Anoro is a brand-name prescription medication that’s approved to treat chronic obstructive pulmonary disease (COPD) in adults. COPD is a group of diseases that includes emphysema and chronic bronchitis. Anoro isn’t approved to treat asthma or to be used as a rescue medication.

Anoro is a maintenance treatment. That means it’s meant to be used long term to control symptoms and prevent flare-ups of COPD. Anoro contains these two drugs:

  • vilanterol, which belongs to a group of drugs called long-acting beta2-agonists (LABAs)
  • umeclidinium, which belongs to a group of drugs called long-acting anticholinergics (LAMAs)

Anoro comes as an inhaler called Anoro Ellipta (Ellipta is the name of the inhaler device). It’s taken by inhaling one puff of medication once a day. Each puff contains 62.5 mcg of umeclidinium and 25 mcg of vilanterol.

Effectiveness

During studies, Anoro was found effective as a long-term maintenance treatment for COPD. A measurement called FEV1 was used during studies to assess people’s response to treatment.

FEV1 (forced expiratory volume in one second) measures how much air you can force from your lungs in one second. A typical FEV1 for someone with COPD is about 1.8 liters (L). An increased FEV1 shows better airflow through your lungs.

In clinical studies, Anoro was compared to its individual drugs (umeclidinium and vilanterol) in people with moderate to severe COPD. After six months of treatment, Anoro was found to be more effective in increasing FEV1 than either of the individual drugs alone.

In one study, FEV1 was increased by 52 milliliters (mL) more with Anoro than with umeclidinium alone. FEV1 was increased by 95 mL more with Anoro than with vilanterol alone.

Anoro is available only as a brand-name medication. It’s not currently available in generic form.

Anoro contains two active drug ingredients: umeclidinium and vilanterol.

Anoro can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Anoro. These lists do not include all possible side effects.

For more information on the possible side effects of Anoro, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

More common side effects

The more common side effects of Anoro can include:

  • upper respiratory infections, such as the common cold or sinus infections
  • chest pain
  • constipation
  • diarrhea
  • pain in your arms or legs
  • muscle spasms
  • neck pain

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Anoro aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Paradoxical bronchospasm (a tightening of your airways; paradoxical means it’s unexpected, since this drug is meant to relax your airways). Symptoms can include:
    • cough
    • trouble breathing that doesn’t get better after you use your inhaler
  • Heart problems. Symptoms can include:
    • chest pain
    • increased blood pressure
    • fast heart rate
    • abnormal heart rhythm
  • New or worsening urinary problems. Symptoms can include:
    • pain when you urinate
    • trouble urinating, including having urinary retention
    • urinating a small amount
    • urinating more often than normal
  • New or worsening eye problems, including narrow-angle glaucoma. Symptoms can include:
    • blurry vision
    • increased pressure in your eyes
    • pain in your eyes
    • seeing halos
  • Hypokalemia (low potassium levels), which can cause heart or muscle problems. Symptoms can include:
    • muscle weakness
    • muscle spasms (twitches)
    • heart palpitations
    • abnormal heart rhythm
  • High blood sugar levels, which can be dangerous for people with diabetes. Symptoms can include:
    • fatigue (lack of energy)
    • excessive thirst
    • urinating more often than normal
    • urinating more often at night
  • Worsening of chronic obstructive pulmonary disease (COPD), including exacerbations (flare-ups). Symptoms can include:
    • shortness of breath, even when you’re at rest
    • cough
    • trouble breathing
    • fatigue (lack of energy)
    • wheezing more than usual
    • coughing up more mucus that usual
  • Severe allergic reaction (see “Allergic reaction” below)

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Anoro. It’s not known for sure how often people have an allergic reaction to Anoro. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • angioedema (swelling under your skin, typically in your eyelids, lips, hands, or feet)
  • swelling of your tongue, mouth, or throat
  • trouble breathing

These symptoms can occur in people who are allergic to Anoro. They can also occur in people who’ve had serious allergic reactions to milk proteins in the past. This is because milk protein powder is used to make Anoro. You shouldn’t take Anoro if you’ve had a serious allergic reaction to milk protein in the past. If you’re unsure if you’ve had a severe allergic reaction, talk to your doctor before using Anoro.

