What is the dosing regimen for Trelegy (fluticasone furoate, umeclidinium, vilanterol)?

Trelegy (Fluticasone Furoate, Umeclidinium, Vilanterol) Dosing Regimen

Trelegy is dosed as one inhalation once daily, delivering 100 mcg fluticasone furoate, 62.5 mcg umeclidinium, and 25 mcg vilanterol via the Ellipta dry powder inhaler. 1, 2

Indications and Formulation

• Trelegy Ellipta is a once-daily triple therapy inhaler containing fluticasone furoate (inhaled corticosteroid), umeclidinium bromide (long-acting muscarinic antagonist), and vilanterol trifenatate (long-acting beta2 agonist) 1
• It is indicated for maintenance treatment in adults with moderate to severe COPD who are not adequately treated by a combination of an ICS and a LABA 1, 2
• The medication is delivered via the Ellipta dry powder inhaler device 3

Dosing Schedule

• Trelegy is administered as one inhalation once daily in the morning 3, 4
• The single-inhaler triple therapy delivers fixed doses of fluticasone furoate 100 mcg, umeclidinium 62.5 mcg, and vilanterol 25 mcg 3, 4
• The once-daily dosing schedule may improve patient adherence compared to multiple-inhaler regimens 4

Administration Technique

• Proper inhaler technique is essential to ensure optimal drug delivery 5
• Using a spacer or valved holding chamber with non-breath-actuated MDIs can decrease local side effects 5
• Mouth washing and spitting after inhalation can reduce the risk of oral thrush (candidiasis) 5

Clinical Considerations

• Single-inhaler triple therapy (FF/UMEC/VI) has been shown to be non-inferior to using two separate inhalers (FF/VI + UMEC) for COPD treatment 3
• The IMPACT study demonstrated that triple therapy had greater effects compared to dual therapies in reducing moderate-severe exacerbations, improving lung function, and enhancing quality of life 4
• The effectiveness of Trelegy in real-world clinical practice is being further evaluated in the INTREPID study across multiple European countries 6

Potential Adverse Effects

• Common local effects include pharyngitis, oral thrush (candidiasis), dysphonia, and cough 5
• Potential systemic effects at high doses include adrenal suppression, decreased bone mineral density, and growth suppression in children 5
• Vilanterol-related effects may include tachycardia, skeletal muscle tremor, and headache 5

Important Precautions

• Higher doses of fluticasone (>1000 mcg/day) are associated with increased risk of systemic side effects 7
• Proper inhaler technique should be demonstrated and regularly assessed to ensure effective medication delivery 5
• Patients should be monitored for potential adverse effects, particularly those related to each component of the triple therapy 5