Trelegy Ellipta is a brand-name prescription medication. It’s FDA-approved for the long-term maintenance treatment of:

However, Trelegy Ellipta isn’t approved for use as a rescue inhaler to ease sudden breathing problems caused by either COPD or asthma. For more information about Trelegy Ellipta’s approved uses, see the “Trelegy Ellipta for COPD” and “Trelegy Ellipta for asthma” sections below.

Drug details

Trelegy Ellipta is a combination medication. It contains these three active drugs that help relieve breathing symptoms of COPD and asthma:

Trelegy Ellipta comes as an inhaler. “Trelegy” is the name of the medication inside the inhaler. The word “Ellipta” refers to the specific type of dry powder inhaler that contains the drug.

This medication is taken as one inhalation (puff) of Trelegy Ellipta once each day.

Trelegy Ellipta is approved for use in adults ages 18 years and older. It’s not approved for use in children.

Effectiveness

For information about the effectiveness of Trelegy Ellipta, see the “Trelegy Ellipta for COPD” and “Trelegy Ellipta for asthma” sections below.

FDA approval

In 2017, the Food and Drug Administration (FDA) approved Trelegy Ellipta to treat COPD. More recently, in 2020, the drug was approved to treat asthma. It’s the first FDA-approved medication containing three active drugs that can be used once a day for either COPD or asthma.

Trelegy Ellipta contains three active drug ingredients: fluticasone, umeclidinium, and vilanterol. It’s available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Trelegy Ellipta can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Trelegy Ellipta. These lists don’t include all possible side effects.

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

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Trelegy Ellipta, you can do so through MedWatch.

Mild side effects

Mild side effects* of Trelegy Ellipta can include:

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.

* This is a partial list of mild side effects from Trelegy Ellipta. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Trelegy Ellipta’s prescribing information.
† This mild side effect is explained in more detail below in “Side effect details.”

Serious side effects

Serious side effects from Trelegy Ellipta 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:

  • Thrush (fungal infection) in the mouth or throat. Symptoms can include:
    • white spots on your tongue or cheeks
    • redness
    • burning feeling
  • Pneumonia. Symptoms can include:
    • fever
    • chills
    • cough
    • increased trouble breathing
    • more mucus or change in color of mucus
  • Weakened immune system. Symptoms can include:
    • infections that keep coming back
    • infections that take a long time to heal
  • Decreased adrenal gland function. Symptoms can include:
  • Bronchospasm (sudden trouble breathing). Symptoms can include:
    • wheezing
    • feeling short of breath
    • tight feeling in your chest
  • Changes in heart rate or blood pressure. Symptoms can include:
    • increased blood pressure
    • a fast or irregular heartbeat
    • feeling aware of your heartbeat
    • chest pain
  • Osteoporosis (weakened bones). Symptoms can include:
    • a bone that breaks more easily than it should
    • curved spine at the shoulders
    • decreased height
    • change in posture
  • Eye problems such as glaucoma or cataracts. Symptoms can include:
    • eye pain
    • blurry vision
    • nausea and vomiting
    • seeing halos or bright colors when looking at lights
    • red eyes
  • Nervous system problems. Symptoms can include:
    • tremor
    • feeling nervous
  • Decreased level of potassium in your blood. Symptoms can include:
    • weakness
    • muscle cramping
    • heart palpitations (feeling of skipped or extra heartbeats)
    • feeling tired
  • Increased blood sugar level. Symptoms can include:
    • feeling thirsty
    • feeling tired
    • urinating more often than normal
    • blurry vision
    • headache
  • Allergic reaction.*

Note: Long-acting beta2-agonists (LABAs) are known to increase the risk of asthma-related death and hospitalization if they’re taken alone. Vilanterol, an ingredient in Trelegy Ellipta, is a LABA. But in Trelegy, it’s combined with fluticasone, an inhaled corticosteroid (ICS), and umeclidinium, an anticholinergic. Clinical trials have shown that when a LABA is used in combination with an ICS, using the LABA does not increase the risk of asthma-related death and hospitalization.

* This serious side effect is explained in more detail below in “Side effect details.”

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 a few of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Trelegy Ellipta. However, no allergic reactions were reported as a side effect of the drug in clinical trials.

It’s important to note that Trelegy Ellipta contains a powder form of lactose (a sugar in milk). So if you have a severe milk protein allergy, you may have an allergic reaction to this medication. There have been reports of very serious allergic reactions in people with milk protein allergies who took other powder medications with lactose in them. If you have a severe protein milk allergy, you shouldn’t use Trelegy Ellipta. Ask your doctor what other treatments are better choices for you.

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:

  • 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 Trelegy Ellipta. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Headache

Trelegy Ellipta may cause headaches. In clinical trials, 4% to 9%* of people who took Trelegy Ellipta developed headaches. This is compared with 3% to 7%* of people who took only fluticasone and vilanterol (two of the three ingredients in Trelegy Ellipta).

If you have headaches that are bothersome to you during your Trelegy Ellipta treatment, talk with your doctor. They may be able to recommend ways to help prevent headaches from occurring.

* This percentage range varied depending on the condition being treated and the dose of treatment given.

Back pain

Back pain may occur with Trelegy Ellipta. In clinical studies, back pain occurred in 2% to 4%* of people who took Trelegy Ellipta. In comparison, back pain only occurred in about 1% to 4%* of people who took only fluticasone and vilanterol (two of the three ingredients in Trelegy Ellipta).

If you develop back pain from taking Trelegy Ellipta, talk with your doctor. They can recommend ways to help ease the pain.

* This percentage range varied depending on the condition being treated and the dose of treatment given.

Weight gain (not a side effect)

Weight gain isn’t a side effect that’s been reported with Trelegy Ellipta use. A long-term study of Trelegy Ellipta looked at side effects of the medication over the course of 52 weeks. There were no reports of weight gain in this study.