Call your doctor right away if you have a severe allergic reaction. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Upper respiratory infections

Upper respiratory infections were some of the most common side effects seen with Anoro use.

In clinical studies, 1% to 2% of people who took Anoro had an upper respiratory infection. These infections included pharyngitis (sore throat) and sinus infections.

Talk with your doctor about ways you can decrease your risk of upper respiratory infections. If you develop an upper respiratory infection while using Anoro, your doctor may recommend treatment. This could include antibiotics or over-the-counter medications for your symptoms.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Anoro comes as an inhaler device called Ellipta. The Anoro Ellipta inhaler contains two medications: umeclidinium and vilanterol.

The inhaler already has the medication inside. You won’t need to put it together or fill it with the drug, as is needed with some other inhalers.

Each inhalation (one puff) of Anoro gives you 62.5 mcg of umeclidinium and 25 mcg of vilanterol. Each inhaler contains a total of 30 puffs.

Dosage for COPD

The usual dosage of Anoro to treat chronic obstructive pulmonary disease (COPD) is one puff taken once a day.

What if I miss a dose?

If you miss a dose of Anoro, take it as soon as you remember. If it’s almost time for your next dose, just take your normal dose.

Don’t take more than one dose (one puff) in a day. Taking more than one dose can increase your risk for serious side effects.

Medication reminders can help you make sure that you don’t miss a dose.

Will I need to use this drug long term?

Anoro is meant to be used as a long-term treatment for COPD. If you and your doctor determine that Anoro is safe and effective for you, you’ll likely take it long term.

As with all medications, the cost of Anoro can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial assistance

If you need financial support to pay for Anoro, help is available. GlaxoSmithKline LLC, the manufacturer of Anoro, offers a monthly coupon for the drug. For more information and to find out if you’re eligible for support, call 888-825-5249 or visit the program website.

You should take Anoro according to your doctor or healthcare provider’s instructions.

When you first get your Anoro prescription, your healthcare provider will explain how to use the inhaler.

The manufacturer of Anoro provides step-by-step written instructions and video instructions that explain how to use your inhaler. Be sure to read all instructions before you start using Anoro.

Keep in mind that when you open the cover of the inhaler, the device makes one dose of the drug available to inhale. If you open and close Anoro’s cover without taking the dose, you will lose that dose.

When to take

You can take Anoro at any time of day, but it should be taken at the same time each day.

Medication reminders can help you make sure that you don’t miss a dose.

The Food and Drug Administration (FDA) approves prescription drugs such as Anoro to treat certain conditions. Anoro is approved to treat chronic obstructive pulmonary disease (COPD).

COPD is a group of chronic (long-term) conditions that includes chronic bronchitis and emphysema. These conditions slowly damage your alveoli (small air sacs in your lungs). Damage to alveoli make it harder for you to breathe.

There isn’t a cure for COPD available yet. However, treatment guidelines recommend long-term therapy to control COPD symptoms and prevent flare-ups. This is called maintenance therapy. Research has found that maintenance therapy can:

  • reduce how often you have exacerbations (flare-ups)
  • reduce how often you have COPD symptoms
  • make your COPD symptoms less severe
  • improve your overall lung function (how well your lungs work) and your overall health

In clinical studies, Anoro improved lung function more than either of the drug’s active ingredients (umeclidinium or vilanterol) when taken alone.

Improvement in lung function was measured using FEV1 (forced expiratory volume in one second). FEV1 is a measurement of how much air you can force out of your lungs in one second. Higher FEV1 values show better airflow through your lungs. A typical FEV1 value for someone with COPD is 1.8 liters (L).

Over six months of treatment, clinical studies found that FEV1 was increased more with Anoro treatment than with either vilanterol or umeclidinium alone. In one study, FEV1 was increased by 52 milliliters (mL) more with Anoro than with umeclidinium treatment. FEV1 was increased by 95 mL more with Anoro than with vilanterol treatment.

