How It Works
Breo Ellipta works by combining two medicines:
- Fluticasone furoate: This corticosteroid works by reducing swelling and inflammation in the lungs, which makes it easier to breathe.
- Vilanterol: This long-acting beta-2 agonist (LABA) works by relaxing the muscles around the airways. This opens them up so air can flow more freely, which also makes it easier to breathe.
| Quick Facts | |
|---|---|
| Common Brands | Breo Ellipta |
| Drug Class | Combination inhaled corticosteroid (ICS) and inhaled long-acting beta-2 agonist (LABA) |
| Generic Status | Generic is available |
| Availability | Prescription only |
Dosing
The recommended dose of Breo Ellipta is one inhalation per day. The device delivers a pre-measured dose of the inhalation powder in each puff. Dosage strengths for adults include:
- 100 mcg fluticasone furoate and 25 mcg vilanterol (100 mcg/25 mcg)
- 200 mcg fluticasone furoate and 25 mcg vilanterol (200 mcg/25 mcg)
The recommended dose depends on what you are taking Breo Ellipta for:
- Asthma: The recommended dose is one inhalation of either the 100 mcg/25 mcg or 200 mcg/25 mcg strength once daily.
- COPD: The recommended dose is one inhalation of the 100 mcg/25 mcg strength once daily.
To use the Breo Ellipta inhaler, follow the instructions included with your medication. Here are general guidelines:
- Open the cover to load one dose.
- Slide the cover until you hear a click.
- Exhale fully through your mouth, making sure to keep the inhaler away from your face.
- Hold the inhaler flat with both hands, and close your lips around the mouthpiece.
- Inhale slowly and deeply through your mouth, without blocking the air vent with your fingers.
- Remove the inhaler from your mouth and hold your breath for 3 to 4 seconds.
- Exhale slowly.
- Rinse your mouth with water and spit it out without swallowing.
Note: Dosing information below is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Breo Ellipta is FDA-approved as a maintenance inhaler for asthma and chronic obstructive pulmonary disease (COPD).
Off-Label Uses
You may see Breo Ellipta prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
There are currently no common off-label uses for Breo Ellipta.
Side Effects
Like all medications, Breo Ellipta can cause side effects. Some common side effects may improve over time as your body adjusts to the medication. Other side effects may be serious and require medical attention.
Common Side Effects
- Headache
- Throat irritation or sore throat
- Hoarseness
- Oral thrush
- Upper respiratory tract infection, such as the flu or common cold
- Back or joint pain
- Infection or swelling in the lungs or sinuses
- Cough
- High blood pressure
- Fever
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur. Stop using Breo Ellipta and call your doctor immediately if you experience:
- Severe allergic reactions: Symptoms include swelling of the face, lips, tongue, or throat; difficulty breathing or swallowing; racing heart; severe rash or itching; and/or fever.
- Sudden breathing problems (paradoxical bronchospasm): It’s possible for Breo Ellipta to cause your airways to tighten instead of relax. Symptoms include worsened breathing, wheezing, or coughing immediately after using Breo Ellipta.
- Oral thrush (oral candidiasis): Breo Ellipta can cause this fungal mouth or throat infection. To lower your risk, it’s important to rinse the mouth with water and spit it out without swallowing after each dose. Symptoms include loss of taste, cracking in the corners of the mouth, and raised white spots or red or white patches in the mouth or throat.
- Pneumonia: Breo Ellipta may increase the risk of pneumonia, especially in people with COPD. Symptoms include difficulty breathing, increased mucus, changes in mucus color, worsened cough, fever, or chills.
- Infections: Breo Ellipta can increase the risk of infection, including serious ones. Symptoms include cough, coughing up blood, shortness of breath, fever, chills, sweats, diarrhea, stomach pain, or weight loss.
- Cardiovascular effects: This medication may cause changes in heart rhythm, an increased heart rate, or elevated blood pressure. Symptoms include chest pain or a fast or irregular heartbeat.