However, it’s possible for the long-term use of inhaled steroids to cause weight gain. Steroids can increase your level of cortisol, which is a hormone that has effects on your metabolism. And too much cortisol can lead to weight gain.

Trelegy Ellipta contains fluticasone, which is an inhaled steroid. So in theory, it’s possible for Trelegy Ellipta to cause you to gain weight. However, as mentioned above, weight gain wasn’t a side effect of Trelegy Ellipta reported in clinical trials.

If you have concerns about gaining weight while taking Trelegy Ellipta, talk with your doctor.

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 fit your needs.

Drug forms and strengths

Trelegy Ellipta comes as an inhaler. “Trelegy” is the name of the medication inside the inhaler. The word “Ellipta” refers to the specific type of dry powder inhaler that contains the drug.

There are a total of 30 doses in each Trelegy Ellipta inhaler. Each inhaler has two foil strips inside it that contain blisters of the medication. These foil strips hold Trelegy Ellipta’s active drugs as follows:

  • one strip holds either 100 micrograms (mcg)* or 200 mcg** of fluticasone in each blister
  • the other strip holds 62.5 mcg of umeclidinium and 25 mcg of vilanterol in each blister

Note: After you inhale a dose of Trelegy Ellipta, be sure to rinse your mouth with water and spit out the water without swallowing. This may help decrease your risk of getting oral thrush, which is a fungal infection in your mouth. Oral thrush is a possible side effect of taking an inhaled steroid medication.

* This strength of Trelegy Ellipta is abbreviated as 100/62.5/25 mcg.
** This strength of Trelegy Ellipta is abbreviated as 200/62.5/25 mcg.

Dosage for chronic obstructive pulmonary disease (COPD)

For chronic obstructive pulmonary disease (COPD), the recommended dosage of Trelegy is one inhalation (puff) of Trelegy Ellipta 100/62.5/25 mcg once each day.

You should try to take your dose of Trelegy Ellipta at the same time each day. Don’t use this medication more than once in 24 hours.

Note: Trelegy Ellipta is meant to be used over time to control COPD symptoms. The drug isn’t meant to be used for sudden breathing problems caused by COPD. Instead, you’ll use a rescue inhaler for sudden trouble breathing. For information about this, see the “Trelegy Ellipta use with other drugs” section below.

Dosage for asthma

For asthma, the recommended dosage of Trelegy is one inhalation (puff) of Trelegy Ellipta once a day. For this condition, your doctor may prescribe either Trelegy Ellipta 100/62.5/25 mcg or Trelegy Ellipta 200/62.5/25 mcg. Their recommendation will depend on how severe your asthma is and whether you’ve used other asthma treatments in the past.

You should try to take your dose of Trelegy Ellipta at the same time each day. Don’t use this medication more than once in 24 hours.

Note: Trelegy Ellipta is meant to be used over time to control asthma symptoms. The drug isn’t meant to be used for sudden breathing problems caused by asthma. Instead, you’ll use a rescue inhaler for sudden trouble breathing. For information about this, see the “Trelegy Ellipta use with other drugs” section below.

What if I miss a dose?

If you miss a dose of Trelegy Ellipta, take it as soon as you remember. Don’t take more than one dose in 24 hours. Never take two doses at once to try to make up for a missed dose.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Trelegy Ellipta is meant to be used as a long-term treatment. The drug was studied and shown to be safe and effective for long-term use in people with either COPD or asthma. If you and your doctor determine that Trelegy Ellipta is safe and effective for you, you’ll likely take it long term.

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

In addition to being FDA-approved to treat chronic obstructive pulmonary disease (COPD), Trelegy Ellipta is also FDA-approved to treat asthma. For more information, see the “Trelegy Ellipta for asthma” section below.

Trelegy Ellipta for COPD

Trelegy Ellipta is a combination medication that’s used to treat symptoms of chronic obstructive pulmonary disease (COPD). COPD is a group of lung conditions that include chronic bronchitis and emphysema, and it can cause wheezing, coughing, and trouble breathing.

With chronic bronchitis, you develop a cough that lasts a long time. And you’ll usually keep coughing up mucus. This can cause an infection in your lungs and make it hard for you to breathe. With emphysema, your lungs are damaged and have trouble passing air in and out. This can cause wheezing and fatigue (lack of energy).

It’s important to note that Trelegy Ellipta is meant to be used over time to control COPD symptoms. The drug isn’t meant to be used for sudden breathing problems caused by COPD. Instead, you’ll use a rescue inhaler for sudden trouble breathing. For information about this, see the “Trelegy Ellipta use with other drugs” section below.

Trelegy Ellipta is made of three medications that work to help ease the symptoms of COPD. For more information about what these drugs do, see the “How Trelegy Ellipta works” section below.

Effectiveness for COPD

In clinical trials, Trelegy Ellipta was effective in treating COPD.

In the trials, Trelegy Ellipta was compared with a combination of placebo plus two of its three drugs: fluticasone and vilanterol. Researchers measured people’s forced expiratory volume in 1 second (FEV1), which is the amount of air you can force out of your lungs in 1 second.

The studies showed that FEV1 in people who took Trelegy Ellipta was between 122 mL and 124 mL higher than it was in people who took fluticasone and vilanterol. Higher FEV1s show better lung function, while lower FEV1s show poorer lung function.

Studies also showed that treatment with Trelegy Ellipta decreased the risk of COPD exacerbations (flare-ups of COPD symptoms). For instance:

  • people who took Trelegy Ellipta had 15% fewer flare-ups each year than people who took fluticasone and vilanterol (two of the three drugs in Trelegy Ellipta)
  • people who took Trelegy Ellipta had 25% fewer flare-ups each year than people who took umeclidinium and vilanterol (two of the three drugs in Trelegy Ellipta)

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

In addition to being FDA-approved to treat asthma, Trelegy Ellipta is also FDA-approved to treat chronic obstructive pulmonary disease (COPD). For more information, see the “Trelegy Ellipta for COPD” section above.