Anoro was also more effective for COPD maintenance treatment than Advair Diskus (salmeterol and fluticasone) in people with moderate to severe COPD. In a three-month clinical study, people’s FEV1 was increased almost two times more with Anoro treatment than with Advair Diskus treatment.

Anoro is only FDA-approved to treat chronic obstructive pulmonary disease (COPD). (See the “Anoro for COPD” section above for more details.) Anoro is not FDA-approved for any other use.

Anoro for asthma (not an appropriate use)

Anoro isn’t FDA-approved to treat asthma. It’s not known if Anoro is safe or effective for treating asthma.

Vilanterol, one of the active drugs in Anoro, belongs to a group of drugs called long-acting beta2-agonists (LABAs). Taking a LABA for asthma treatment without also taking an inhaled corticosteroid (ICS) can increase your risk of asthma-related death.

If you have COPD and asthma and you’re considering taking Anoro with an ICS, talk with your doctor about whether this is safe for you.

Note: Clinical studies haven’t found an increased risk of death when Anoro is used to treat COPD.

Your doctor will also prescribe other medications to be used with Anoro.

Most people with chronic obstructive pulmonary disease (COPD) will also sometimes need to use a short-acting bronchodilator. Short-acting bronchodilators are used as rescue inhalers when you need quick relief of your COPD symptoms.

Examples of short-acting bronchodilators that can be prescribed along with Anoro include:

  • albuterol (ProAir HFA, Proventil HFA, Ventolin HFA)
  • levalbuterol (Xopenex, Xopenex HFA)

These drugs work faster in your lungs than Anoro does. They help relax muscles in your airways, helping air move better inside your lungs. This can help improve your breathing when you feel short of breath. You should always have your rescue inhaler with you.

However, rescue inhalers aren’t meant to be used on a regular basis. If you’re using your rescue medication more often than usual, talk with your doctor. They may change your maintenance treatment (such as Anoro) to help improve your COPD symptoms. This may help so that you can use your rescue inhaler less often.

Other drugs are available that can treat chronic obstructive pulmonary disease (COPD). Some drugs may be better suited for you than others. If you’re interested in finding an alternative to Anoro, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other drugs that may be used as long-term treatment for COPD are listed below. These lists don’t include all the drugs used for this condition. Alternative drug treatments include:

  • long-acting beta2-agonists (LABAs) such as:
    • salmeterol (Serevent)
    • formoterol (Foradil, Perforomist)
    • arformoterol (Brovana)
    • olodaterol (Striverdi)
    • indacaterol (Arcapta)
  • long-acting anticholinergics (LAMAs) such as:
    • tiotropium (Spiriva)
    • aclidinium (Tudorza)
    • glycopyrrolate (Seebri)
  • combination medications that contain two or more drugs. Some of these inhalers for COPD treatment contain an inhaled corticosteroid (ICS). Combination medications that are used as maintenance treatment for COPD include:
    • budesonide/formoterol (Symbicort)
    • fluticasone/salmeterol (Advair)
    • fluticasone/vilanterol (Breo)
    • tiotropium/olodaterol (Stiolto)
    • fluticasone/vilanterol/umeclidinium (Trelegy)
    • glycopyrrolate/formoterol (Bevespi)

You may wonder how Anoro compares to other medications that are prescribed for similar uses. Here we look at how Anoro and Trelegy are alike and different.

Uses

Anoro and Trelegy are both FDA-approved as a long-term maintenance treatment for chronic obstructive pulmonary disease (COPD).

Drug forms and administration

Anoro and Trelegy are both inhalers.

Anoro contains two drugs: umeclidinium and vilanterol. Umeclidinium is a long-acting anticholinergic (LAMA). Vilanterol is a long-acting beta2-agonist (LABA).

Trelegy also contains umeclidinium and vilanterol. In addition, it contains a third drug called fluticasone, which is a corticosteroid.

Anoro and Trelegy are each taken as one inhalation (puff) once a day.

