Breo Ellipta 100/25 (fluticasone, vilanterol)

Breo Ellipta general information  

What is Breo Ellipta used for?

Breo Ellipta inhaler 100/25 is a combination medication used for the regular long-term treatment and management of reversible obstructive airways disease, such as asthma, where a combination medication is considered appropriate.  This includes, patients already using a combination medication, or using an inhaled preventer medication but are not adequately controlled and are still having symptoms, or patients using a reliever medication as needed, to treat symptoms of asthma, but are not adequately controlled.  Breo Ellipta Inhaler should not be used for severe asthma or as a “reliever” for asthma attack.  Breo Ellipta 100/25 is also used for treatment of moderate to severe chronic obstructive pulmonary disease (COPD), which is a non-reversible obstructive airways disease, to relieve symptoms, such as shortness of breath, chronic cough with sputum production, tightness of the chest and wheezing and to help prevent frequent exacerbations; also chronic bronchitis and emphysema.  However, Breo Ellipta inhaler 100/25 should not be used to treat an acute exacerbation in COPD.  The combination of medications in Breo Ellipta 100/25 Inhaler work together to provide better control of asthma to protect against symptoms, prevent exacerbations of asthma or COPD and improve lung function.   

How does Breo Ellipta work?

Breo Ellipta inhaler 100/25 contains a combination of two medications that work by different mechanisms of action to control obstructive airways disease in asthma and chronic obstructive pulmonary disease (COPD).  Fluticasone in Breo Ellipta inhaler 100/25 is a corticosteroid that blocks Inflammation, one of the underlying causes of asthma.  This is a preventer medication and works by inhibiting the production of inflammatory chemicals like cytokines, released by several immune cell types, including macrophages and lymphocytes, in the airways in response to asthma trigger, such as allergens or irritants in the air.  Inhibition of these cytokine reduces inflammation and swelling of the airways.  Vilanterol in Breo Ellipta inhaler is a long-acting beta₂-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways.  This reduces bronchospasm (constriction or the airways) relieving symptoms of asthma such as tightness of the chest, wheezing and shortness of breath.  Fluticasone and Vilanterol in Breo Ellipta inhaler 100/25 work synergistically together to enhance the anti inflammatory activity of Breo Ellipta inhaler, providing relief for up to 24 hours.  They are delivered as a dry inhalation powder directly into the bronchioles of the lung and work together to improve lung function, and to reduce symptoms and exacerbations of asthma and COPD.

What does Breo Ellipta contain?

Breo Ellipta inhaler contains the active ingredients fluticasone furoate (100mcg) a corticosteroid and vilanterol trifenatate a long-acting bronchodilator (25mcg), used in combination to treat asthma and COPD.  Each blister also contains 12.5 milligram lactose monohydrate per blister and magnesium stearate.  Breo Ellipta inhaler comprises a plastic inhaler with two double foil blister strips, containing the active ingredients as an inhalation powder, with one strip containing fluticasone and the other strip containing vilanterol.  Each foil strip contains 30 blisters for 30 doses, providing a single dose with each actuation (puff).

Should you use Breo Ellipta with other asthma inhalers?

Breo Ellipta inhaler 100/25 is used as a long-term “preventer” medication to reduce inflammation and swelling of the airways of the lung, and reduce bronchospasm (constriction or narrowing of the bronchioles or small airways) as part of an asthma management plan to reduce symptoms and exacerbations of asthma, and to improve lung function.  You may also be prescribed a short-acting bronchodilator for relief of bronchospasm during an asthma attack, to be used as needed.  Both are intended to be taken together, only if recommended by your doctor.   

Treating asthma with Breo Ellipta

Breo Ellipta inhaler 25/100 contains a combination of fluticasone, a corticosteroid that blocks Inflammation, one of the underlying causes of asthma; and vilanterol, a long-acting bronchodilator that relieves bronchospasm (constriction or narrowing of the bronchioles or small airways) and widens the airways to allow air to flow more easily into the lungs.  Breo Ellipta inhaler 25/100 is used as an asthma prevention medication to improve lung function, and to reduce exacerbations of asthma and symptoms like tightness of the chest, wheezing and shortness of breath.  Fluticasone and Vilanterol in Breo Ellipta inhaler work synergistically together to enhance the anti inflammatory activity of Breo Ellipta inhaler, providing relief for up to 24 hours.  Breo Ellipta inhaler should not be used as a “reliever” or “rescue” medication for an asthma attack.   

