What is the most common dosing regimen of Trelegy (fluticasone furoate, umeclidinium, vilanterol) for moderate Chronic Obstructive Pulmonary Disease (COPD)?

Trelegy Dosing for Moderate COPD

Trelegy Ellipta is dosed as one inhalation once daily of fluticasone furoate/umeclidinium/vilanterol 100/62.5/25 mcg for moderate COPD. 1

Standard Dosing Regimen

• One inhalation once daily is the only available and recommended dosing schedule for Trelegy Ellipta 2
• The fixed-dose combination contains fluticasone furoate 100 mcg (ICS), umeclidinium 62.5 mcg (LAMA), and vilanterol 25 mcg (LABA) per inhalation 1
• This once-daily regimen offers a significant adherence advantage over twice-daily alternatives like budesonide/formoterol 2, 3

Clinical Context for Use in Moderate COPD

While Trelegy is FDA-approved for moderate to severe COPD, the American Thoracic Society specifically recommends triple therapy like Trelegy for patients with persistent moderate to severe dyspnea despite dual therapy, and for those at high risk of COPD exacerbations 2. This means that in moderate COPD, triple therapy should be reserved for:

• Patients inadequately controlled on ICS/LABA dual therapy 1
• Those with frequent exacerbations (≥1 moderate/severe exacerbation in the prior year) 3
• Patients with persistent dyspnea despite dual bronchodilator or ICS/LABA therapy 2

Important Administration Details

• Delivered via the Ellipta dry powder inhaler device 2
• Proper inhaler technique must be demonstrated before prescribing, as up to 76% of COPD patients make critical errors with inhaler use 4
• Beta-blocking agents (including eyedrop formulations) must be avoided in patients using this medication 4

Evidence Supporting Once-Daily Dosing

The once-daily dosing has been extensively validated in clinical trials showing that FF/UMEC/VI 100/62.5/25 mcg once daily significantly reduces moderate/severe exacerbation rates (rate ratio 0.64 in patients with recent exacerbations) and improves lung function and health status compared to twice-daily dual therapy 3. The European Respiratory Society suggests that single inhaler triple therapy may reduce mortality in individuals with moderate-severe disease compared to dual therapy options 2.

Common Pitfall to Avoid

Do not attempt to adjust or split the dose—Trelegy comes only as a fixed-dose combination in a single strength, and the once-daily regimen is the only evidence-based dosing schedule 1, 2. There is no role for twice-daily dosing or dose titration with this medication.