Trelegy Ellipta for asthma

Trelegy Ellipta is a combination medication that’s used to treat asthma. Asthma is a lung condition that makes it hard to breathe due to swelling and narrowing in your airways.

With asthma, you may have symptoms such as:

  • cough
  • wheezing
  • tightness in your chest

It’s important to note that Trelegy Ellipta is meant to be used over time to control asthma symptoms. The drug isn’t meant to be used for sudden breathing problems caused by asthma. Instead, you’ll use a rescue inhaler for sudden trouble breathing. For information about this, see the “Trelegy Ellipta use with other drugs” section below.

Trelegy Ellipta is made of three medications that work to help treat symptoms of asthma. For more information about what these drugs do, see the “How Trelegy Ellipta works” section below.

Effectiveness for asthma

In clinical trials, Trelegy Ellipta was effective in treating asthma.

In the trials, Trelegy Ellipta was compared with two of its three drugs: fluticasone and vilanterol. Researchers measured people’s forced expiratory volume in 1 second (FEV1), which is the amount of air you can force out of your lungs in 1 second.

One study showed that FEV1 in people who took Trelegy Ellipta was 59 mL higher than it was in people who took fluticasone and vilanterol. Higher FEV1s show better lung function, while lower FEV1s show poorer lung function.

The studies also showed that asthma exacerbations (flare-ups of asthma symptoms) occurred in:

  • 16% of people who took Trelegy Ellipta
  • 16% of people who took fluticasone and vilanterol

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

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for chronic obstructive pulmonary disease (COPD)

Here are some examples of other drugs that may be used to treat chronic obstructive pulmonary disease (COPD).

Alternative combination medications for COPD

Other combination medications that may be used to treat COPD include:

Other alternative medications for COPD

Other medications that may be used to treat COPD include:

  • anticholinergics, such as:
  • LABAs, such as:
    • formoterol (Foradil, Perforomist)
    • indacaterol (Arcapta)
    • salmeterol (Serevent)
    • olodaterol (Striverdi)
  • oral medications, such as:
    • roflumilast (Daliresp)
    • theophylline (Theochron)

Note: Trelegy Ellipta and the alternative drugs listed here are meant to be used over time to control COPD symptoms. They aren’t meant to be used for sudden breathing problems caused by COPD. Instead, you’ll use a rescue inhaler for sudden trouble breathing. For information about this, see the “Trelegy Ellipta use with other drugs” section below.

Alternatives for asthma

Here are some examples of other drugs that may be used to treat asthma.

Alternative combination medications for asthma

Other combination medications that may be used to treat asthma include:

  • a long-acting beta2-agonist (LABA) and an inhaled steroid, such as:
    • formoterol/budesonide (Symbicort)
    • formoterol/mometasone (Dulera)
    • salmeterol/fluticasone (Advair Diskus)
    • vilanterol/fluticasone (Breo Ellipta)

Other alternative medications for asthma

Other medications that may be used to treat asthma include:

  • inhaled corticosteroids, such as:
    • fluticasone (Flovent HFA)
    • budesonide (Pulmicort Flexhaler)
    • mometasone (Asmanex Twisthaler)
    • beclomethasone (Qvar RediHaler)
    • ciclesonide (Alvesco)
  • leukotriene modifiers, such as:
    • montelukast (Singulair)
    • zafirlukast (Accolate)
    • zileuton (Zyflo)
  • LABAs, such as:
    • salmeterol (Serevent)
  • oral medications, such as:
    • theophylline (Theo-24)

Note: Trelegy Ellipta and the alternative drugs listed here are meant to be used over time to control asthma symptoms. They aren’t meant to be used for sudden breathing problems caused by asthma. Instead, you’ll use a rescue inhaler for sudden trouble breathing. For information about this, see the “Trelegy Ellipta use with other drugs” section below.

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

Ingredients

Trelegy Ellipta contains three active drug ingredients: fluticasone, vilanterol, and umeclidinium. Breo Ellipta contains two active drug ingredients: fluticasone and vilanterol.

Uses

Both Trelegy Ellipta and Breo Ellipta are approved for use in adults as long-term treatment of:

However, Breo Ellipta is approved as a maintenance treatment for asthma only when:

  • asthma symptoms aren’t well controlled on a long-term asthma medication such as an inhaled corticosteroid ICS), or
  • asthma is severe enough that it needs to be treated with both an ICS and a long-acting beta2-agonist (LABA) drug

Note: Neither Trelegy Ellipta nor Breo Ellipta is approved to treat sudden trouble breathing. If you have sudden trouble breathing, your doctor will likely want you to use a rescue inhaler such as albuterol (Ventolin HFA, ProAir) or levalbuterol (Xopenex).

Drug forms and administration

Trelegy Ellipta and Breo Ellipta both come as disposable inhalers. “Trelegy” and “Breo” are the names of the medications inside the inhalers. The word “Ellipta” refers to the specific type of inhaler that contains the drug.

Both Trelegy Ellipta and Breo Ellipta are dry powder inhalers. The medication is in a powder form that you breathe into your lungs. These inhalers are easy to use and include a dose counter so that you know when to refill your prescription.

For both Trelegy Ellipta and Breo Ellipta, you’ll take one inhalation (puff) of the medication once a day.

Side effects and risks

Trelegy Ellipta and Breo Ellipta both contain fluticasone furoate and vilanterol. Trelegy Ellipta also contains umeclidinium. Therefore, these medications can cause some similar and some different side effects. Below are examples of these side effects.

Mild side effects

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

Serious side effects

This list contains examples of serious side effects that can occur with Trelegy Ellipta, with Breo Ellipta, or with both drugs (when taken individually):

Effectiveness

Trelegy Ellipta and Breo Ellipta are both approved to treat COPD and asthma in adults.

The use of Trelegy Ellipta and Breo Ellipta in treating COPD has been directly compared in a clinical study called the IMPACT trial.

