Is Wixela (fluticasone furoate, umeclidinium, and vilanterol) the same as Trelegy (fluticasone furoate, umeclidinium, and vilanterol)?

Wixela and Trelegy Are Not the Same Medications

No, Wixela and Trelegy are not the same medications as they contain different active ingredients and are used for different indications. 1, 2, 3

Key Differences Between Wixela and Trelegy

• Trelegy Ellipta is a triple therapy inhaler containing:

  • Fluticasone furoate (inhaled corticosteroid)
  • Umeclidinium bromide (long-acting muscarinic antagonist/LAMA)
  • Vilanterol trifenatate (long-acting beta2 agonist/LABA) 1, 2

• Wixela Inhub is a dual therapy inhaler containing:

  • Fluticasone propionate (inhaled corticosteroid)
  • Salmeterol (long-acting beta2 agonist/LABA) 3

Important Clinical Implications

• Medication Components: Trelegy contains three active ingredients (triple therapy) while Wixela contains only two (dual therapy) 1, 4

• Specific Ingredients:

  • Different corticosteroids: Fluticasone furoate (Trelegy) vs. Fluticasone propionate (Wixela) 1, 3
  • Different LABAs: Vilanterol (Trelegy) vs. Salmeterol (Wixela) 1, 3
  • Trelegy includes umeclidinium (LAMA) which is not present in Wixela 1, 4

• Clinical Use:

  • Trelegy is indicated for maintenance treatment of moderate to severe COPD in patients not adequately treated by ICS/LABA combination 1, 4
  • Wixela is a generic equivalent to Advair Diskus, used for asthma or COPD 3

Clinical Considerations for Triple vs. Dual Therapy

• Triple therapy (like Trelegy) is recommended for:

  • Patients with persistent moderate to severe dyspnea despite dual therapy 5
  • Patients at high risk of COPD exacerbations 5
  • Severe COPD patients who remain symptomatic despite dual therapies 4

• Single inhaler triple therapy (SITT) may reduce mortality in individuals with moderate-severe disease compared to dual therapy options 5

Practical Considerations

• Delivery Device:

  • Trelegy uses the Ellipta inhaler device 1, 6
  • Wixela uses the Inhub device (similar to Advair Diskus) 3

• Dosing Frequency:

  • Trelegy is administered once daily 1, 4
  • Wixela is typically administered twice daily 3

Common Pitfalls to Avoid

• Medication Confusion: Do not substitute Wixela for Trelegy as they contain different medications with different dosing schedules 1, 3

• Therapeutic Equivalence: While Wixela is bioequivalent to Advair Diskus, it is not equivalent to Trelegy, which has an additional bronchodilator component (umeclidinium) 3

• Patient Education: Patients switching between these medications need clear education on the differences in devices, dosing schedules, and expected effects 7

• Adherence Considerations: Once-daily dosing with Trelegy may improve adherence compared to multiple-inhaler or twice-daily regimens 4, 6