Breo is a brand-name prescription medication. It’s used to treat:

  • chronic obstructive pulmonary disease (COPD), a group of lung diseases that include chronic bronchitis and emphysema
  • asthma

Breo comes in a powder inhaler and is available in two doses. One dose is Breo 100/25, which is used to treat COPD. The other is Breo 200/25. Both doses can be used to treat asthma.

Breo helps prevent COPD symptom flare-ups and asthma attacks. The drug relaxes muscles in the airways of your lungs and keeps them open so you can breathe better.

Breo contains two drugs. The first is fluticasone furoate, which belongs to a class of drugs called inhaled corticosteroids (ICSs). This is one of the most effective drug classes for controlling asthma.

The second drug is vilanterol trifenatate. It’s a long-acting beta2-adrenergic agonist (LABA), a class of drugs that relax muscles in the airways.

Use for COPD

Breo 100/25 is approved to help the lungs work better by relaxing muscles in the airways and to reduce the number of symptom flare-ups in people with COPD.

In clinical studies of COPD, people who took Breo had fewer symptom flare-ups than people who took only vilanterol, a drug contained in Breo. People treated with Breo had 21 to 34 percent fewer moderate or severe flare-ups.

Use for asthma

Breo is approved to prevent asthma attacks in adults whose asthma isn’t under control with their current medication. Breo isn’t a rescue therapy, which is a treatment for asthma attacks that have already started.

In a clinical study, people who took Breo had fewer asthma flare-ups. This study compared Breo to fluticasone, a drug that’s contained in Breo. People who took Breo had a 20 percent lower risk of flare-ups.

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

Breo contains two active drug ingredients: fluticasone furoate and vilanterol trifenatate. Neither drug is available in generic form.

Breo can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Breo. This list doesn’t include all possible side effects.

For more information on the possible side effects of Breo, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

Possible side effects depend on how your body responds to either Breo 100/25 for chronic obstructive pulmonary disease (COPD) or Breo for asthma.

More common side effects when used for COPD

The more common side effects of Breo 100/25 in people with COPD can include:

  • back and joint pain
  • fever

More common side effects when used for asthma

The more common side effects of Breo in people with asthma can include:

  • abnormal heart rhythm (heartbeat that’s too fast, too slow, or irregular)
  • voice loss

More common side effects when used for COPD or asthma

The more common side effects of Breo 100/25 in people with COPD and Breo in people with asthma can include:

  • inflammation (swelling) in lung airways
  • cough
  • headache
  • fever
  • oral thrush or esophageal thrush (fungal infection in your mouth or throat)
  • respiratory infections such as the common cold or flu
  • sore throat
  • pneumonia

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 Breo 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 are similar in treatment for both COPD and asthma. They can include:

  • Heart-related problems such as changes in blood pressure or heart rhythm. Symptoms can include:
    • chest pain or pressure
    • abnormal heart rhythm (heartbeat that’s too fast, too slow, or irregular)
    • shortness of breath
    • lightheadedness or dizziness
    • fainting
  • Oral thrush or esophageal thrush (fungal infection in your mouth or throat). Symptoms can include:
    • painful white bumps in your mouth
    • dry skin at the corners of your mouth
    • trouble swallowing
  • Pneumonia. Symptoms can include:
    • chest pain
    • shortness of breath
    • cough (or coughing up mucus)
    • fever
  • Hypercorticism (high cortisol levels). Symptoms can include:
    • weight gain, mainly around your upper back and midsection
    • rounder face
    • bruising easily
    • slow healing cuts or wounds
    • acne
  • Adrenal suppression (low cortisol levels). Symptoms can include:
    • muscle weakness
    • tiredness
    • skin that appears darker
    • less of an appetite
  • Lower bone density. Symptoms can include:
    • back pain
    • loss of height
    • slouch posture
    • bone fractures
  • Glaucoma and cataracts (eye problems). Symptoms can include:
    • blind spots
    • headache
    • eye pain
    • nausea and vomiting
    • clouded or blurred vision
    • trouble seeing at night
    • seeing “halos” around light
    • sensitivity to light and glare
  • Hyperglycemia (high blood sugar level). Symptoms can include:
    • urinating often
    • fatigue
    • feeling thirstier than normal
    • blurry vision
    • headache
  • Hypokalemia (low potassium levels). Symptoms can include:
    • fatigue
    • weakness
    • muscle cramps
    • constipation
    • heart palpitations (feeling of skipped or extra heartbeats)
  • Stunted growth in children and teens

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on certain side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Breo. 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

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

Weight gain

Taking Breo may cause you to gain weight. This is a result of high cortisol levels, which is a rare potential side effect of the drug. Actually, Breo can cause both hypercorticism (high cortisol levels) and adrenal suppression (low cortisol levels).

Breo contains fluticasone furoate, an inhaled corticosteroid (ICS). Taking corticosteroids can affect your body’s ability to make cortisol, which is a stress hormone. Cortisol controls metabolism, blood sugar, and other body functions, which can affect your body weight.

High cortisol levels may cause you to gain weight. Low cortisol levels may cause you to lose weight. It isn’t known how often weight gain or loss occurs in people taking Breo.

If you’re concerned about how Breo might affect your weight, talk with your doctor.

Oral thrush or esophageal thrush (mouth or throat fungal infection)

Using Breo may increase your risk of oral thrush or esophageal thrush. These fungal infections occur in your mouth or throat. In clinical studies, up to 5 percent of people with COPD and 2 percent of people with asthma who took Breo had oral or esophageal thrush.

To help reduce your risk of thrush, after each dose, rinse your mouth with water and spit it out. Don’t swallow. If you’re concerned about your risk of thrush, talk with your doctor.

