What are the effects of taking Trelegy (fluticasone furoate, umeclidinium, and vilanterol) and Flovent (fluticasone propionate) and Albuterol (salbutamol)?

From the Guidelines

Taking Trelegy and Flovent together may result in an unnecessarily high dose of corticosteroid, which should be discussed with your healthcare provider to minimize the risk of side effects. When using multiple inhalers, proper timing is important - use albuterol first if needed for immediate relief, wait 15-30 minutes, then use maintenance inhalers like Trelegy. Always follow your healthcare provider's specific instructions regarding dosing and scheduling of these medications. The use of inhaled corticosteroids, such as fluticasone in Trelegy and Flovent, is effective in reducing airway inflammation and improving asthma control, as stated in the expert panel report 3 (EPR-3) guidelines 1. However, the potential risks and benefits of using these medications together should be carefully considered, and alternative treatment options should be discussed with your healthcare provider. Additionally, the use of albuterol as a short-acting rescue inhaler is recommended for relief of acute symptoms and prevention of exercise-induced bronchospasm, as supported by the Beta Agonist Study (BAGS) 1. It is essential to monitor the patient's response to therapy and adjust the treatment plan as needed to achieve optimal asthma control and minimize the risk of side effects. The Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 report also highlights the importance of individualized treatment plans and regular monitoring of patients with COPD or asthma 1. Overall, the goal of treatment should be to achieve optimal control of symptoms, improve quality of life, and reduce the risk of exacerbations and side effects. Key points to consider when taking Trelegy, Flovent, and albuterol include:

• Proper timing of inhaler use to minimize interactions and side effects
• Monitoring of asthma control and adjustment of treatment plan as needed
• Discussion of potential risks and benefits of using multiple inhalers with your healthcare provider
• Importance of individualized treatment plans and regular monitoring of patients with COPD or asthma.

From the FDA Drug Label

WARNINGS As with other inhaled beta-adrenergic agonists, albuterol sulfate inhalation solution can produce paradoxical bronchospasm, which can be life threatening. ADVERSE REACTIONS The results of clinical trials with albuterol sulfate inhalation solution in 135 patients showed the following side effects which were considered probably or possibly drug related:

The FDA drug label does not answer the question.

From the Research

Medications and Their Uses

• Tirllegy: Not explicitly mentioned in the provided studies, but based on the context, it is likely a triple therapy inhaler containing an inhaled corticosteroid (ICS), a long-acting beta2-agonist (LABA), and a long-acting muscarinic antagonist (LAMA) 2.
• Flovent: Contains fluticasone propionate, an inhaled corticosteroid (ICS) used for asthma treatment 3, 4, 5.
• Albuterol: A short-acting beta2-agonist used for rapid relief of acute asthma symptoms 6.

Treatment of Asthma

• Inhaled corticosteroids (ICS) are the standard of care for persistent asthma, with combination therapy including ICS and LABA effective for patients who require more than ICS alone 6, 3.
• Long-acting muscarinic antagonists (LAMA) and biological agents can also be used as controller medications for moderate and severe asthma 6.
• Combination therapy with ICS and LABA provides greater asthma control than increasing the ICS dose alone, and reduces the frequency and severity of exacerbations 3, 4, 5.

Comparison of Medications

• Fluticasone/salmeterol combination therapy is compared to budesonide/formoterol in several studies, with results showing similar effectiveness but some differences in outcomes 4, 5.
• Fluticasone is associated with greater improvement in lung function and better asthma symptom control than budesonide, while formoterol is associated with greater improvement in lung function and better symptom control than salmeterol 5.

Safety and Tolerability

• The risk of growth retardation is lower with fluticasone than budesonide, and with budesonide/formoterol than with budesonide monotherapy 5.
• No significant differences in tolerability profiles are reported between ICS and LABA therapies, although some studies note a higher risk of serious adverse events with certain combinations 4.