Breo Ellipta for chronic obstructive pulmonary disease (COPD)

Breo Ellipta inhaler 25/100 contains a combination of fluticasone, a corticosteroid and anti-inflammatory medication that blocks Inflammation, and is used to treat moderate to severe chronic obstructive pulmonary disease (COPD), a chronic non-reversible progressive inflammatory lung disease that also includes bronchitis, emphysema.  Breo Ellipta inhaler 100/25 is used to relieve symptoms of COPD caused by bronchospasm (narrowing of the airways), such as shortness of breath, chronic cough with sputum production, tightness of the chest and wheezing and to help prevent frequent exacerbations, however, Breo Ellipta inhaler 100/25 should not be used to treat an acute exacerbation in COPD.  

What are the side effects of Breo Ellipta?

The most commonly reported side effects when taking Breo Ellipta include fungal infection in the mouth or throat or tongue (candidiasis or thrush), persistent soreness in the mouth or throat, distorted voice, weakened immune system and increased chance of getting infections like pneumonia and bronchitis, upper respiratory tract infection like sinusitis, pharyngitis. rhinitis, influenza; headache, tachycardia (rapid heartbeat), tremor (shaky or tense feeling), palpitations, muscle cramps, abdominal pain, joint pain (arthralgia), back pain, fractures, fever.

What are the health risks of Breo Ellipta?

Long term use of Breo Ellipta may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently, which may slow down the growth rate in children and adolescents and will need regular monitoring.  This may also cause decreased bone mineral density if used for long periods. 

What is paradoxical bronchospasm?

All inhaled asthma medications can cause paradoxical bronchospasm, which is when the inhaled medication taken to relieve or prevent bronchospasm actually makes it worse, causing wheezing, shortness of breath and tightness of the chest.  If this happens you should inform your doctor and take their advice.

When should Breo Ellipta not be used?

You should not use Breo Ellipta inhaler 25/100 if you:

• are allergic to fluticasone or vilanterol or milk proteins or any ingredients in Breo Ellipta
• are pregnant or are breastfeeding, without discussion with your doctor
• have liver disease
• have osteoporosis, without discussion with your doctor
• have tuberculosis of the lung or other long term lung infection
• have severe cardiovascular disease
• are taking medicines that interact with Breo Ellipta, like ritonavir for HIV infection, ketoconazole for fungal infection, or a beta-blocker like propranolol

How should Breo Ellipta be taken?

You should use your Breo Ellipta by taking one puff once daily morning or evening but at the same time each day, as recommended by your doctor.  You should begin to feel relief of symptoms within 15 minutes of inhalation but Breo Ellipta inhaler is intended as a long-term medication to maintain control of symptoms.  You should continue to take your Breo Ellipta inhaler 25/100 as long as recommended by your doctor and you should not stop taking your Breo Ellipta inhaler even if you feel better. 

How to use your Breo Ellipta inhaler

Follow the instructions provided for using your Breo Ellipta inhaler. 

1. Open the cover of your Breo Ellipta inhaler until it clicks to release a dose of medication. 
2. Breathe out as far as is comfortable and then place the mouthpiece in your mouth and inhale through your mouth until your lungs are full. 
3. Hold your breath for a few seconds, and then breathe normally.  The dose counter will indicate how many doses you have left in you inhaler.
4. Close the cover.
5. Rinse your mouth after use.

How long should you take Breo Ellipta?

You should continue to take your Breo Ellipta 25/100 Inhaler as long as recommended by your doctor and you should not stop taking your Breo Ellipta inhaler even if you feel better. 

Missed dose of Breo Ellipta

If you miss a dose of Breo Ellipta take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Breo Ellipta be stored?

You should store your Breo Ellipta below 25°C in a cool dry place.