Pneumonia

Taking Breo may increase your risk for pneumonia. In clinical studies, up to 7 percent of people with COPD and more than 2 percent of people with asthma who took the drug developed pneumonia.

If you think you might have pneumonia, talk with your doctor.

Lower bone density

One clinical study linked long-term use of inhaled corticosteroids (ICSs) to lower bone density. It’s not known whether this leads to bone fractures. Major risk factors for reduced bone density include:

  • not exercising enough
  • family history of osteoporosis (fragile bones)
  • menopause before age 45
  • smoking
  • older age
  • poor nutrition
  • long-term use of drugs that can reduce bone mass, such as anticonvulsants (seizure medications) and oral corticosteroids

If you’re at risk for lower bone density, talk with your doctor before starting Breo.

Glaucoma and cataracts

After FDA approval, there have been reports linking certain eye diseases to long-term treatment with Breo. These are eye conditions that can cause serious vision problems, such as glaucoma and cataracts.

If you have problems with your eyes or trouble seeing while taking Breo, talk with your doctor. They may want you to visit an eye doctor.

High blood sugar levels

According to some cases that were reported after FDA approval, Breo can increase blood sugar levels. Hyperglycemia occurs when you have high blood sugar levels. This may affect people who have type 1 or type 2 diabetes. Talk with your doctor if you’re at risk for diabetes or already have it.

Low potassium levels (not a side effect)

In clinical studies, Breo didn’t cause hypokalemia (low potassium levels) in people with COPD or asthma. This is true even though Breo contains a long-acting beta2-adrenergic agonist (LABA). This type of drug may cause low potassium levels, which can lead to heart rhythm problems.

Hypokalemia from the use of LABA medications may go away within a few days and doesn’t usually require treatment.

Typically, your doctor will first start you on a low dosage of the drug. They will adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

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

Breo comes as a disposable light gray and blue inhaler. The inhaler contains two foil blister strips of powder medication:

  • One strip contains either 100 mcg or 200 mcg of fluticasone furoate per blister.
  • The other strip contains 25 mcg of vilanterol trifenatate per blister.

Each strip contains 30 blisters, for a total of 30 doses. Each time you fully open the inhaler cover, a new dose is ready for you.

Dosage for COPD

Breo 100/25 once a day is the only recommended dosage for chronic obstructive pulmonary disease (COPD). One dose contains 100 mcg of fluticasone furoate and 25 mcg of vilanterol trifenatate.

Using your inhaler, inhale Breo through your mouth once a day. Be sure to take it at the same time each day. Don’t use it more than once every 24 hours.

Dosage for asthma

If you have asthma, your doctor will prescribe a dosage of Breo based on:

  • how severe your asthma is
  • your previous asthma treatment
  • other medical conditions you may have

Here are the two possible doses of Breo to help prevent asthma attacks:

  • Breo 100/25: One dose contains 100 mcg of fluticasone furoate and 25 mcg of vilanterol trifenatate.
  • Breo 200/25: One dose contains 200 mcg of fluticasone furoate and 25 mcg of vilanterol trifenatate.

Using your inhaler, inhale the drug through your mouth once a day. Be sure to take it at the same time each day. Don’t use it more than once every 24 hours.

The maximum dose of Breo for asthma is one inhalation of Breo 200/25 per day. If you are taking Breo 100/25 and need a higher dose, your doctor may prescribe Breo 200/25. If you have asthma symptoms between doses, use a rescue medication such as a short-acting beta2-adrenergic agonist (SABA). This may give you immediate relief.

Preventing thrush

Whether you use Breo for COPD or asthma, you’ll want to reduce your risk of getting thrush.

After you take a dose, rinse your mouth with water and spit it out. Don’t swallow. This may help prevent oral thrush or esophageal thrush (a fungal infection in your mouth or throat). See the “Breo side effects” section above for more information on thrush.

What if I miss a dose?

If you miss a dose of Breo, take it as soon as you remember. Don’t take more than one inhalation per day. Take the next dose at the usual time. Don’t try to catch up by taking an extra dose or increasing the next dose. This can cause dangerous side effects.

Will I need to use this drug long term?

If Breo is effective and safe for you, you’ll probably use this drug long term. Breo is typically used long term to treat COPD, and to prevent asthma attacks in adults with asthma.

As with all medications, the cost of Breo can vary. To find current prices for Breo in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Breo, or if you need help understanding your insurance coverage, help is available.

GlaxoSmithKline plc, the manufacturer of Breo, offers a program called GSK for You. For more information and to find out if you’re eligible for support, call 888-825-5249 or visit the program website.

The Food and Drug Administration (FDA) approves prescription drugs such as Breo to treat certain conditions.

Breo for COPD

Breo is approved to help the lungs work better in people with chronic obstructive pulmonary disease (COPD). COPD is a group of lung diseases that include chronic bronchitis and emphysema. The drugs help you breathe by relaxing muscles in your airway and helping to keep them open. The drug is also approved to decrease the number of COPD flare-ups that people have.

Breo for asthma

Breo is also approved to help prevent asthma attacks in adults who:

  • don’t have their asthma under control with a long-term asthma medication, or
  • require treatment with an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA)

Don’t use Breo as rescue therapy. It’s not meant to treat asthma attacks that have already started.

For a helpful video on how to take Breo, visit the drug maker’s website. Below are some basic instructions on how to take Breo. Be sure to take the drug as your doctor or healthcare provider instructs.

If it’s your first use of the inhaler, remove the inhaler from the package. Then take the following steps.

Note: Don’t open and close the inhaler unless you plan to take a dose. You’ll lose the dose if you don’t inhale at that time. (Lost doses stay in the inhaler, but you can no longer take them. It’s not possible to take a double dose or extra dose with one inhalation.)