In this trial, forced expiratory volume in 1 second (FEV1) was measured. (This is a measurement of lung function and shows how much air you can breathe out in 1 second.) Higher FEV1s show better lung function, while lower FEV1s show poorer lung function. The study showed that people who took Trelegy Ellipta were able to force out 97 mL more air in 1 second than people who took Breo Ellipta.

In another clinical study, Trelegy Ellipta was compared with the two active ingredients in Breo Ellipta. Both treatment regimens were effective in controlling asthma exacerbations in 16% of people.

Costs

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

Trelegy Ellipta costs significantly more than Breo Ellipta. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Like Breo Ellipta (above), the drug Symbicort has uses similar to those of Trelegy Ellipta. Here’s a comparison of how Trelegy Ellipta and Symbicort are alike and different.

Ingredients

Trelegy Ellipta contains three active drug ingredients: fluticasone, vilanterol, and umeclidinium.

Symbicort has two active drug ingredients in it: budesonide and formoterol.

Uses

Both Trelegy Ellipta and Symbicort are used in adults for the long-term treatment of:

However, Symbicort is approved as a maintenance treatment for asthma only when:

  • asthma symptoms aren’t well controlled on a long-term asthma medication such as an inhaled corticosteroid ICS), or
  • asthma is severe enough that it needs to be treated with both an ICS and a long-acting beta2-agonist (LABA) drug

In addition to being approved for use in adults with asthma, Symbicort is also approved to treat asthma in children ages 6 years and older.

Note: Neither Trelegy Ellipta nor Symbicort is approved to treat sudden trouble breathing. If you have sudden trouble breathing, your doctor will likely want you to use a rescue inhaler such as albuterol (Ventolin HFA, ProAir) or levalbuterol (Xopenex).

Drug forms and administration

Here’s some information about the forms of each drug and how you take them.

Trelegy Ellipta form

Trelegy Ellipta comes as an inhaler. “Trelegy” is the brand name of the medication inside the inhaler. The word “Ellipta” refers to the specific type of dry powder inhaler that contains the drug. The medication is in a powder form that you breathe into your lungs. You’ll take one inhalation (puff) of the medication once a day.

Symbicort form

Symbicort comes as a metered dose inhaler. This is an inhaler that dispenses the drug as a spray, which you breathe into your lungs. The doses are delivered in premeasured puffs. You’ll usually take two puffs of the medication twice a day.

Side effects and risks

Trelegy Ellipta and Symbicort both contain medications that work in similar ways to treat your COPD. Therefore, these medications can cause some very similar side effects. Below are examples of these side effects.

Mild side effects

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

Serious side effects

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

Effectiveness

Trelegy Ellipta and Symbicort are both approved to treat COPD and asthma in adults. Symbicort is also approved to treat asthma in children ages 6 years and older.

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Trelegy Ellipta and Symbicort to be effective for treating these conditions.

Costs

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

Trelegy Ellipta costs significantly more than Symbicort. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

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

Your insurance plan may require you to get prior authorization before approving coverage for Trelegy Ellipta. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the information and let you and your doctor know if your plan will cover Trelegy Ellipta.

If you’re not sure if you’ll need to get prior authorization for Trelegy Ellipta, contact your insurance company.

Financial assistance

If you need financial support to pay for Trelegy Ellipta, help is available. GlaxoSmithKline LLC, the manufacturer of Trelegy Ellipta, offers a coupon for the medication. 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 Trelegy Ellipta according to your doctor’s or healthcare provider’s instructions.

Trelegy Ellipta comes as an inhaler. “Trelegy” is the brand name of the medication inside the inhaler. The word “Ellipta” refers to the specific type of dry powder inhaler that contains the drug.

Your doctor or pharmacist can help you take your first dose or show you the proper technique. There’s also a video on the manufacturer’s website that shows you the correct way to take Trelegy Ellipta.

You’ll take one inhalation (puff) of Trelegy Ellipta once a day. The medication is in a powder form, and you’ll inhale it into your lungs as you take one deep breath. Even if you don’t taste or feel your dose, don’t take another dose. If you open and close the cover of the inhaler without inhaling the medication, you’ll lose the dose. The lost dose will still be in the inhaler, but it’s not possible for you to take two doses with one puff.

The inhaler has a counter that tells you how many doses of medication are left. Be sure to write the date that you open the inhaler on the label. Trelegy Ellipta is good for only 6 weeks after opening it or until the counter reads “0,” meaning that no doses are remaining.

When to take

You should take one puff of Trelegy Ellipta once a day at about the same time each day. Don’t take more than one dose in 24 hours.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Trelegy Ellipta doesn’t interact with alcohol. However, it’s possible that alcohol may worsen chronic obstructive pulmonary disease (COPD) or asthma symptoms, which Trelegy Ellipta is used to treat.

Alcohol may also weaken the activity of your immune system, making it easier for you to get an infection. One such infection (pneumonia) can affect your lungs and may worsen COPD or asthma.

If you drink alcohol, talk with your doctor whether it’s safe for you to continue drinking while you’re taking Trelegy Ellipta.

Trelegy Ellipta can interact with several other medications. It’s not known to interact with supplements or foods.

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

Trelegy Ellipta and other medications

Below is a list of medications that can interact with Trelegy Ellipta. This list does not contain all drugs that may interact with Trelegy Ellipta.

Before taking Trelegy Ellipta, 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.

Trelegy Ellipta and Spiriva

You shouldn’t take Trelegy Ellipta if you’re also taking tiotropium (Spiriva). This is because both of these medications have a drug called an anticholinergic in them. (For more about anticholinergics, see “Trelegy Ellipta and other anticholinergic medications” right below.)

Taking these medications together may increase your risk for side effects. And some of these side effects can become serious, such as overheating or hallucinating. So if you’re taking Spiriva, you’ll need to stop using it before you start Trelegy Ellipta treatment.

Trelegy Ellipta and other anticholinergic medications

Trelegy Ellipta contains umeclidinium, which is a type of drug called an anticholinergic. If you take umeclidinium with another anticholinergic medication, the drugs’ effects can combine and increase your risk for side effects. (For more about possible side effects of Trelegy Ellipta, see the “Trelegy Ellipta side effects” section above.) You shouldn’t take Trelegy Ellipta with other anticholinergic medications.

