fluticasone furoate and vilanterol inhalation powder (Breo Ellipta)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: fluticasone furoate and vilanterol inhalation powder
BRAND NAMES: Breo Ellipta
DRUG CLASS AND MECHANISM: Breo Ellipta for oral inhalation is a combination of fluticasone and vilanterol and is used for treating chronic obstructive pulmonary disease (COPD). Fluticasone is a man-made steroid of the glucocorticoid family which is related to the naturally-occurring steroid hormone, cortisol or hydrocortisone, produced by the adrenal glands. Glucocorticoid steroids have potent anti- inflammatory actions. When used as an inhaler, fluticasone travels to the airways in the lung. In COPD patients, the suppression of inflammation within the airways reduces the inflammatory-stimulated spasm of the smooth muscle cells surrounding the airways that narrows the airways and makes getting air into and out of the lungs more difficult. When used in lower doses, very little fluticasone is absorbed into the body. When higher doses are used, fluticasone is absorbed and may cause side effects elsewhere in the body.
Vilanterol is a bronchodilator of the beta-2 agonist type. Beta-2 agonists are medications that stimulate beta-2 receptors on the smooth muscle cells that surround the airways, causing these muscle cells to relax and thereby opening the airways. It is similar to salmeterol (Serevent). Breo Ellipta opens the airways and increases air supply to the lungs of COPD patients. The FDA approved Breo Ellipta in May 2013.
GENERIC AVAILABLE: no
STORAGE: Breo Ellipta should be kept at room temperature, 15 C to 30 C (59 F to 86 F) and stored in a dry place away from light.
DOSING: The recommended dose is one inhalation once daily by mouth. Following administration, the mouth should be rinsed thoroughly with water without swallowing to reduce risk of fungal infections.
DRUG INTERACTIONS: Ritonavir (Norvir), atazanavir (Reyataz), clarithromycin (Biaxin), indinavir (Crixivan), itraconazole (Sporanox), ketoconazole, nelfinavir (Viracept), and telithromycin (Ketek) may increase levels of fluticasone and vilanterol in the body by reducing the breakdown of fluticasone and vilanterol by liver enzymes. This may increase side effects of Breo Ellipta.
Combining or using Breo Ellipta within two weeks of stopping monoamine oxidase inhibitors (for example, phenelzine), tricyclic antidepressants (for example, amitriptyline [Endep, Elavil]), or other drugs that affect heart rate and rhythm, may increase risk of heart-related side effects.
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