Step 1. Prepare a dose

  • Slide the inhaler cover open until you hear a click.
  • If the counter doesn’t count down as the cover clicks open, a dose won’t be prepared. If this happens, call your pharmacist or doctor.

Step 2. Inhale a dose

  • Hold the inhaler, making sure your fingers aren’t covering the air vents.
  • Breathe out fully, but not into the inhaler.
  • Bring the inhaler to your mouth and close your lips tightly around the mouthpiece.
  • Take a steady, deep breath through your mouth. Don’t breathe in through your nose.
  • Move the inhaler away from your mouth and hold your breath for three to four seconds or as long you’re comfortable.
  • Breathe out slowly.

Step 3. Reset the inhaler and rinse your mouth

  • To clean the mouthpiece, wipe it with a dry tissue before closing the cover. Then slide the cover back as far as it will go.
  • Rinse your mouth with water after your dose. Be sure to spit the water out. Don’t swallow. Doing this helps prevent thrush (see the “Breo side effects” section above for more information).

When to use

Take Breo at the same time every day. Don’t use Breo more than once every 24 hours.

Other drugs are available that can treat your condition. Some may be better suited for you than others. If you’re interested in finding an alternative to Breo, talk with your doctor. They can suggest other medications that may work well for you.

Alternatives for COPD

Examples of other drugs that may be used to treat chronic obstructive pulmonary disease (COPD) include:

long-acting bronchodilators, such as:

  • tiotropium (Spiriva HandiHaler, Spiriva Respimat, Tiova)
    • salmeterol (Serevent)
    • formoterol (Foradil, Perforomist)
    • arformoterol (Brovana)
    • indacaterol (Arcapta)
    • aclidinium (Tudorza)
    • umeclidinium (Incruse Ellipta)
    • glycopyrrolate (Lonhala Magnair, Seebri Neohaler)
    • revefenacin (Yupelri)
  • inhaled corticosteroids, such as:
    • fluticasone (Flovent HFA, others)
    • budesonide (Pulmicort Flexhaler, others)
  • combination inhalers, such as:
    • salmeterol and fluticasone (Advair Diskus)
    • formoterol and budesonide (Symbicort)
  • phosphodiesterase-4 inhibitors, such as:
    • roflumilast (Daliresp)
  • theophylline

Alternatives for asthma

Examples of other drugs that may be used for long-term control of asthma attacks include:

  • long-acting beta2-agonists (LABAs), such as:
    • tiotropium (Spiriva Respimat only)
    • salmeterol (Serevent)
    • formoterol (Foradil, Perforomist)
  • inhaled corticosteroids, such as:
    • fluticasone (Flovent HFA, Flonase, others)
    • budesonide (Pulmicort Flexhaler, Uceris, others)
    • flunisolide (Aerospan HFA)
    • ciclesonide (Alvesco)
    • beclomethasone (Qvar)
    • mometasone (Asmanex)
    • fluticasone furoate (Arnuity Ellipta)
  • leukotriene modifiers, such as:
    • montelukast (Singulair)
    • zafirlukast (Accolate)
    • zileuton (Zyflo)
  • combination inhalers, such as:
    • fluticasone and salmeterol (Advair)
    • budesonide and formoterol (Symbicort)
    • formoterol and mometasone (Dulera)
  • theophylline

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

Uses

Breo and Advair Diskus are FDA-approved to help the lungs work better in people with chronic obstructive pulmonary disease (COPD). The drugs help you breathe by relaxing muscles in your airways and helping them stay open. Both drugs are also approved to reduce the number of COPD flare-ups that people have.

Breo and Advair Diskus are also FDA-approved to prevent asthma attacks in people who:

  • don’t have their asthma under control with a long-term asthma medication, or
  • require treatment with an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA)

Neither Breo nor Advair Diskus is approved for use as rescue therapy or to treat asthma attacks that have already started. Breo is only approved for use in adults. Advair Diskus is approved for treatment in people ages 4 years and older.

Breo and Advair Diskus both contain two drugs from two different drug classes. These drugs belong to the same classes of medication. This means they work the same way within the body.

Breo contains:

  • fluticasone furoate (an ICS)
  • vilanterol trifenatate (a LABA)

Advair Diskus contains:

  • fluticasone propionate (an ICS)
  • salmeterol (a LABA)

Note: Advair is also available as Advair HFA. This version is approved to prevent asthma attacks in certain cases but isn’t approved for the treatment of COPD.

Drug forms and administration

Both Breo and Advair come in an inhaler.

Breo forms and administration

Breo comes in a disposable light gray and blue inhaler. The inhaler contains two foil blister strips of powder medication:

  • One strip contains either 100 mcg or 200 mcg of fluticasone furoate per blister.
  • The other strip contains 25 mcg of vilanterol trifenatate per blister.

Each strip contains 30 blisters, for a total of 30 doses. Each time you fully open the inhaler cover, a new dose is ready for you. For both COPD and asthma, you inhale the drug once per day.

Advair Diskus forms and administration

Advair Diskus comes in a powder inhaler. The inhaler contains a foil blister strip of powder medication. It includes 100, 250, or 500 mcg of fluticasone propionate and 50 mcg of salmeterol per blister. For both COPD and asthma, you inhale the drug twice per day.

Side effects and risks

Breo and Advair Diskus act in similar ways in the body. Because of this, they can cause very similar side effects, which can vary depending on the condition the drugs are used for. Below are examples of these side effects.

More common side effects

Side effects are possible if you take Breo or Advair Diskus for chronic obstructive pulmonary disease (COPD). Here are examples of more common side effects that can occur with Breo, with Advair Diskus, or with both drugs (when taken individually).