Examples of examples of drugs that contain an anticholinergic medication include:

If you’re taking an anticholinergic drug, tell your doctor before you start using Trelegy Ellipta. They may be able to recommend a different medication that doesn’t interact with Trelegy Ellipta.

Trelegy Ellipta and certain antimicrobial drugs

Antimicrobial drugs are medications that are used to treat infections. These medications can be used for many different types of infections, such as bacterial, viral, or fungal. Some antimicrobial drugs inhibit (block) the activity of CYP3A4, which is an enzyme that breaks down Trelegy Ellipta. And this can cause the level of Trelegy Ellipta in your body to be too high, increasing your risk for side effects. (To learn more, see the “Trelegy Ellipta side effects” section above.)

The following medications are antimicrobials that can interact with Trelegy Ellipta:

  • ketoconazole (Nizoral)
  • ritonavir (Norvir)
  • clarithromycin (Biaxin XL)
  • indinavir (Crixivan)
  • itraconazole (Sporanox)
  • lopinavir (with ritonavir in Kaletra)
  • nelfinavir (Viracept)
  • saquinavir (Fortovase)
  • telithromycin
  • voriconazole (Vfend)
  • erythromycin (Erythrocin)

If you take any antimicrobial medications, especially the ones in the list above, talk with your doctor. There may be another medication to treat your infection that won’t interact with Trelegy Ellipta.

Trelegy Ellipta and certain antidepressant medications

Certain antidepressant medications can interact with Trelegy Ellipta. The combination of these medications can cause a problem with your heart rhythm. Specifically, it’s important to avoid taking monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants while you’re using Trelegy Ellipta. You should avoid using these medications for at least 2 weeks before you start Trelegy Ellipta treatment.

Examples of MAOIs include:

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

Examples of tricyclic antidepressants include:

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

If you’re taking an antidepressant, talk with your doctor before you start using Trelegy Ellipta. They may suggest other medications.

Trelegy Ellipta and drugs that may affect your heart rhythm

Some drugs can prolong (lengthen) a part of your heart rhythm called the QT interval. Because Trelegy Ellipta can also affect your heart rhythm, you shouldn’t take these medications while using Trelegy Ellipta. You should stop taking these medications 2 weeks before you start Trelegy Ellipta treatment.

Other drugs that may prolong your QT interval include:

  • Certain heart medications, such as:
    • amiodarone (Nexterone, Pacerone)
    • sotalol (Betapace, Sotylize)
    • quinidine
    • procainamide
    • dofetilide (Tikosyn)
  • Certain antibiotics, such as:
    • levofloxacin (Levaquin)
    • ciprofloxacin (Cipro)
    • moxifloxacin (Avelox)
  • Certain antipsychotics, such as:
    • haloperidol (Haldol)
    • quetiapine (Seroquel)
    • ziprasidone (Geodon)
  • Other medications:

If you take any of these medications or other drugs for your heart rhythm, talk with your doctor before you start Trelegy Ellipta treatment. They may have alternate medications that don’t interact with Trelegy Ellipta.

Trelegy Ellipta and certain diuretics

A diuretic (water pill) helps your body get rid of extra water and salt. A certain type of diuretic called a non-potassium sparing diuretic can cause a decrease in your potassium level. Because Trelegy Ellipta can also decrease your potassium level, the combination of these medications can be dangerous. If your potassium level gets too low, you can have heart problems such as an irregular heart rhythm (a heartbeat that’s too fast, too slow, or uneven).

Examples of non-potassium sparing diuretics include:

  • hydrochlorothiazide (Microzide)
  • indapamide
  • bumetanide (Bumex)
  • furosemide (Lasix)
  • torsemide (Demadex)
  • ethacrynic acid (Edecrin)

If you’re taking a non-potassium sparing diuretic, tell your doctor before you start using Trelegy Ellipta. They may be able to recommend a different diuretic.

Trelegy Ellipta and beta-blockers

Beta-blockers are common medications that help decrease blood pressure and steady your heart rhythm. However, beta-blockers can block the effects of Trelegy Ellipta and cause the medication to not work properly. Beta-blockers can also increase the risk of bronchospasm (sudden trouble breathing) in people with chronic obstructive pulmonary disease (COPD) or asthma. You shouldn’t take beta-blockers while you’re using Trelegy Ellipta.

Examples of beta-blockers include:

  • propranolol (Inderal, Innopran XL)
  • carvedilol (Coreg)
  • labetalol (Trandate)
  • nadolol (Corgard)
  • metoprolol (Toprol XL, Lopressor)

If you’re taking a beta-blocker, tell your doctor before you start using Trelegy Ellipta. They may suggest a medication other than a beta-blocker.

Trelegy Ellipta and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Trelegy Ellipta. However, you should still check with your doctor or pharmacist before using any of these products while taking Trelegy Ellipta.

Trelegy Ellipta and foods

There aren’t any foods that have been specifically reported to interact with Trelegy Ellipta. If you have any questions about eating certain foods with Trelegy Ellipta, talk with your doctor.

Trelegy Ellipta is an inhaled medication that’s used for long-term treatment of chronic obstructive pulmonary disease (COPD) and asthma. These conditions affect your airways, making it hard to breathe sometimes.

For more information about COPD and asthma, see the “Trelegy Ellipta for COPD” and “Trelegy Ellipta for asthma” sections above.

What Trelegy Ellipta does

Trelegy Ellipta is a combination medication that contains three drugs: fluticasone, umeclidinium, and vilanterol. The drugs work in the following ways to help relieve your COPD symptoms:

  • Fluticasone. This drug is called an inhaled corticosteroid (ICS). It decreases swelling in your airways and opens them up, helping you to breathe easier.
  • Umeclidinium. This medication is known as an anticholinergic. It relaxes the muscles in your airways and helps you breathe in more oxygen.
  • Vilanterol. This drug is called a long-acting beta2-agonist (LABA). It also helps your airways stay open and relaxed.