- Adrenal suppression: Long-term use of inhaled corticosteroids can reduce the adrenal glands’ ability to produce natural stress hormones, a condition called adrenal insufficiency. The risk may be higher when switching from an oral corticosteroid to Breo Ellipta or when the body is under stress. Symptoms include fatigue, weakness, low blood pressure, nausea, or vomiting.
- Eye problems: Prolonged use of Breo Ellipta may increase eye pressure, which may worsen narrow-angle glaucoma or cataracts. Symptoms include blurry vision, vision loss, eye pain or redness, severe headache, vomiting, or seeing vision halos.
- Bone problems: Long-term use of Breo Ellipta may weaken the bones, leading to reduced bone density (osteopenia) or an increased risk of fractures from osteoporosis.
- High blood sugar (hyperglycemia): Breo Ellipta can raise blood sugar levels. Symptoms include confusion and increased hunger, thirst, or urination.
- Low potassium levels (hypokalemia): Breo Ellipta can lead to low potassium levels, which can be serious. Symptoms include muscle cramps or twitching, constipation, and unusual weakness or tiredness.
- Nervous system effects: This medication may affect your nervous system, leading to symptoms like nervousness or tremor (shaking).
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Prevent Oral Thrush
To lower the risk of developing a fungal infection in the mouth, it is highly recommended to thoroughly rinse your mouth with water and spit it out after every dose. Do not swallow any of the water you use to rinse your mouth.
Maintain A Routine
You can take Breo Ellipta at any time of day. The important thing is to choose a time that works for you and try to use it at the same time each day.
Only Open The Cover When You’re Ready To Take Your Dose
The Ellipta device does not require priming or shaking prior to use. Sliding the cover open loads a dose. Only open the cover when you are completely ready to inhale.
Always Have A Rescue Inhaler With You
Breo Ellipta is not a rescue inhaler. Always keep a rescue inhaler with you for emergencies. Contact your provider if you experience chest tightness, wheezing, coughing, or shortness of breath.
Keep The Inhaler In Its Sealed Foil Tray Until The First Use
Once opened, write the date on the label. The inhaler should be discarded after 6 weeks or when the dose counter reaches “0” — whichever comes first.
Keep Up With Regular Medical Appointments And Testing
Regular checkups help your provider see how well the medication is working for you.
Clean The Device Weekly
Gently wipe the mouthpiece with a dry cloth or tissue once a week. Never wash the inhaler or submerge it in water.
Store At Room Temperature
Breo Ellipta should be stored at 68°F to 77°F (20°C to 25°C) in a cool, dry place away from light.
Tell Your Provider If You’re Pregnant Or Breastfeeding
It is not known if Breo Ellipta can affect pregnancy or pass into breast milk. Tell your healthcare provider if you are pregnant, breastfeeding, or planning to be, so they can advise you whether this medication is safe for you to take.
Try To Avoid Missing A Dose
If you miss a dose of Breo Ellipta, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and only use the inhaler on your next dose as usual. Do not take double or extra doses of Breo Ellipta to make up for a missed one.
Drug Interactions
Certain medications and substances can interact with Breo Ellipta, potentially altering how it works or increasing the risk of side effects. For example:
- Other LABAs: Breo Ellipta should not be used with other inhaled medications containing long-acting beta-agonists, such as formoterol or salmeterol, as it increases the risk of experiencing a serious asthma attack.
- Beta-blockers: Medications used for heart conditions or high blood pressure, like metoprolol or propranolol, can prevent Breo Ellipta from working as well.
- Diuretics (“water pills”): Taking Breo Ellipta with these blood pressure medications can increase the risk of low potassium levels.
- Antifungals: Breo Ellipta should not be used with medications such as ketoconazole, itraconazole, posaconazole, or voriconazole.
- HIV/AIDS medications: Certain antiviral drugs can interact with Breo Ellipta.
- Monoamine oxidase inhibitors (MAOIs): Breo Ellipta should not be used within two weeks of these medicines for depression.
- Tricyclic antidepressants: Medications like amitriptyline or nortriptyline can interact with Breo Ellipta.