  • Can occur with Breo:
    • cough
  • Can occur with Advair Diskus:
    • dizziness
    • tiredness or malaise (overall feeling of discomfort)
    • voice loss
  • Can occur with both Breo and Advair Diskus:
    • airway inflammation (swelling)
    • back and joint pain
    • fever
    • headache
    • oral thrush and esophageal thrush (fungal infection in your mouth or throat)
    • pneumonia
    • respiratory infections such as the common cold or flu
    • sore throat

Side effects are also possible if you take Breo or Advair Diskus for asthma attacks. Here are examples of more common side effects that can occur with Breo, with Advair Diskus, or with both drugs (when taken individually).

  • Can occur with Breo:
    • few unique common side effects
  • Can occur with Advair Diskus:
    • diarrhea
    • nausea and vomiting
  • Can occur with both Breo and Advair Diskus:
    • abnormal heart rhythm (heartbeat that’s too fast, too slow, or irregular)
    • airway inflammation (swelling)
    • cough
    • fever
    • headache
    • muscle and joint pain
    • oral thrush and esophageal thrush (fungal infection in your mouth or throat)
    • respiratory infections such as the common cold or flu
    • sore throat
    • voice loss

Serious side effects

If you have COPD or asthma, serious side effects can occur with Breo, with Advair Diskus, or with both drugs (when taken individually). Here are some examples:

  • Can occur with Breo:
    • few unique serious side effects
  • Can occur with Advair Diskus:
    • Churg-Strauss syndrome (swelling of blood vessels)
  • Can occur with both Breo and Advair Diskus:
    • worsening chronic obstructive pulmonary disease (COPD) and serious asthma attacks
    • heart-related problems such as changes in blood pressure or heart rhythm
    • severe allergic reaction
    • oral thrush and esophageal thrush (fungal infection in your mouth or throat)
    • pneumonia
    • hypercorticism (high cortisol levels) and adrenal suppression (low cortisol levels)
    • lower bone density
    • glaucoma and cataracts
    • hyperglycemia (high blood sugar levels)
    • hypokalemia (low potassium levels)
    • stunted growth in children and teens

Effectiveness

The use of Breo and Advair Diskus in treating COPD and asthma has been directly compared in clinical studies. In one study, more than 800 people with asthma took Breo or Advair Diskus. Both drugs improved patients’ breathing over 24 weeks of treatment.

Three other studies found similar results in people with COPD. The combined study results showed that Breo improved breathing slightly more than Advair Diskus. The difference was small enough that the authors thought it wasn’t meaningful.

Costs

Breo and Advair Diskus are both brand-name drugs. Breo doesn’t have a generic form. Advair Diskus is available as the generic drug fluticasone/salmeterol. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, brand-name Advair Diskus is more expensive than Breo. But the generic version of Advair Diskus is less expensive than Breo. The actual price you’ll pay for any of these drugs depends on your insurance plan, your location, and the pharmacy you use.

In addition to Advair Diskus (above), other medications are also prescribed for uses similar to those of Breo. Below are comparisons between Breo and other medications.

Breo vs. Symbicort

Breo and Symbicort include medications from the same drug classes. This means that they work in similar ways within the body.

Breo contains:

  • fluticasone furoate, which is an inhaled corticosteroid (ICS)
  • vilanterol trifenatate, which is a long-acting beta2-adrenergic agonist (LABA)

Symbicort contains:

  • budesonide (ICS)
  • formoterol fumarate dihydrate (LABA)

Uses

Breo and Symbicort are FDA-approved to treat chronic obstructive pulmonary disease (COPD). The drugs relax muscles in the airways in your lungs, which helps you breathe better. Both drugs are also approved to decrease the number of COPD flare-ups that people have.

In addition, Breo and Symbicort are FDA-approved to help prevent asthma attacks in people who:

  • don’t have their asthma under control with a long-term asthma medication, or
  • require treatment with an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA)

Breo is approved only for use in adults. Symbicort is approved for treatment in people ages 6 and older. Neither drug is approved for use as rescue therapy or to treat asthma attacks that have already started.

Drug forms and administration

Both Breo and Symbicort come in an inhaler. Find out more details below.

Breo forms and administration

Breo comes in a disposable light gray and blue powder inhaler. The inhaler contains two foil blister strips of powder medication:

  • One strip contains either 100 mcg or 200 mcg of fluticasone furoate per blister.
  • The other strip contains 25 mcg of vilanterol trifenatate per blister.

Each strip contains 30 blisters, for a total of 30 doses. Each time you fully open the inhaler cover, a new dose is ready for you. For both COPD and asthma, you inhale the drug once per day.

Symbicort forms and administration

Symbicort comes in a metered-dose aerosol inhaler. For both COPD and asthma, you inhale the drug twice per day.

Symbicort comes in two doses:

  • Symbicort 80/4.5 contains 80 mcg of budesonide and 4.5 mcg of formoterol. Each inhaler contains 120 puffs.
  • Symbicort 160/4.5 contains 160 mcg of budesonide and 4.5 mcg of formoterol. Each inhaler contains 120 puffs.

Side effects and risks

Breo and Symbicort both act in similar ways in the body and therefore can cause very 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 Breo, with Symbicort, or with both drugs (when taken individually) for chronic obstructive pulmonary disease (COPD).

  • Can occur with Breo:
    • back and joint pain
    • fever
    • headache
  • Can occur with Symbicort:
    • few unique common side effects
  • Can occur with both Breo and Symbicort:
    • inflammation (swelling) in the airways in your lungs
    • back and joint pain
    • cough
    • oral thrush or esophageal thrush (fungal infection in your mouth or throat)
    • pneumonia
    • respiratory infections such as the common cold or flu
    • sore throat

These lists contain examples of more common side effects that can occur with Breo, with Symbicort, or with both drugs (when taken individually) for preventing asthma attacks.