How long does it take to work?

Trelegy Ellipta should start working after your first dose. However, you may not notice a change in your breathing symptoms right away. Trelegy Ellipta is a long-term treatment that will work over time to ease COPD and asthma symptoms and help you breathe easier. So it’s important that you keep taking Trelegy Ellipta every day even if you don’t notice a difference in your breathing right away.

Note: You shouldn’t use Trelegy Ellipta to treat sudden breathing problems caused by COPD or asthma. Instead, to treat a flare-up, your doctor will likely want you to use a rescue inhaler such as albuterol (Ventolin HFA, ProAir) or levalbuterol (Xopenex). For more information about this, see the “Trelegy Ellipta use with other drugs” section below.

Using more than the recommended dosage of Trelegy Ellipta can lead to serious side effects. There were no overdoses reported in people who took Trelegy Ellipta in clinical studies. However, because there are three different drugs in Trelegy Ellipta, taking too much Trelegy Ellipta would mean taking too much of all three drugs. The drugs are fluticasone, umeclidinium, and vilanterol.

Overdose symptoms

Fluticasone is an inhaled steroid medication. This medication works mainly in your lungs and isn’t absorbed well into your body. Therefore, an overdose isn’t likely to occur.

Taking too much umeclidinium isn’t likely to cause you any serious side effects. If the drug does cause side effects, you may have:

A vilanterol overdose may include serious symptoms, such as:

  • seizures
  • chest pain
  • high blood pressure or low blood pressure
  • increased heart rate
  • irregular heartbeat
  • feeling nervous
  • dry mouth
  • muscle cramps
  • heart attack or death

Because these medications can affect the heart, your doctor will monitor your heart if you take too much Trelegy Ellipta.

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.

Trelegy Ellipta is approved for long-term treatment of chronic obstructive pulmonary disease (COPD) and asthma. It should be taken every day to treat your condition over a long-term period.

Trelegy Ellipta contains three different drugs (fluticasone, umeclidinium, and vilanterol), so you usually won’t need to take another maintenance medication along with it.

However, your doctor will likely want you to have a rescue inhaler in case you have sudden breathing problems.

Trelegy Ellipta with a rescue inhaler

Trelegy Ellipta isn’t approved to treat sudden trouble breathing. If you have sudden breathing problems, your doctor will likely want you to use a rescue inhaler.

Examples of rescue inhalers include albuterol (Ventolin HFA, ProAir) and levalbuterol (Xopenex). You can use your rescue inhaler in between your doses of Trelegy Ellipta if you have flare-ups of COPD or asthma symptoms.

It’s not known if Trelegy Ellipta is safe to use during pregnancy. There’s no human data available to determine if any or all of the ingredients in the medication are safe for use while pregnant.

Trelegy Ellipta hasn’t been studied in pregnant animals either. However, the three drugs (fluticasone, umeclidinium, and vilanterol) in Trelegy Ellipta have been studied separately. The combination of fluticasone and vilanterol has been studied as well.

In these animal studies, there were no harmful effects on babies whose mothers were given fluticasone or umeclidinium while pregnant. However, babies whose mothers were given vilanterol while pregnant did have birth defects affecting their bones. Finally, babies whose mothers were given the combination of fluticasone and vilanterol didn’t have an increased risk of birth defects.

Trelegy Ellipta shouldn’t be used later in pregnancy (at or after 28 weeks) or during labor unless recommended by your doctor. The drug vilanterol may relax the uterus, which can prevent contractions and cause problems during labor and delivery.

If you’re pregnant or are planning to become pregnant, talk with your doctor before using Trelegy Ellipta. They may be able to suggest a different treatment.

It’s not known if Trelegy Ellipta is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Trelegy Ellipta.

It’s not known if Trelegy Ellipta is safe to take while breastfeeding. There’s no human data available on whether the active drugs in Trelegy Ellipta pass into breast milk or how the drug may affect a child. The three active drugs in Trelegy Ellipta are fluticasone, umeclidinium, and vilanterol.

In animal studies, umeclidinium was seen in the breast milk of mothers who were given the drug. However, this doesn’t mean that Trelegy Ellipta will be present in human breast milk.

If you’re breastfeeding, talk with your doctor before taking Trelegy Ellipta. They can advise you on the best way to feed your child.

Here are answers to some frequently asked questions about Trelegy Ellipta.

Can I use Trelegy Ellipta as a rescue inhaler?

No, you should never use Trelegy Ellipta as a rescue inhaler. This is because it can take time for the medications in Trelegy Ellipta to begin working. If you’re having sudden trouble breathing, your doctor will likely want you to use a rescue inhaler such as albuterol (Ventolin HFA, ProAir) or levalbuterol (Xopenex).

If you have questions about how to treat sudden breathing problems while taking Trelegy Ellipta, talk with your doctor. They can discuss rescue inhaler options with you.

Should I feel or taste anything after taking a dose of Trelegy Ellipta?

You may. Some people do feel or taste Trelegy Ellipta after taking it. However, other people don’t feel or taste the medication, even if they use the inhaler properly. It’s important that even if you don’t feel or taste your dose, you don’t take another dose. This can cause you to breathe in too much medication, which may be harmful to you.

Why can’t I use Trelegy Ellipta if I have a milk allergy?

Trelegy Ellipta contains lactose, which is a type of sugar in milk. Lactose is an inactive ingredient in Trelegy Ellipta that helps the medication reach your lungs. (An active ingredient is the part of the medication that makes it work. An inactive ingredient is any part of the medication that’s not the active ingredient.)

So if you have a milk allergy, you may have an allergic reaction to the lactose in Trelegy Ellipta. These allergic reactions can be serious. There have been reports of severe allergic reactions occurring in people with milk protein allergies who took other powder medications with lactose in them.

