Trelegy Ellipta is a combination maintenance inhaler used to treat adults with chronic obstructive pulmonary disease (COPD) and asthma. It contains three active ingredients: fluticasone (a corticosteroid), umeclidinium (a long-acting muscarinic antagonist), and vilanterol (a long-acting beta agonist). Together, these help reduce airway inflammation, relax airway muscles, and help keep your airways open. The typical dose is one puff inhaled through the mouth once a day. Common side effects include headache, cough, and back pain.
Maintenance treatment of asthma
Maintenance treatment of chronic obstructive pulmonary disease (COPD)
Trelegy Ellipta is a combination of three medications that work together to help you breathe easier.
Fluticasone is an inhaled corticosteroid. It's thought to lower inflammation and swelling in the lungs.
Umeclidinium is a long-acting muscarinic antagonist (LAMA), a type of anticholinergic medication. It blocks acetylcholine to relax the muscles in your airways.
Vilanterol is a long-acting beta agonist (LABA). It relaxes the muscles in your lungs to open up your airways.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Only need to inhale one puff once a day
Combination of three medications within a single inhaler
Approved for both COPD and asthma
Common side effects include headache and cough
Can't use if severely allergic to milk proteins because it contains lactose
Need to rinse your mouth after each dose to prevent oral thrush
Use Trelegy Ellipta once a day at the same time every day to prevent COPD or asthma attacks. You can use it at any time of the day, but using it daily helps it work best.
Trelegy Ellipta won't help during sudden breathing problems. If you have a COPD or asthma attack, use a rescue inhaler like albuterol if you have sudden trouble breathing for fast relief.
Contact your pulmonologist right away if Trelegy Ellipta doesn’t seem to work as well, if you need more doses than usual, or if your breathing feels worse. These could be signs that your condition isn't under control.
Don't start any new medications while using Trelegy Ellipta without asking your pulmonologist or pharmacist first. It can interact with other medications, such as beta blockers or tricyclic antidepressants.
Trelegy Ellipta commonly causes upper respiratory tract infections with symptoms like stuffy nose or sore throat. Using a humidifier, drinking fluids, and getting rest might help ease these symptoms.
Some people using Trelegy Ellipta might feel side effects like fast heartbeat, chest pain, shakiness, or nervousness. Tell your pulmonologist right away if you notice any of these symptoms.
Store Trelegy Ellipta at room temperature in a dry place, away from heat or sunlight. Keep any unused inhalers sealed in the original foil pouch until you're ready to use them.
Tips for how to use Trelegy Ellipta:
Write use-by date: Once you open the foil tray, write down the use-by date on the inhaler (6 weeks from the day you opened it). Throw away the inhaler when either 6 weeks have passed or the dose counter shows “0”, whichever comes first.
Unlike most inhalers, you don't need to prime or shake Trelegy Ellipta. EEach time you open the cover, it gets one dose ready. Only open it when you’re ready to take your medicine.
Taking a dose: When you're ready to take your dose, slide the cover until it clicks. Breathe out fully, away from the inhaler.
Place the mouthpiece in your mouth and take a long, steady, deep breath in. Then try to hold your breath for 3 to 4 seconds, or as long as is comfortable, to help the medication reach deep into your lungs.
After use: Rinse your mouth with water and then spit it out. This helps lower your chance of getting a mouth or throat infection called oral thrush.
Cleaning: Never wash the inhaler with water or any liquid. Instead, clean the mouthpiece every once in a while by wiping it with a dry cloth. Water or moisture can clog the inhaler and keep the medication from coming out properly.
Trelegy Ellipta can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Trelegy Ellipta isn't made to treat sudden breathing problems. Don’t use it as a rescue inhaler because it won’t work fast enough. Instead, use a short-acting rescue inhaler like albuterol for sudden symptoms such as wheezing or shortness of breath.
If you notice you're using your rescue inhaler more often than usual, tell your pulmonologist. This could be a sign that your condition is getting worse. Don’t take extra doses of Trelegy Ellipta — it won’t help and could lead to serious side effects like heart problems, shakiness, or dizziness.
Risk factors: Using too much Trelegy Ellipta | Also using other LABAs
Don't use Trelegy Ellipta more often or at higher doses than prescribed. Using too much can lead to serious side effects, including heart problems and, in rare cases, death. Since Trelegy Ellipta already contains a long-acting beta agonist (LABA), don’t use any other inhalers that also have a LABA — such as Serevent Diskus (salmeterol) or Perforomist (formoterol) — while using this medication.
Risk factors: Not rinsing and spitting after using Trelegy Ellipta
Trelegy Ellipta can sometimes cause a yeast infection in your mouth or throat called oral thrush. If you notice white patches or a cotton-like feeling in your mouth or throat, let your prescriber know — it can usually be treated with antifungal medication. In some cases, your prescriber might have you pause treatment. To help prevent thrush, rinse your mouth with water after each dose, and spit the water out — don’t swallow it.
Risk factors: COPD
Trelegy Ellipta might raise your risk of lower respiratory infections, including pneumonia. In rare cases, some of these infections can be serious or even fatal. This risk is especially important to watch for in people with COPD, since pneumonia symptoms can look very similar to a flare-up. Let your care team know right away if you have symptoms like more mucus, mucus changing color, fever, chills, coughing more than usual, more trouble breathing
Risk factors: Active, chronic (long-term), or recurrent infection | Medical conditions that weaken the immune system | Taking other medications that can weaken the immune system
Trelegy Ellipta can make it harder for your body to fight infections. Serious infections, like tuberculosis (TB), chickenpox, and measles can be more dangerous if you're using this medication. Don't use Trelegy Ellipta if you have an active infection or an infection that keeps coming back without talking with your prescriber first. Tell your care team right away if you have signs of an infection, like fever, cough, sore throat, muscle aches, or feeling very tired.