  • Can occur with Breo:
    • fever
  • Can occur with Symbicort:
    • stuffy nose
    • upset stomach
    • vomiting
  • Can occur with both Breo and Symbicort:
    • airway inflammation (swelling)
    • back and joint pain
    • cough
    • headache
    • oral thrush or esophageal thrush (fungal infection in your mouth or throat)
    • respiratory infections such as the common cold or flu
    • sore throat
    • voice loss

Serious side effects

This list contains examples of serious side effects that can occur with Breo and Symbicort (when taken individually). The two drugs have mostly similar side effects.

  • Can occur with both Breo and Symbicort:
    • serious asthma attacks
    • worsening chronic obstructive pulmonary disease (COPD) or asthma
    • heart-related problems such as changes in blood pressure or heart rhythm
    • severe allergic reaction
    • oral thrush or esophageal thrush (fungal infection in your mouth or throat)
    • pneumonia
    • hypercorticism (high cortisol levels) and adrenal suppression (low cortisol levels)
    • lower bone density
    • glaucoma and cataracts
    • hyperglycemia (high blood sugar levels)
    • hypokalemia (low potassium levels)
    • stunted growth in children and teens

Effectiveness

The use of Breo and Symbicort in treating COPD and asthma have been directly compared in a clinical study. Researchers found that Symbicort improved asthma symptoms better than Breo after four weeks of treatment. However, the study was very small, and more trials are needed to confirm the results.

Costs

Breo and Symbicort are both brand-name drugs. They don’t have generic forms. Brand-name medications usually cost more than generics.

According to estimates from GoodRx.com, Breo and Symbicort generally cost about the same. The actual price you would pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Breo vs. Anoro

Breo and Anoro both contain the drug vilanterol. This means that they work in similar ways within the body.

Breo contains:

  • fluticasone furoate, which is an inhaled corticosteroid (ICS)
  • vilanterol trifenatate, which is a long-acting beta2-adrenergic agonist (LABA)

Anoro contains:

  • umeclidinium bromide, which is a long-acting muscarinic antagonist
  • vilanterol trifenatate, which is a LABA

Uses

Breo and Anoro are both FDA-approved to help treat chronic obstructive pulmonary disease (COPD). The drugs help you breathe better by relaxing muscles in your airways.

Breo is also FDA-approved to reduce the number of COPD flare-ups in people who have them.

Breo is also used to help prevent asthma attacks in adults who:

  • don’t have their asthma under control with a long-term asthma medication, or
  • require treatment with an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA)

Anoro isn’t approved to treat asthma. Neither drug is approved for use as rescue therapy or to treat asthma attacks that have already started.

Drug forms and administration

Both Breo and Anoro come in the form of an inhaler. Find out more details below.

Breo forms and administration

Breo comes in a disposable light gray and blue powder inhaler. The inhaler contains two foil blister strips of powder medication:

  • One strip contains either 100 mcg or 200 mcg of fluticasone furoate per blister.
  • The other strip contains 25 mcg of vilanterol trifenatate per blister.

Each strip contains 30 blisters, for a total of 30 doses. Each time you fully open the inhaler cover, a new dose is ready for you. For both COPD and asthma, you inhale the drug once per day.

Anoro forms and administration

Anoro comes in a disposable light gray and red powder inhaler in one-dose strength. The inhaler contains two foil blister strips of powder medication:

  • One blister strip contains 62.5 mcg of umeclidinium bromide per blister.
  • The other strip contains 25 mcg of vilanterol trifenatate per blister.

For COPD treatment, you inhale Anoro once per day.

Side effects and risks

Breo and Anoro both act in similar ways in the body. Because of this, they can cause very similar side effects. Below are examples of these side effects.

More common side effects

Side effects are possible if you take Breo or Anoro for chronic obstructive pulmonary disease (COPD). Here are examples of more common side effects that can occur with Breo, Anoro, or with both drugs (when taken individually).

  • Can occur with Breo:
    • pneumonia
    • headache
    • airway inflammation (swelling)
    • oral thrush or esophageal thrush (fungal infection in your mouth or throat)
  • Can occur with Anoro:
    • chest pain
    • constipation
    • diarrhea
    • muscle twitch
    • neck pain
    • pain in arms and legs
    • urinary tract infection
  • Can occur with both Breo and Anoro:
    • back and joint pain
    • cough
    • fever
    • abnormal heart rhythm (heartbeat that’s too fast, too slow, or irregular)
    • respiratory infections such as the common cold or flu
    • sore throat

Serious side effects

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

  • Can occur with Breo:
    • hypercorticism (high cortisol levels) and adrenal suppression (low cortisol levels)
    • lower bone density
    • pneumonia
    • stunted growth in children and teens
    • glaucoma
  • Can occur with Anoro:
    • urinary retention (bladder doesn’t empty completely)
  • Can occur with both Breo and Anoro:
    • serious asthma attacks
    • worsening chronic obstructive pulmonary disease (COPD) or asthma
    • heart-related problems such as changes in blood pressure or heart rhythm
    • severe allergic reaction
    • oral thrush or esophageal thrush (fungal infection in your mouth or throat)
    • glaucoma (eye problems)
    • hyperglycemia (high blood sugar levels)
    • hypokalemia (low potassium levels)

Effectiveness

These drugs haven’t been directly compared in clinical studies. But in separate studies, both Breo and Anoro were found to be effective in treating chronic obstructive pulmonary disease (COPD).

Costs

Breo and Anoro are both brand-name drugs. They don’t have generic forms. Brand-name medications usually cost more than generics.