If you have a milk allergy, talk with your doctor about safe treatments for your condition.

Will I be able to use Trelegy Ellipta if I have eye problems?

You may be able to. It depends on what types of eye problems you have. Trelegy Ellipta can cause eye problems such as glaucoma, increased eye pressure, cataracts, blurry vision, and other vision changes. The drug can also make a certain type of glaucoma called narrow-angle glaucoma worse. This can eventually cause vision loss if it’s not treated.

While you’re taking Trelegy Ellipta, it’s important that you go for regular eye exams. Your doctor will be able to determine if Trelegy Ellipta is safe for you to take with your specific eye problem.

How can I help prevent thrush while using Trelegy Ellipta?

You can prevent thrush from developing by always rinsing your mouth after you take your dose of Trelegy Ellipta. And don’t swallow the water that you rinse with. Thrush is a fungal infection that can occur due to the use of inhaled steroids such as fluticasone, one of the drugs in Trelegy Ellipta.

Symptoms of thrush include mouth pain or white patches in the mouth. If you develop symptoms of thrush, be sure to see your doctor. They can recommend medication to treat the current infection. Your doctor or pharmacist may also be able to recommend ways to help prevent a thrush infection from occurring in the future.

This drug comes with several precautions. Before taking Trelegy Ellipta, talk with your doctor about your health history. Trelegy Ellipta may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction, especially to milk protein. If you had an allergic reaction to Trelegy Ellipta in the past, you shouldn’t take the medication again. And if you have a severe allergy to milk protein, you shouldn’t take Trelegy Ellipta because the medication contains lactose (a type of sugar in milk) mixed in with its active drugs. To learn more, see “Common questions about Trelegy Ellipta” above.
  • Heart problems. Trelegy Ellipta can increase your pulse rate and blood pressure, and cause irregular heart rates. So if you have decreased blood flow in your heart, an irregular heartbeat, or high blood pressure, tell your doctor before you take Trelegy Ellipta. They’ll likely monitor you for any changes in your heartbeat, blood pressure, or heart rhythm during your treatment and have you stop taking the drug if necessary.
  • Worsening of COPD. It’s possible that your chronic obstructive pulmonary disease (COPD) can quickly get worse. In this case, you shouldn’t use Trelegy Ellipta. The drug hasn’t been studied in people with worsening or life threatening COPD symptoms. Your COPD may be getting worse if your symptoms are no longer controlled by Trelegy Ellipta. Other signs of worsening COPD include your rescue inhaler not being as effective or needing to use your rescue inhaler more often than usual. Ask your doctor what other treatments are better choices for you.
  • Sudden breathing problems with COPD or asthma. Trelegy Ellipta should not be used to treat sudden problems with breathing in people with chronic obstructive pulmonary disease (COPD) or asthma. If you have sudden difficulty breathing, you shouldn’t take this medication. Ask your doctor what other treatments you should use instead.
  • Decreased adrenal function. Taking Trelegy Ellipta may cause your adrenal glands to produce too much or too little cortisol. Cortisol is also known as a “stress hormone” that affects metabolism, blood sugar, inflammation (swelling), and blood pressure. One of the ingredients in Trelegy Ellipta, fluticasone, can increase or decrease the level of cortisol. If you already have a problem with your adrenal gland, taking Trelegy Ellipta may increase your risk for developing problems with your metabolism, blood sugar, or blood pressure. If you have an adrenal disorder, such as Cushing’s syndrome, talk with your doctor before using Trelegy Ellipta. They’ll monitor your blood sugar levels and blood pressure during your treatment.
  • Seizures. If you have a history of seizures or seizure disorders, Trelegy Ellipta can increase your risk of having a seizure. Talk with your doctor about other treatments that are better choices for you.
  • Thyroid disorders. If you have hyperthyroidism (an overactive thyroid), Trelegy Ellipta may worsen the condition. Before taking the medication, be sure to tell your doctor if you have a thyroid disorder. They’ll monitor your thyroid levels while you’re taking Trelegy Ellipta.
  • Diabetes. If you have diabetes, your doctor may monitor you more often while you take Trelegy Ellipta. This is because the drug may cause your blood glucose (blood sugar) to increase, which can make your diabetes worse. Talk with your doctor before you start taking Trelegy Ellipta if you have diabetes.
  • Liver problems. If you have liver disease, your body may not metabolize (break down) Trelegy Ellipta as quickly as it should. This means you may have more medication in your body and may have more severe side effects from it. Talk with your doctor about your liver disease and taking Trelegy Ellipta.
  • Osteoporosis. An ingredient in Trelegy Ellipta called fluticasone may decrease your bone mineral density. So if you have osteoporosis (bone weakness) or are at risk for it and take Trelegy Ellipta, you may be more likely to have bone fractures. Your doctor may check your bone density before you start taking the medication to check your risk for developing osteoporosis. And if Trelegy Ellipta works well for you but your bone density decreases, your doctor may recommend medication to prevent or treat osteoporosis.
  • Immune system problems. If you have weakened immune system or if you’re taking medication that can weaken your immune system, such as prednisone, you’re at a higher risk of developing an infection. (Your immune system is your body’s defense against infection.) The inhaled steroid in Trelegy Ellipta (fluticasone) may weaken your immune system even more. This means that you may be at an even higher risk of getting an infection. If you have any immune system problems or are taking medication that can affect your immune system and are exposed to chickenpox or measles, tell your doctor right away. These conditions can become very serious and even cause death in people with a weakened immune system.
  • Glaucoma. If you have a history of acute narrow-angle glaucoma, Trelegy Ellipta may make the condition worse. Tell your doctor right away if you’re taking the medication and have any symptoms affecting your eyes, such as eye pain or blurry vision. They may recommend a different treatment.
  • Urinary retention. If you have problems with your prostate or bladder that cause urinary retention (not being able to fully empty your bladder), Trelegy Ellipta may worsen your urinary retention. Your doctor will monitor you during treatment with this drug, and they’ll recommend another medication for you if needed.
  • Current infections. If you have a current viral, bacterial, parasitic, or fungal infection, tell your doctor before taking Trelegy Ellipta. This medication can decrease your immune system’s ability to fight an infection, which could make the infection worse. Depending on the type of infection, your doctor may not have you start using Trelegy Ellipta until your infection is treated.
  • Pregnancy. It’s not known if Trelegy Ellipta is safe to take during pregnancy. For more information, please see the “Trelegy Ellipta and pregnancy” section above.
  • Breastfeeding. It’s not known if Trelegy Ellipta is safe to take while breastfeeding. For more information, please see the “Trelegy Ellipta and breastfeeding” section above.

