PIL-IFU.PDF

Trelegy Ellipta Official Website. (NA). HOW TRELEGY WORKS. Retrieved from https://www.trelegy.com/using-trelegy/how-trelegy-works/