Side effects and risks

Anoro and Trelegy each contain a LAMA and a LABA. Therefore, they can cause some similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Anoro, with Trelegy, or with both drugs (when taken individually).

  • Can occur with Anoro:
    • chest pain
    • pain in your arms or legs
    • muscle spasms
    • neck pain
  • Can occur with Trelegy:
    • yeast infection in your mouth
    • headache
    • back pain
    • joint pain
    • urinary tract infection (UTI)
    • gastroenteritis (stomach flu)
    • mouth and throat pain
    • cough
    • abnormal sense of taste
    • voice that sounds hoarse or shaky
  • Can occur with both Anoro and Trelegy:
    • upper respiratory infections, such as the common cold or sinus infection
    • constipation
    • diarrhea

Serious side effects

These lists contain examples of serious side effects that can occur with Anoro, with Trelegy, or with both drugs (when taken individually).

  • Can occur with Anoro:
    • few unique serious side effects
  • Can occur with Trelegy:
    • new infections or worsening of infections that you already have
    • hormonal disorders, such as Cushing syndrome
    • decreased bone density, which can lead to osteoporosis
    • pneumonia
  • Can occur with both Anoro and Trelegy:
    • paradoxical bronchospasm
    • new or worsening eye problems, including narrow-angle glaucoma
    • new or worsening urinary problems, including urinary retention
    • hyperglycemia (high blood sugar levels)
    • hypokalemia (low potassium levels)
    • worsening of COPD, including exacerbations (flare-ups)
    • severe allergic reactions
    • heart problems, such as high blood pressure or abnormal heart rhythm

Effectiveness

Anoro and Trelegy are both used as maintenance treatment of COPD.

Treatment of COPD with Anoro and Trelegy has been directly compared in a clinical study.

In a one-year clinical study, people with COPD who took Trelegy had 25% fewer moderate to severe exacerbations (flare-ups) than people who took Anoro. People who took Trelegy also had a 16% lower risk of having an exacerbation during the study.

The study also tested how the two drugs improved quality of life in people with COPD. The people were given a survey that asked them about their daily COPD symptoms. Lower scores indicated better COPD symptom control. Scores that decreased by at least four points were considered a meaningful improvement.

Surveys were given before people started either drug and after one year of treatment with either Anoro or Trelegy. In people taking Trelegy, scores were decreased by at least 4 points in 42% of the people. In those taking Anoro, scores were decreased by at least 4 points in 34% of the people.

Costs

Anoro and Trelegy are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Anoro may cost less than Trelegy. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

In addition to Trelegy (see above), other medications similar to Anoro are also available. Here we look at how Anoro and Advair are alike and different.

Uses

Anoro and Advair Diskus are both FDA-approved for use as a long-term maintenance treatment for chronic obstructive pulmonary disease (COPD).

Advair Diskus is also approved to reduce the number of COPD exacerbations (flare-ups) in people with the condition. It’s approved for this purpose in people who’ve had flare-ups in the past.

Advair Diskus is also approved to treat asthma in adults and children (ages 4 years and older).

Note: There are two forms of Advair: Advair Diskus and Advair HFA. Only Advair Diskus is approved as a maintenance treatment for COPD.

Drug forms and administration

Anoro and Advair Diskus both come as inhalers.

Anoro contains two active drugs: umeclidinium (a long-acting anticholinergic) and vilanterol (a long-acting beta2-agonist).

Advair Diskus contains two other active drugs: salmeterol (a long-acting beta2-agonist) and fluticasone (an inhaled corticosteroid).

Advair comes in two forms: Advair HFA and Advair Diskus. Only Advair Diskus is FDA-approved as maintenance treatment for COPD. The dosage of Advair Diskus that’s approved to treat COPD is 250 mcg of fluticasone and 50 mcg of salmeterol.

Anoro is taken as one inhalation (puff) once a day. Advair Diskus is taken as one inhalation twice a day.

Side effects and risks

Anoro and Advair Diskus both contain a long-acting beta2-agonist. Therefore, they can cause some similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Anoro, with Advair Diskus, or with both drugs (when taken individually).