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

When you get Trelegy Ellipta from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective 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 about whether you might still be able to use it.

When you open the tray that contains Trelegy Ellipta, write the date that you opened it on the label of the inhaler. Once opened, the tray is good for only 6 weeks. If you don’t use all 30 doses in 6 weeks, the inhaler is expired and you should throw it away. Only open the tray when you’re ready to start using the inhaler so you can use all of the doses before the inhaler expires.

Storage

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

You should store your Trelegy Ellipta inhaler at room temperature between 68°F and 77°F (20°C and 25°C). Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms. Keep Trelegy Ellipta in a dry place, away from sunlight and heat.

Store the inhaler in the unopened tray until you’re ready to use it. Once opened, the inhaler expires in 6 weeks.

Disposal

If you no longer need to take Trelegy Ellipta 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.

Once the counter on the inhaler reads “0” (meaning that no doses are remaining), you can dispose of Trelegy Ellipta. If the medication has been opened for 6 weeks, even if you haven’t used all of the doses, it’s expired and should be disposed of. The inhaler isn’t reusable, and you can’t refill it.

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

Indications

Trelegy Ellipta is indicated for use in adults with either chronic obstructive pulmonary disease (COPD) or asthma. It is used for long-term maintenance treatment of these conditions. The drug should not be used to treat acute bronchospasm associated with either COPD or asthma.

Mechanism of action

Trelegy Ellipta contains three active drug ingredients: fluticasone furoate, umeclidinium, and vilanterol. The combination of drugs works to control COPD or asthma symptoms over time.

Fluticasone furoate is an inhaled corticosteroid that works by decreasing inflammation, which is a main component of COPD and asthma symptoms. The exact way that fluticasone works to decrease inflammation is not known. However, in rats it is believed that pro-inflammatory transcription factors are inhibited along with antigen-induced lung eosinophilia. This may cause the anti-inflammatory effects that are seen with fluticasone treatment.

Umeclidinium is an anticholinergic drug, also known as a long-acting muscarinic antagonist (LAMA) drug. Its effects are seen through the inhibition of M3 receptors, which leads to bronchodilation. Bronchodilation is important in the treatment of COPD or asthma, as it helps to let more air into the lungs and allows for easier breathing.

Vilanterol is a long-acting beta2-agonist (LABA). It works by activating adenyl cyclase, which then catalyzes a reaction from adenosine triphosphate (ATP) to cyclic 3,5,adenosine monophosphate (cyclic AMP). Cyclic AMP causes bronchodilation via relaxation of bronchial muscles. It also inhibits release of hypersensitivity mediators from mast cells such as histamine. Blocking these mediators can also decrease inflammation in the airways.

Together, these drugs work in the body to decrease inflammation and increase the space in the airways to allow more air into the lungs. Because of these actions, they work together to decrease COPD or asthma symptoms and make it easier for patients to breathe.

Pharmacokinetics and metabolism

Three active drug ingredients make up Trelegy Ellipta: fluticasone furoate, umeclidinium, and vilanterol. These medications each have their own time to maximum concentration (Cmax), time to steady state, metabolism, half-life, and elimination route.

Fluticasone furoate has a very low oral systemic bioavailability, about 1.3%. Cmax was reached about 30 minutes to 1 hour post-dose. Steady state occurred within 6 days of daily dosing. Fluticasone furoate is metabolized mainly by cytochrome P450 (CYP) 3A4. The half-life of fluticasone furoate is about 24 hours. It is mainly eliminated via the fecal route after an intravenous dose is given.

Umeclidinium is minimally orally absorbed. Its Cmax occurs about 5 to 15 minutes post-dose. Steady state occurs within 14 days of daily use. This medication is also metabolized hepatically. However, it is mainly metabolized by CYP2D6 and is also a substrate for the P-glycoprotein transporter. It is usually oxidized via hydroxylation or O-dealkylation and then conjugated via glucuronidation to produce metabolites. These metabolites are either minimally active or have not yet been studied to determine activity. Umeclidinium has a half-life of about 11 hours. After an intravenous dose, 58% is excreted in the feces and 22% is excreted in the urine.

Vilanterol is also minimally absorbed orally. Its Cmax occurs at 5 to 15 minutes post-dose. It reaches steady state within 14 days of daily dosing. It is primarily metabolized via CYP3A4 and is also a substrate of P-glycoprotein transporter. Its metabolites have minimal activity. Its half-life is 11 hours. After oral administration, 70% of the drug was recovered in urine and 30% was recovered in feces.

Contraindications

Trelegy Ellipta is contraindicated for use in people with severe milk protein allergies. Trelegy Ellipta contains lactose as a major excipient. There have been reports of serious allergic reactions, including anaphylaxis, when people with milk allergies take Trelegy Ellipta.

Trelegy Ellipta is also contraindicated in people with allergies to any of the ingredients in the medication, including fluticasone furoate, umeclidinium, vilanterol, lactose monohydrate, and magnesium stearate.

Storage

Trelegy Ellipta should be stored at room temperature between 68°F and 77°F (20°C and 25°C). Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms, as it is a dry powder inhaler. It should be stored in a dry place and kept away from sunlight and heat.

Once opened, the inhaler is only good for 6 weeks. It should be stored in the unopened foil tray until it is ready for use.

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.