Recommended Dosage of Trelegy (Fluticasone Furoate, Umeclidinium, Vilanterol)
The recommended dose of Trelegy is one inhalation of fluticasone furoate 100 mcg, umeclidinium 62.5 mcg, and vilanterol 25 mcg once daily. 1
Dosage Information
Trelegy Ellipta is a dry powder inhaler containing:
- Fluticasone furoate (inhaled corticosteroid [ICS])
- Umeclidinium bromide (long-acting muscarinic antagonist [LAMA])
- Vilanterol trifenatate (long-acting beta2 agonist [LABA]) 2
The medication is designed for once-daily administration, which can help improve patient adherence compared to multiple-inhaler regimens.
Indications
Trelegy is indicated for:
- Maintenance treatment of adults with moderate to severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an ICS and a LABA 2
- Patients who require triple therapy when dual therapies are insufficient for symptom control 3
Clinical Evidence Supporting Once-Daily Dosing
Recent evidence from the ELLITHE study (2024) demonstrated that once-daily single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol resulted in:
- Significant and clinically relevant improvements in COPD Assessment Test (CAT) scores (-2.6 units; p<0.0001)
- Improved lung function with FEV1 increases of 93 mL (p<0.0001)
- Reduced exacerbation rates (0.2 events/year during treatment compared to 1.4 events/year pre-study) 3
Administration Guidelines
- Administer one inhalation once daily at the same time each day
- The medication should be administered via the ELLIPTA inhaler device
- Proper inhaler technique is essential for optimal medication delivery
- Patients should avoid eating, drinking, or rinsing for 30 minutes after administration 1
Monitoring and Safety Considerations
Monitor for local side effects including:
- Oral candidiasis
- Nasal irritation
- Epistaxis (nosebleeds)
- Pharyngitis
- Cough 1
Assess treatment effectiveness within 4-6 weeks of initiation
Regular follow-up is recommended to evaluate symptom control and potential adverse effects
Common Pitfalls to Avoid
- Incorrect inhaler technique: Ensure patients receive proper instruction on using the ELLIPTA device
- Inadequate adherence: The once-daily dosing regimen is designed to improve compliance, but patients should still be educated on the importance of consistent use
- Failure to monitor for adverse effects: Regular assessment for local and systemic side effects is essential
- Not rinsing mouth after use: This can increase the risk of oral candidiasis
Trelegy represents an advancement in COPD management by providing three medication classes in a single inhaler with once-daily dosing, potentially improving treatment adherence while delivering effective symptom control.