  • Can occur with Anoro:
    • chest pain
    • constipation
    • diarrhea
    • muscle spasms
    • pain in your arms or legs
    • neck pain
  • Can occur with Advair Diskus:
    • yeast infection in your mouth
    • irritation in your throat
    • voice that sounds hoarse or shaky
    • headache
    • muscle pain
    • bone pain
  • Can occur with both Anoro and Advair Diskus:
    • upper respiratory infections, such as the common cold or sinus infections

Serious side effects

These lists contain examples of serious side effects that can occur with Anoro, with Advair Diskus, or with both drugs (when taken individually).

  • Can occur with Anoro:
    • new or worsening urinary problems
  • Can occur with Advair Diskus:
    • new infections or worsening of infections that you already have
    • hormonal disorders, such as Cushing syndrome
    • decreased bone density, which can lead to osteoporosis
    • eosinophilic conditions (problems with certain white blood cells), including Churg-Strauss syndrome
    • pneumonia
  • Can occur with both Anoro and Advair Diskus:
    • paradoxical bronchospasm
    • new or worsening eye problems, including narrow-angle glaucoma
    • hyperglycemia (high blood sugar levels)
    • hypokalemia (low potassium levels)
    • worsening of COPD, including exacerbations (flare-ups)
    • severe allergic reactions
    • heart problems, such as high blood pressure or abnormal heart rhythm

Effectiveness

Anoro and Advair Diskus have different FDA-approved uses, but they’re both used as maintenance treatments for COPD.

Treatment of COPD with Anoro and Advair Diskus has been directly compared in clinical studies.

In a three-month study, people with moderate to severe COPD were given either Anoro or Advair Diskus. People’s FEV1 (a measure of their lung function) was improved by 80 mL more with Anoro treatment than with Advair Diskus.

In another clinical study, which lasted three months, FEV1 was increased almost two times more with Anoro treatment than with Advair Diskus treatment.

Costs

Anoro and Advair are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Anoro may cost more than Advair. The actual price you’ll pay for either drug will depend on your insurance plan, your location, and the pharmacy you use.

There’s no known interaction between Anoro and alcohol.

However, research has found that drinking alcohol over many years can damage the cilia in your airways. Cilia are small, hair-like structures that help trap and remove germs from the air you breathe. When cilia are damaged, you’re more likely to breathe germs into your lungs.

Chronic alcohol drinking can also damage immune system cells in your lungs. When this happens, the cells aren’t able to fight off infections as well.

Both of these effects caused by alcohol can increase your risk of lung infections (including pneumonia). They can also make your COPD symptoms worse.

If you drink alcohol, talk with your doctor about how much is safe for you to drink.

Anoro can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Anoro and other medications

Below are lists of medications that can interact with Anoro. These lists do not contain all the drugs that may interact with Anoro.

Before taking Anoro, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Anoro and certain antibacterial and antifungal drugs

Taking Anoro with certain antibacterial or antifungal drugs can increase levels of Anoro in your body. This is because some of these medications can prevent Anoro from being broken down (metabolized). This leads to increased levels of Anoro, which can cause serious side effects.

Examples of certain antibacterial drugs that can increase Anoro levels include:

  • clarithromycin
  • telithromycin

Examples of certain antifungals that can increase Anoro levels include:

  • itraconazole (Omnel, Sporanox, Tolsura)
  • ketoconazole (Extina, Nizoral, Xolegel)
  • voriconazole (Vfend)

If you need to take one of these antibacterial or antifungal drugs with Anoro, your doctor may monitor you more closely than usual for side effects.

Anoro and certain antiviral drugs

Taking Anoro with certain antiviral drugs used to treat HIV or hepatitis can increase levels of Anoro in your body. This can increase your risk for side effects.

Examples of antiviral drugs that can increase Anoro levels if taken together include:

  • ritonavir (Norvir)
  • indinavir (Crixivan)
  • lopinavir
  • saquinavir (Invirase)

Many antivirals come as part of a combination medication (which contains more than one drug). You may want to check your medications to see if you’re taking any combination medications that contain one of the drugs listed above.