According to estimates from GoodRx.com, Breo was less expensive than Anoro. The actual price you would pay for either drug would depend on your insurance plan, your location, and the pharmacy you use.

Breo and alcohol don’t interact with each other. However, some alcohol may contain sulfites, which can trigger chronic obstructive pulmonary disease (COPD) flare-ups or asthma attacks. If you drink alcohol, talk with your doctor about how much alcohol is safe for you.

Breo can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can affect how well a drug works, while others can cause increased side effects.

Breo and other medications

Below is a list of medications that can interact with Breo. This list doesn’t contain all drugs that may interact with Breo.

Before taking Breo, tell your doctor and pharmacist 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.

Certain antimicrobial medications

Antimicrobial medications treat infections caused by bacteria, viruses, or fungi. If you take Breo with certain antimicrobial drugs, the level of Breo in your body may get higher. This may increase the number and strength of side effects. If you take any of these medications, talk with your doctor about the risks of using Breo.

Examples of these medications include:

  • ketoconazole (Nizoral, Extina, Xolegel, others)
  • ritonavir (Norvir)
  • clarithromycin (Biaxin)
  • itraconazole (Sporanox)
  • voriconazole (Vfend)

Certain antidepressants

Taking Breo with certain depression medications can cause heart rhythm problems. If you take any of these medications, talk with your doctor about the risks of using Breo.

Examples of these medications include:

  • certain monoamine oxidase inhibitors (MAOIs), such as:
    • isocarboxazid (Marplan)
    • phenelzine (Nardil, Nardelzine)
    • tranylcypromine
    • selegiline (Emsam, Eldepryl, Zelapar)
    • rasagiline (Azilect)
  • certain tricyclic antidepressants (TCAs), such as:
    • amitriptyline (Endap)
    • clomipramine (Anafranil)
    • doxepin (Sinequan)
    • imipramine (Tofranil)
    • nortriptyline (Aventyl, Pamelor)
    • protriptyline (Vivactil)

Other drugs that can affect your heart rhythm

Certain drugs can increase your QT interval, which is a measurement used to check how your heart beats. Taking these drugs with Breo can increase your risk of heart rhythm problems. If you take any of these medications, talk with your doctor about the risks of using Breo.Examples of these medications include:

  • certain antiarrhythmics (heart rhythm) medications, such as:
    • amiodarone (Cordarone, Nextrone, Pacerone)
    • sotalol (Betapace, Betapace AF, Sorine)
    • quinidine
    • procainamide
  • certain antimicrobials, such as:
    • levofloxacin
    • ciprofloxacin (Cipro, Cipro XR)
    • erythromycin (Erythrocin)
    • ketoconazole (Nizoral, Extina, Xolegel, others)
  • other medications, such as:
    • sumatriptan (Imitrex)
    • zolmitriptan (Zomig)
    • methadone (Dolophine)

Certain blood pressure and heart medications

Beta-blockers are a type of heart and blood pressure medication. Taking certain beta-blockers can block the action of Breo in your body. This can cause the blood vessels in your lungs to constrict (narrow). As a result, it may be harder for you to breathe. It may also put you at a higher risk for asthma attacks.

Examples of these beta-blockers include:

  • carvedilol (Coreg)
  • labetalol (Normodyne, Trandate, others)
  • nadolol (Corgard)
  • propranolol (Hemangeol, Inderal, InnoPran XL)

Certain diuretics

Non-potassium-sparing diuretics are another type of heart and blood pressure medication. Taking Breo with these drugs causes potassium to leave your body through urine. Low levels of potassium in the body can lead to heart problems. These include an abnormal heart rhythm (a heartbeat that’s too fast, too slow, or irregular).

Examples of non-potassium-sparing diuretics include:

  • chlorathiazide (Diuril)
  • hydrochlorothiazide (Apo-Hydro, Aquazide, Microzide, others)
  • bumetanide (Bumex)
  • furosemide (Lasix)
  • torsemide (Demadex)

Your doctor may prescribe Breo alone or with other drugs to treat chronic obstructive pulmonary disease (COPD) or asthma. It’s typical to use more than one medication for these diseases.

To manage COPD and asthma symptoms, it’s common to use rescue (short-acting) medications. These drugs work when you’re in between doses of long-term medications such as Breo.

Most long-term medications, including Breo, aren’t approved to treat asthma attacks that are already happening. And you usually can’t use these long-term drugs more than once or twice a day. You can use short-acting inhalers multiple times a day to treat sudden COPD flare-ups or asthma attacks.

Other types of medications your doctor might prescribe to use with Breo include:

  • Short-acting beta2-adrenergic agonists
    • albuterol (Proventil HFA, ProAir HFA, Ventolin HFA)
    • levalbuterol (Xopenex, Xopenex HFA)
  • Long-acting muscarinic antagonists (LAMAs)
    • aclidinium (Tudorza Pressair)
    • glycopyrrolate (Seebri Neohaler, Longhala Magnair)
    • tiotropium (Spiriva HandiHaler, Spiriva Respimat)
    • umeclidinium (Incruse Ellipta)

Breo and Incruse Ellipta

The drug combination of Breo and Incruse Ellipta is used to treat COPD only. Incruse Ellipta is a brand-name medication that contains umeclidinium bromide, a LAMA. Breo is a combination of an ICS (fluticasone fumerate) and a LABA (vilanterol trifenatate).

Together, Breo and Incruse Ellipta contain three types of drugs: a LABA, a LAMA, and an ICS. This combination may help people whose COPD isn’t controlled by one or two drugs. The brand-name medication Trelegy Ellipta contains these three drugs in a single inhaler. It’s used once a day for COPD.

