From the Guidelines
Yes, AirSupra (levalbuterol) can be used as a rescue medication for patients on Trelegy (fluticasone furoate, umeclidinium, vilanterol). AirSupra is a short-acting beta-agonist (SABA) that provides quick relief of acute bronchospasm, making it appropriate for rescue use when breakthrough symptoms occur despite maintenance therapy with Trelegy 1. Patients should use AirSupra as needed for sudden symptoms like wheezing, chest tightness, or shortness of breath, typically 1-2 inhalations every 4-6 hours as needed.
The dosage of levalbuterol for acute symptoms can be guided by the recommendations for asthma exacerbations, which suggest that for adults, 1.25-2.5 mg every 20 minutes for 3 doses, then 1.25-5 mg every 1-4 hours as needed can be used 1. It's essential to note that levalbuterol administered in one-half the mg dose of albuterol provides comparable efficacy and safety 1.
It's crucial to continue taking Trelegy regularly as prescribed since it's a maintenance medication containing an inhaled corticosteroid, a long-acting muscarinic antagonist, and a long-acting beta-agonist that works to control underlying inflammation and provide long-term bronchodilation. If a patient finds they need to use AirSupra more than twice a week, this may indicate that their asthma or COPD is not well-controlled, and they should consult their healthcare provider about potentially adjusting their maintenance therapy. The medications work through different mechanisms and timeframes - Trelegy provides sustained control while AirSupra offers immediate relief during acute symptoms.
Key points to consider:
- AirSupra (levalbuterol) is appropriate for rescue use in patients on Trelegy.
- Dosage should be as needed, with guidance from recommended dosages for acute asthma symptoms.
- Continued use of Trelegy as prescribed is essential for maintaining control of underlying inflammation and bronchodilation.
- Frequent need for AirSupra may indicate poorly controlled asthma or COPD, necessitating a review of maintenance therapy.
From the Research
AirSupra as a Rescue Medication
- AirSupra, also known as levalbuterol, is a short-acting β2-agonist (SABA) used for the relief of bronchospasm in patients with asthma and chronic obstructive pulmonary disease (COPD) 2.
- There is no direct evidence in the provided studies that specifically addresses the use of AirSupra as a rescue medication for a patient on Trelegy (fluticasone furoate, umeclidinium, vilanterol).
- However, studies have shown that as-needed use of a fixed-dose combination of albuterol and budesonide can result in a significantly lower risk of severe asthma exacerbation than as-needed use of albuterol alone among patients with uncontrolled moderate-to-severe asthma 3, 4.
- Additionally, Trelegy has been shown to be effective as a maintenance treatment for adults with moderate to severe COPD who are not adequately treated by a combination of an ICS and a LABA 2, 5.
- A study comparing Trelegy use with multiple inhalers found that patients using Trelegy had greater symptoms, but did not differ in adherence, medication attitudes, or medication beliefs 6.
Considerations for Use
- The use of AirSupra as a rescue medication for a patient on Trelegy may be considered based on individual patient needs and medical history.
- However, it is essential to note that the provided studies do not directly address the safety and efficacy of using AirSupra as a rescue medication in conjunction with Trelegy.
- Patients using Trelegy may still experience symptoms and require rescue medication, and the choice of rescue medication should be based on individual patient needs and medical history 6.