If you need to take one of these antivirals with Anoro, your doctor may monitor you more closely than usual for side effects.

Anoro and certain antidepressants

Taking Anoro with certain antidepressants can increase your risk for abnormal heart rhythms (heart rates that are too fast, too slow, or irregular). Abnormal heart rhythms can lead to more serious heart problems, such as heart attacks.

Taking Anoro with two specific types of antidepressants can cause abnormal heart rhythms. These types of drugs are monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).

Anoro and monoamine oxidase inhibitors

Taking Anoro with an MAOI or within two weeks of stopping an MAOI can cause unsafe heart rhythms. Examples of MAOI’s include:

  • phenelzine (Nardil)
  • isocarboxazid (Marplan)
  • selegiline (Emsam, Zelapar)

Anoro and tricyclic antidepressants

Taking Anoro with a TCA or within two weeks of stopping a TCA can cause abnormal heart rhythms. Examples of TCA’s include:

  • amitriptyline
  • imipramine (Tofranil)
  • desipramine (Norpramin)
  • nortriptyline (Pamelor)

If you need to take an antidepressant with Anoro, talk with your doctor about which options are safe for you.

Anoro and certain blood pressure or heart rate medications

Taking Anoro with certain blood pressure or heart rate medications, called beta-blockers, can make Anoro less effective. Taking these drugs with Anoro could also cause the muscles in your airways to tighten, making it harder for you to breathe.

Examples of beta-blockers include:

  • atenolol (Tenormin)
  • carvedilol (Coreg)
  • metoprolol (Lopressor, Toprol XL)
  • propranolol (Inderal, Innopran XL)

Anoro should only be taken with a beta-blocker in an emergency situation, such as during a heart attack.

Anoro and certain urinary incontinence medications

One of the active drugs in Anoro, called umeclidinium, is an anticholinergic drug. Anticholinergics can also be used to treat urinary incontinence (loss of bladder control).

Taking Anoro with another anticholinergic can increase your risk for serious side effects. Examples of anticholinergics that can increase your risk of side effects if taking with Anoro include:

  • fesoterodine (Toviaz)
  • oxybutynin (Ditropan XL)
  • tolterodine (Detrol)
  • solifenacin (VESIcare)
  • darifenacin (Enablex)

If you need to take Anoro with an anticholinergic drug, your doctor will monitor you more closely than usual for side effects. They may also recommend different treatment for your COPD or urinary incontinence.

Anoro and certain diuretics

Taking Anoro with certain diuretics (often called water pills) can increase your risk for hypokalemia (low potassium levels). Hypokalemia can cause abnormal heart rhythms (heartbeats that are too slow, to fast, or uneven) and other muscle problems.

Examples of diuretics that can cause low potassium levels if taken with Anoro include:

  • furosemide (Lasix)
  • torsemide (Demadex)
  • hydrochlorothiazide (Microzide)
  • chlorthalidone

Some diuretics also come as part of a combination medication (which contains more than one drug). You may want to check your medications to see if you’re taking any combination medications that contain one of the drugs listed above.

If your need to take a diuretic with Anoro, your doctor may closely monitor your potassium levels.

Chronic obstructive pulmonary disease (COPD) is a group of diseases that damages your lungs. These diseases are progressive, which means they get worse over time. Most people with COPD have chronic bronchitis or emphysema, or both.

Chronic bronchitis is a disease that causes swelling in the lining of your airways. As a result, your airways fill up with mucus. Emphysema is a disease that damages your alveoli (small air sacs in your lungs). Both diseases make it harder for you to inhale oxygen into your lungs and exhale carbon dioxide out of your lungs.

Umeclidinium is one of the active drugs in Anoro. It belongs to a group of drugs called long-acting anticholinergics (LAMA). LAMAs block the action of acetylcholine, a chemical messenger in your body. Acetylcholine tells certain muscles (such as those in your lungs) to tighten. Umeclidinium helps prevent the muscles in your lungs from tightening. This helps keep your airways open, making it easier for air to flow into and out of your lungs.

