Trelegy Ellipta Treatment Plan
Trelegy Ellipta 100-62.5-25 mcg should be administered as one inhalation once daily at the same time each day, with the patient rinsing their mouth with water (without swallowing) after each use to reduce the risk of oral candidiasis. 1
Dosing and Administration
- Take exactly 1 puff (actuation) once daily by oral inhalation 1
- Use at the same time every day to maintain consistent therapeutic levels 1
- Do not use more than once every 24 hours - more frequent administration increases the risk of adverse effects 1
- Rinse mouth with water after inhalation without swallowing to help prevent oropharyngeal candidiasis 1
Expected Therapeutic Response
- Onset of action occurs approximately 15 minutes after administration (defined as 100-mL increase in FEV1), though individual patients will experience variable time to onset and degree of symptom relief 1
- Triple therapy with fluticasone furoate/umeclidinium/vilanterol improves lung function, health status, and reduces exacerbation rates in patients with moderate to severe COPD 2, 3
Rescue Medication Use
- If shortness of breath or asthma symptoms occur between doses, use an inhaled short-acting beta2-agonist (e.g., albuterol) for immediate relief 1
- Increasing use of rescue medication (>2 days per week for symptom relief) indicates inadequate control and may require treatment reassessment 4
Patient Education and Monitoring
- The first treatment should be administered under supervision to ensure proper inhaler technique 4
- Patients must be shown how to use the ELLIPTA inhaler correctly - critical inhaler errors can lead to treatment failure 5
- Schedule follow-up within 4-8 weeks to assess treatment response, exacerbation frequency, and symptom control using validated tools 6
- Monitor for adverse effects including pharyngitis, sinusitis, lower respiratory tract infection, and cardiovascular effects (most common adverse reactions occurring in ≥1% of patients) 7
Important Safety Considerations
- Do not use for relief of acute bronchospasm - this is a maintenance medication only 1, 7
- Contraindicated in patients with severe hypersensitivity to milk proteins or any ingredients 7, 1
- Use with caution in patients with cardiovascular disorders, convulsive disorders, thyrotoxicosis, diabetes mellitus, narrow-angle glaucoma, or prostatic hyperplasia due to beta-adrenergic and anticholinergic effects 7
- Avoid concomitant use with other anticholinergic medications or additional LABA therapy due to risk of overdose and additive effects 7