- Medicines that can cause QT prolongation: Breo Ellipta should not be used within two weeks of any medicine that can affect the heart rhythm.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
How long does it usually take for Breo Ellipta to start improving breathing?
The initial effects may begin within minutes of inhalation, but it may take a few days to weeks to experience the full effects of the medication.
Do you have to rinse your mouth out with water after every use?
Yes, standard guidelines suggest rinsing your mouth with water and spitting it out after every dose. This practice washes away residual steroid powder in the mouth, lowering the chance of developing a fungal infection called oral thrush.
Can I use Breo Ellipta as a rescue inhaler if I am having a sudden asthma attack?
No. Breo Ellipta is a daily maintenance controller and will not provide the rapid relief needed during a sudden asthma attack or COPD flare-up. Always keep a fast-acting rescue inhaler with you for sudden breathing emergencies.
What happens if I open the inhaler cover and then close it without taking a breath?
The Ellipta device is designed so that sliding the cover open automatically prepares and loads a single dose of the powder. If you close the cover without inhaling, that specific dose is discarded within the device and is lost. It will not be delivered during the next use.
Why don’t I feel or taste any powder when I inhale the medication?
The medication is formulated as an extremely fine, dry powder. Because the particles are so small, many patients do not taste or feel the powder entering their throat or lungs. As long as the dose counter decreases by one, the device has successfully released the medication.
Is there a difference between taking Breo once a day versus taking Advair twice a day?
Both medications are combination inhalers containing an inhaled corticosteroid and a long-acting beta-agonist. However, their specific active ingredients and durations of action differ. Breo Ellipta is formulated to provide a full 24 hours of symptom control from a single daily dose, while Advair requires dosing every 12 hours (twice a day) to maintain continuous coverage.
What should I do if the dose counter turns red?
The dose counter on the front of the inhaler tracks how many puffs remain. When the counter approaches zero, it typically indicates the device is nearly empty. When the counter reaches “0,” the inhaler contains no more medication and should be disposed of and replaced with a new one.
Does using an inhaled steroid make me more susceptible to pneumonia?
Clinical studies have shown that people with COPD who regularly use inhalers containing corticosteroids, such as Breo Ellipta, may have an increased risk of pneumonia. Symptoms of lung infection may include fever, chills, worsened cough, or changes in mucus color or production.
Can I safely take my daily albuterol nebulizer treatments while using this maintenance inhaler?
Albuterol is a short-acting rescue inhaler. It is generally standard practice for people on maintenance inhalers like Breo Ellipta to also have access to albuterol for sudden symptom relief.
Should I take my daily dose in the morning or the evening for the best results?
Breo Ellipta can be taken at any time of the day. The important thing is consistency. Providers typically recommend choosing a specific time that fits easily into your daily routine so you are less likely to miss a dose.
Is it safe to use this specific combination inhaler during pregnancy?
It is not known if or how the active ingredients in Breo Ellipta might affect a developing fetus or a pregnancy. It’s recommended that people who are pregnant or planning to become pregnant consult their healthcare provider to carefully weigh the risks and benefits.
Comparable Medications
Breo Ellipta, Advair (fluticasone propionate/salmeterol), Trelegy (fluticasone/umeclidinium/vilanterol), Anoro (umeclidinium/vilanterol), or albuterol (ProAir / Ventolin)?
There are several medications that your doctor can prescribe in place of Breo Ellipta. Here are a few possible alternatives below.
Advair
A twice-daily maintenance inhaler for asthma and COPD that combines an inhaled corticosteroid with a long-acting beta-agonist (LABA).
Trelegy Ellipta
From $899.99
A once-daily maintenance inhaler for asthma and COPD that combines an inhaled corticosteroid, a long-acting beta-agonist (LABA), and long-acting muscarinic antagonist (LAMA).
Anoro Ellipta
From $649.99
A once-daily maintenance inhaler for COPD that combines a long-acting muscarinic antagonist (LAMA) and a long-acting beta-agonist (LABA).
Albuterol HFA
From $43.99
A bronchodilator rescue inhaler used to relieve asthma attacks.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.