Vilanterol is the other active drug in Anoro. It’s a long-acting beta2-agonist (LABA). Vilanterol attaches to certain muscle cells in your lungs. When it attaches to these cells, the muscles relax. This helps open your airways and lets you breathe more easily.

How long does it take to work?

Anoro will start working within several minutes after you take your dose. However, Anoro doesn’t work fast enough to be used as a rescue inhaler. You’ll still need to use your rescue inhaler for emergency situations.

There haven’t been enough studies in humans to know if Anoro is safe to use during pregnancy. Studies in animals showed some harm to the fetus when the mother received very high doses of Anoro. However, animal studies don’t always predict what will happen in humans.

If you become pregnant while taking Anoro, call your doctor right away. You may need to use a different COPD medication during your pregnancy.

Additionally, Anoro could interfere with normal muscle contractions during labor and delivery. Be sure to tell your doctor if you are taking Anoro before giving birth. They will determine whether it’s safe for you to use the drug immediately before and during delivery.

It’s not known if Anoro passes into breast milk in humans. If you’re breastfeeding and considering taking Anoro, talk with your doctor about the potential risks and benefits.

Here are answers to some frequently asked questions about Anoro.

Is Anoro a steroid?

No, Anoro doesn’t contain any steroids.

Anoro contains two drugs that aren’t steroids: a long-acting anticholinergic drug (called umeclidinium) and a long-acting beta2-agonist drug (called vilanterol). These drugs work to open and relax muscles in your airways so you can breathe more easily.

Sometimes a type of steroid (called a corticosteroid) is prescribed for people with chronic obstructive pulmonary disease (COPD). Corticosteroids are used to reduce inflammation and improve COPD symptoms.

Inhaled corticosteroids may be taken along with other COPD drugs, including Anoro. This combination of treatment can help decrease COPD symptoms, reduce COPD exacerbations (flare-ups), and improve your overall lung function.

Is Anoro safe to use for asthma?

It’s not known if Anoro is safe to use for asthma treatment.

In fact, one of the ingredients in Anoro (called vilanterol) increases the risk of death from asthma. This increased risk occurs if vilanterol is used alone (without an inhaled corticosteroid) to treat asthma. Because Anoro contains vilanterol, it may not be safe to take if you have asthma.

Note: Clinical studies have not found an increased risk of death when vilanterol is used to treat chronic obstructive pulmonary disease (COPD).

Can I use both Anoro and Spiriva?

Anoro and Spiriva (tiotropium) shouldn’t be used together. They both contain a long-acting anticholinergic (LAMA) drug. LAMAs help you breathe more easily by preventing the muscles in your airways from tightening.

LAMAs can also cause side effects in your body, especially if you take too much of a LAMA drug. Taking Anoro and Spiriva together will increase your risk of these serious side effects, which can include:

  • eye problems, such as blurry vision
  • drowsiness
  • memory problems
  • confusion
  • trouble urinating
  • delirium

Be sure to tell your doctor or pharmacist about all of the drugs you’re taking. They will make sure that you don’t take more than one LAMA at a time.

Should I use Anoro when I have COPD flare-ups?

Don’t use Anoro to treat sudden breathing problems. Anoro doesn’t work quickly enough to help you breathe during emergency situations.

Your doctor may tell you to continue using Anoro when you have an exacerbation (flare-up). However, it won’t be the only drug you need at that time.

Talk with your doctor about what you should do during a flare-up. They will help you create a treatment plan for emergency situations. They may prescribe a rescue inhaler.

I don’t taste Anoro after I use it. Is that OK?

Yes, it’s fine if you don’t taste Anoro after you’ve inhaled it. If you take Anoro according to its instructions, you’ll still get your full dose. If you can’t taste the drug, don’t take another inhalation (puff).