Risk factors: Using Trelegy Ellipta for a long time | Using too much Trelegy Ellipta
When you use Trelegy Ellipta at the right dose, it’s less likely to affect your body’s natural balance of steroid hormones. But if you use too much, or if you're very sensitive to steroids, it can cause problems like high steroid levels or adrenal suppression, which means your body might not make enough of its own steroids. Let your prescriber know if you feel very tired, weak, or sick to your stomach — especially during times of stress or after surgery — as these could be signs of low steroid hormone levels.
If you're switching from oral steroids like prednisone to Trelegy Ellipta, your body might need time to adjust. Oral steroids can weaken your adrenal glands over time, and they might not bounce back right away after you stop. If you’ve been taking high doses of oral steroids, your pulmonologist will help you slowly lower the dose to reduce the risk of side effects.
Trelegy Ellipta can sometimes cause a sudden tightening of the airways called paradoxical bronchospasm, meaning your breathing might get worse instead of better. This can be dangerous and life-threatening. If you notice more wheezing, coughing, or shortness of breath after using it, stop the medication right away and contact your prescriber.
Risk factors: Severe allergy to milk proteins (lactose)
Serious allergic reactions to Trelegy Ellipta can happen. Get medical help right away if you notice hives, a rash, swelling of face or throat, or trouble breathing. If you have a severe milk protein allergy, don't use Trelegy Ellipta — it contains lactose, which could cause a dangerous reaction.
Risk factors: History of heart problems | High blood pressure
Trelegy Ellipta might affect your heart, so it should be used with caution if you have conditions like high blood pressure, irregular heartbeat, or a history of heart disease. Tell your prescriber if you notice chest pain, a fast or pounding heartbeat, or dizziness while using this inhaler. They might check your heart regularly to make sure this medication is safe for you.
Risk factors: Using Trelegy Ellipta long term | Unable to move for a long period of time | Family history of osteoporosis | Menopause | Tobacco use | Older adults | Poor diet | Taking medications that can cause bone loss
Using Trelegy Ellipta over a long time can cause a small drop in bone strength. This might not always lead to broken bones, but it can be a concern if you have risk factors like being older, going through menopause, smoking, eating poorly, not being active, or taking certain medications.
Since people with COPD often have some of these risk factors, your prescriber might check your bone health before you start using Trelegy Ellipta and from time to time afterward. If your bone strength gets too low but you still need this inhaler, your prescriber might suggest ways to help protect your bones.
Risk factors: Using Trelegy Ellipta long term
Using Trelegy Ellipta long term can raise your risk of eye problems like glaucoma, high eye pressure, or cataracts. Be on the lookout for symptoms such as eye pain or pressure, blurry vision, red eyes, or seeing halos or bright colors around lights. These could be signs of a serious eye condition. If you notice any of these, contact your prescriber right away. They might send you to an eye specialist to check for problems.
Risk factors: Enlarged prostate | Bladder-neck blockage
Trelegy Ellipta contains a long-acting muscarinic antagonist (LAMA), which is a type of anticholinergic. Anticholinergic medications can sometimes cause trouble urinating, so this medication should be used carefully if you already have trouble emptying your bladder. This includes people with an enlarged prostate or bladder-neck blockage. Let your prescriber know right away if you have signs of urinary retention, such as difficulty urinating or pain with urination. These could be signs of a serious problem that needs medical attention.
Risk factors: Using too much Trelegy Ellipta | High thyroid hormone | History of seizures
Speak to your prescriber before using Trelegy Ellipta if you have health conditions like seizures, or high thyroid hormone. This inhaler can sometimes make these conditions worse or lead to serious side effects. Be sure to share your full medical history with your prescriber before starting this medication.
Risk factors: Using Trelegy Ellipta too much
Trelegy Ellipta can sometimes cause low potassium levels or high blood sugar, though this is usually temporary and doesn’t need treatment. But in some cases, low potassium can affect your heart. Let your care team know if you have muscle pain or weakness, muscle cramps, or an irregular heartbeat — these could be signs of low potassium.
COPD: The typical dose is 1 inhalation of 100 mcg/62.5 mcg/25 mcg (fluticasone/umeclidinium/vilanterol) by mouth once a day.
Asthma: The typical dose is 1 inhalation of 100 mcg/62.5 mcg/25 mcg or 200 mcg/62.5 mcg/25 mcg (fluticasone/umeclidinium/vilanterol) by mouth once a day.
Treatment of sudden, severe asthma attacks or COPD flare-ups
Severe allergy to milk proteins
Maintenance treatment of asthma
Maintenance treatment of chronic obstructive pulmonary disease (COPD)
Maintenance treatment of chronic obstructive pulmonary disease (COPD)
Maintenance treatment of asthma in people ages 5 years and older
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Garrison, S. R., et al. (2012). Nocturnal leg cramps and prescription that precedes them: A sequence symmetry analysis. Archives of Internal Medicine.
GlaxoSmithKline LLC. (2023). Trelegy Ellipta- fluticasone furoate, umeclidinium bromide and vilanterol trifenatate powder [package insert]. DailyMed.
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Magee, J. S., et al. (2018). Paradoxical Bronchoconstriction with Short-Acting Beta Agonist. American Journal of Case Reports.
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Siler, T. M., et al. (2015). Efficacy and safety of umeclidinium added to fluticasone furoate/vilanterol in chronic obstructive pulmonary disease: Results of two randomized studies. Respiratory Medicine.
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