Breo and Spiriva

The drug combination of Breo and Spiriva may be used to treat COPD or severe asthma. Spiriva is a brand-name medication that contains tiotropium bromide, which falls in the LAMA drug class. Breo contains an ICS (fluticasone fumerate) and a LABA (vilanterol trifenatate).

Together, Breo and Spiriva provide treatment with three drug classes including a LABA, a LAMA, and an ICS. This may help people whose COPD or asthma isn’t controlled by one or two drugs.

Breo and albuterol

The drug combination of Breo and albuterol is used to treat asthma and COPD. Breo is a medication for the long-term treatment of COPD. It also helps prevent asthma attacks. It’s not approved as rescue therapy or to treat asthma attacks that have already started. Breo contains an ICS (fluticasone furoate) and a LABA (vilanterol trifenatate).

Albuterol, on the other hand, is a short-acting beta2-adrenergic agonist (SABA). It’s approved for treating COPD flare-ups and asthma attacks.

You can use albuterol between doses of Breo to treat any sudden attacks. This means you’ll have treatment to help prevent COPD flare-ups and asthma attacks.

Breo helps you breathe better by relaxing muscles in your airways. The drug helps treat chronic obstructive pulmonary disease (COPD), reduce COPD symptom flare-ups, and prevent asthma attacks in adults.

When you have COPD or asthma and your symptoms flare up, your airways may narrow. This can make it harder to breathe. Narrowed airways can have many causes, including:

  • muscle twitches in the airways
  • fluid or sputum (mucus) buildup
  • tightening of blood vessels in the lungs

Breo contains fluticasone furoate, an inhaled corticosteroid (ICS). It also contains vilanterol trifenatate, a long-acting beta2-adrenergic agonist (LABA).

It’s not known how fluticasone affects COPD and asthma. But ICS drugs can reduce inflammation (swelling), so that may be how fluticasone helps control COPD and asthma.

LABAs work by causing airway muscles in the lungs to relax, so you’re able to breathe easier.

How long does it take to work?

Breo begins working as soon as you take it. But you may not notice an improvement right away. This is because it’s a drug that’s used for long-term treatment. It’ll gradually improve the way your lungs work and help prevent COPD flare-ups and asthma attacks later.

Most people start to breathe easier about 15 minutes after taking a dose of Breo.

There haven’t been enough studies in humans to know if Breo is safe to use during pregnancy. In animal studies, the fetus was at risk for birth defects when the mother was given the drug. However, animal studies don’t always predict the way humans would respond.

If you’re pregnant or planning to become pregnant, talk with your doctor. Together you can explore the risks and benefits of taking Breo during pregnancy.

There haven’t been enough studies to show whether Breo appears in breast milk. Inhaled corticosteroids (ICSs) similar to fluticasone furoate, a drug in Breo, have been found in breast milk. So it’s best to weigh the potential benefits and risks of taking Breo while breastfeeding.

Talk with your doctor before you start breastfeeding to see if Breo is right for you.

Here are answers to some frequently asked questions about Breo.

Is Breo a steroid inhaler?

Yes. Breo contains fluticasone furoate, which is an inhaled corticosteroid. This type of drug helps ease swelling in your airways so you can breathe easier.

Is Breo safe for use in children?

No. Breo isn’t approved for treating children younger than age 18. In clinical studies, Breo wasn’t safe and effective in treating children for chronic obstructive pulmonary disease (COPD) or asthma. Other drugs are available that have been approved for use in children. These include albuterol (ProAir HFA, Ventolin HFA, others) and tiotropium (Spiriva Respimat).

Can I stop using Breo anytime?

Breo is a long-term medication for treating chronic obstructive pulmonary disease (COPD) and asthma. So it’s important to take the drug as your doctor prescribes. Talk with your doctor before making any changes to your treatment plan.

Can I use Breo to treat sudden symptoms of asthma?

No. Breo isn’t approved as rescue therapy. This means it isn’t used for the treatment of sudden asthma attacks that have already started. Other short-term drugs can help in those cases such as albuterol (ProAir HFA, Ventolin HFA, others).

Should I be able to taste Breo when I inhale it?

You may not be able to taste the drug, even if you’re using the inhaler correctly. So don’t be concerned if you don’t taste it. And definitely don’t take another dose. That may cause you to take in too much of the drug.

Should I be concerned that Breo contains a LABA drug?

No, but it’s easy to see why there may be some confusion. Breo contains two drugs. In clinical studies, people who took only one of the drugs in Breo had an increased risk for serious asthma attacks. But this wasn’t the case for people who took both of the drugs in Breo.

The first drug that Breo contains is fluticasone furoate, which belongs to a class of drugs called inhaled corticosteroid (ICSs). The second drug is vilanterol trifenatate, a long-acting beta2-adrenergic agonist (LABA).

Using LABA drugs alone has shown to increase the risk of serious asthma attacks. In some clinical studies, people took LABAs alone for asthma. These people had an increased risk for asthma-related problems including hospitalization and even death.

In other clinical studies, people took LABAs with inhaled corticosteroids (ICSs). There were no additional risks for asthma-related problems when taking both LABAs and ICSs. Therefore, LABAs should be used with ICSs to the reduce risk of serious asthma attacks.

In severe cases, COPD and asthma can cause death. If you think you’re having a serious asthma attack, call your doctor right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Have the ingredients in Breo ever caused deaths?

All drugs have side effects. Some can lead to serious problems, including death. The combination of drugs in Breo has not been linked with deaths.

In clinical studies, some people who took Breo died from serious cases of pneumonia and heart problems. These are possible side effects of the drug. However, there isn’t enough information to know if Breo was the cause of death. That’s because the number of deaths was the same in people who took a placebo (treatment with no active medication).