Before taking Anoro, talk with your doctor about your health history. Anoro may not be right for you if you have certain medical conditions. These include:

  • Asthma. Anoro shouldn’t be used to treat asthma without combining it with an inhaled corticosteroid. Using Anoro alone can lead to an increased risk of asthma-related death. If you have asthma, talk with your doctor about whether Anoro is right for you.
  • Severe allergic reaction. You shouldn’t take Anoro if you’ve had a severe allergic reaction to any of the ingredients in Anoro. Its main ingredients are umeclidinium and vilanterol. If you’re unsure if you’ve had a severe allergic reaction to Anoro or any of its ingredients, talk with your doctor.
  • Allergy to milk proteins. The powder used to make Anoro contains milk proteins. If you’re allergic to milk proteins, avoid using Anoro.
  • Heart problems. Anoro can cause heart problems, including high blood pressure, fast heartbeat, and abnormal heart rhythm. If you have heart problems, Anoro may make them worse. Talk with your doctor about whether Anoro is safe for you.
  • Convulsive disorders, including seizures. Anoro can make seizure disorders worse. If you have a seizure disorder, talk with your doctor about whether Anoro is right for you.
  • Urinary problems. Anoro can cause new or worsening urinary retention (trouble urinating). If you have a history of urinary problems or prostate problems, talk with your doctor about whether Anoro is right for you.
  • Thyroid disorder. Anoro can cause high levels of thyroid hormone. If you have hyperthyroidism, talk with your doctor about whether Anoro is right for you.
  • Narrow-angle glaucoma. Anoro can cause new or worsening narrow-angle glaucoma. If you have a history of high pressure in your eyes (called glaucoma), talk with your doctor about whether Anoro is right for you.

Note: For more information about the potential negative effects of Anoro, see the “Anoro side effects” section above.

Using more than the recommended dosage of Anoro can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • dry mouth and throat
  • blurry vision
  • constipation
  • fast heart rate
  • chest pain
  • high blood pressure
  • headache
  • nausea
  • seizures
  • serious heart problems, such as heart attack

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Anoro from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Anoro should be stored at room temperature (68°F–77°F/20°C–25°C) in its original packaging, until your first use. Once you’ve opened Anoro and removed it from its packaging, keep the device away from direct heat and light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Anoro can be used for up to six weeks after you first open it.

Disposal

If you no longer need to take Anoro and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Anoro (umeclidinium and vilanterol) is indicated for long-term maintenance treatment of chronic obstructive pulmonary disease (COPD).

It’s not approved to treat asthma or to be used as a rescue medication.

Mechanism of action

Anoro contains umeclidinium (long-acting anticholinergic) and vilanterol (long-acting beta2-agonist).

Umeclidinium is an antagonist at the M3 muscarinic receptor in airway smooth muscle. Antagonism at the M3 receptor causes bronchodilation.

Vilanterol is an agonist at beta2-adrenergic receptors. Agonism at the beta2 receptor increases intracellular cyclic AMP, leading to bronchial smooth muscle relaxation. Vilanterol also inhibits immediate hypersensitivity-induced mediator release, decreasing immune responses.

Pharmacokinetics and metabolism

Maximum concentration of both umeclidinium and vilanterol is reached within 5 to 15 minutes after inhalation. Steady-state concentrations of each drug are reached within 14 days.

Plasma protein binding is approximately 89% for umeclidinium and 94% for vilanterol. Metabolism of umeclidinium occurs primarily via CYP2D6. Metabolism of vilanterol occurs via CYP3A4.

Umeclidinium and vilanterol are substrates for P-gp transporter.

Half-life is 11 hours. Elimination of umeclidinium occurs through feces (92%) and urine (<1%). Elimination of vilanterol occurs through urine (70%) and feces (30%).

Contraindications

Anoro is contraindicated in people with a history of severe hypersensitivity reactions to umeclidinium, vilanterol, any of Anoro’s excipients, or milk proteins.

Vilanterol, one of the active drugs in Anoro, is contraindicated for use in asthma treatment, if not used in combination with an inhaled corticosteroid.

Storage

Anoro should be stored in a dry place, away from direct sunlight and heat. Store at room temperature (68°F–77°F/20°C–25°C). It should remain in the moisture-protective foil tray until immediately prior to initial use.

Discard six weeks after opening.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Anoro ellipta Images