What is the recommended dose of Breo Ellipta (fluticasone furoate and vilanterol) for adults?

Recommended Dosage of Breo Ellipta for Adults

The recommended dosage of Breo Ellipta (fluticasone furoate/vilanterol) for adults with COPD is 100/25 mcg (containing fluticasone furoate 100 mcg and vilanterol 25 mcg), administered as 1 actuation once daily by oral inhalation. 1

Dosage by Indication

For COPD:

• Dosage: 100/25 mcg once daily
• Administration: 1 actuation via Ellipta dry powder inhaler
• Timing: Should be used at the same time every day
• Maximum dose: Do not exceed 1 inhalation every 24 hours 1

For Asthma:

• Initial dosage: 100/25 mcg once daily
• Alternative dosage: 200/25 mcg once daily may be considered for patients who do not respond adequately to the 100/25 mcg dose
• Maximum dose: 200/25 mcg once daily 1

Administration Instructions

1. Administer at the same time every day
2. Do not use more than once every 24 hours
3. After inhalation, rinse mouth with water without swallowing to reduce the risk of oropharyngeal candidiasis
4. For acute symptoms between doses, use a short-acting beta2-agonist (rescue medication, e.g., albuterol) 1

Clinical Efficacy

Breo Ellipta has demonstrated significant efficacy in clinical trials:

• Bronchodilation: Provides rapid onset of action (within 15 minutes) with maximum effect at 12 hours 2
• Duration: Maintains bronchodilation throughout a 24-hour period, with evidence of effect lasting up to 72 hours after a single dose 2
• Lung function: Improves pulmonary function more effectively than placebo and fluticasone furoate alone 3
• Exacerbations: Reduces exacerbation rates more effectively than vilanterol alone 3

Important Considerations

Contraindications:

• Primary treatment of status asthmaticus or other acute episodes of COPD or asthma
• Severe hypersensitivity to milk proteins
• Demonstrated hypersensitivity to fluticasone furoate, vilanterol, or any excipients 1

Safety Concerns:

• Increased risk of pneumonia with long-term use (as with all ICS agents) 3
• Not indicated for relief of acute bronchospasm 1

Advantages:

• Once-daily administration may improve treatment adherence compared to twice-daily regimens 3
• Single-inhaler therapy has been shown to be non-inferior to using multiple inhalers for the same medications 4

Monitoring

• Assess efficacy within 4-6 weeks of starting treatment
• Monitor for common side effects including:
  • Pharyngitis
  • Epistaxis (nosebleeds)
  • Headache
  • Cough 1

Breo Ellipta offers the convenience of once-daily dosing while providing effective control of COPD and asthma symptoms, with demonstrated improvements in lung function and reduction in exacerbations.