Breo used to have a boxed warning for increased risk of asthma-related death. This is because one of its ingredients belongs to the drug class called long-acting beta2-adrenergic agonists (LABAs). When LABAs are taken alone to treat asthma, they can increase risk of asthma-related death.

Breo no longer has this boxed warning. That’s because the Food and Drug Administration (FDA) found that when LABAs are used with inhaled corticosteroids, there is no increased risk of serious asthma problems. Breo contains a LABA (vilanterol trifenatate) and an inhaled corticosteroid (fluticasone furoate), so it poses no increased risk.

Before taking Breo, talk with your doctor about your health history. Breo may not be right for you if you have certain medical conditions. Examples of these conditions are listed below.

Worsening COPD or asthma

In some cases, your chronic obstructive pulmonary disease (COPD) or asthma may get worse quickly and Breo shouldn’t be used. These include life-threatening or quickly progressing cases of COPD or asthma that aren’t controlled by medication. Breo also shouldn’t be used as rescue therapy or for asthma attacks that have already started.

Your COPD or asthma may be getting worse if:

  • Breo no longer helps your symptoms
  • your short-acting beta2-adrenergic agonist (SABA) medication no longer helps your symptoms
  • you’re using your SABA medication more often

In severe cases, COPD and asthma can cause death. If you think your disease is progressing quickly, call your doctor right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Decreased bone density

Risk factors for decreased bone density include:

  • not exercising enough
  • family history of osteoporosis (fragile bones)
  • menopause before age 45
  • smoking
  • older age
  • poor nutrition
  • long-term use of drugs that can lower bone mass, such as anticonvulsants (seizure medications) and oral corticosteroids

If you have more than one of these risk factors, talk with your doctor. You’ll need regular follow-ups to check your bone density while you take Breo.

Abnormal heart rhythm

Breo can cause irregular heart rhythms by lowering potassium levels. If you have a history of heart rhythm problems, talk with your doctor. Together you can see if Breo is right for you.

Diabetes

Breo may cause hyperglycemia (high blood sugar levels) in people who are at risk for diabetes. Breo may also cause ketoacidosis (increased levels of ketones in the blood) in people with diabetes. If you have a history of any of these issues, talk with your doctor. The two of you can see if Breo is right for you.

Milk allergy

Breo contains lactose, an ingredient in milk. People with severe allergies to milk protein can experience severe allergic reactions after inhaling Breo.

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

Using more than the recommended dose of Breo can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • hypercorticism (high cortisol levels) and adrenal suppression (low cortisol levels). You may notice:
    • weight gain, mostly around your midsection and upper back
    • purple stretch marks on your skin
    • easy bruising
    • slow healing cuts or wounds
    • acne
  • seizures
  • chest pain
  • changes in blood pressure
  • headache
  • dry mouth
  • abnormal heart rhythm (heartbeat that’s too fast, too slow, or irregular)
  • nausea
  • tiredness and malaise (overall feeling of discomfort)

What to do in case of overdose

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

When you get Breo 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 with your pharmacist. They can tell you 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 it.

Store your Breo inhaler at room temperature between 68°F and 77°F (20°C and 25°C). Pick a dry place away from sunlight and heat. Keep the inhaler out of the reach of children.

The medication is good for up to six weeks. This is from the time you remove it from the foil tray or after the counter reaches zero, whichever comes first.

Disposal

If you no longer need to take Breo 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

Breo is FDA-approved for use in adults (18 years and older) for the:

  • long-term maintenance treatment of airflow obstruction and reducing exacerbations in people with chronic obstructive pulmonary disease (COPD)
  • treatment of asthma

Breo isn’t indicated for relief of acute bronchospasm.

Mechanism of action

Breo contains both fluticasone furoate and vilanterol; thus, there are several mechanisms at work.

The exact mechanism for fluticasone furoate on COPD and asthma isn’t known. However, corticosteroids affect a wide range of cell types that mediate inflammation, which is an important component in COPD and asthma pathophysiology.

Fluticasone furoate is a corticosteroid with anti-inflammatory activity. This activity affects several pathways including NF-kB, which is a pro-inflammatory mediator.

Vilanterol is a long-acting beta2-adrenergic agonist (LABA) that relaxes bronchial smooth muscle. Vilanterol binds to beta2 receptors, which increases levels of cyclic 3′,5′ adenosine monophosphate (cyclic AMP). Cyclic AMP is known to induce smooth muscle relaxation, and also regulates mast cells from releasing inflammatory mediators.

Pharmacokinetics and metabolism

Plasma levels of fluticasone furoate and vilanterol may not indicate therapeutic effect. Absolute bioavailability is 15.2 percent of fluticasone furoate and 27.3 percent of vilanterol due to absorption of the inhaled dose. Time to maximum concentration is 0.5 to 1 hour for fluticasone furoate and 10 minutes for vilanterol after inhalation.

Fluticasone furoate and vilanterol are both metabolized hepatically, primarily via the CYP3A4 enzyme.

Contraindications

Breo in contraindicated in patients with:

  • primary treatment of status asthmaticus or other acute episodes of COPD or asthma where intensive measures are required, or
  • severe hypersensitivity to milk proteins, fluticasone furoate, vilanterol, or any of the excipients

Storage

Breo should be stored at room temperature between 68°F and 77°F (20°C and 25°C). Store it in a dry place away from direct heat or sunlight. Breo should be kept out of the reach of children.

Breo comes in an unopened moisture-protective foil tray. It should only be removed from the tray immediately before the initial use. Dispose of the inhaler six weeks after removing it from the foil tray or after the medication counter reads zero (after all blisters have been used), whichever comes first.

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 shouldn’t 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 doesn’t indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.