What is the correct prescription and administration instructions for Trelegy Ellipta (fluticasone furoate, umeclidinium, vilanterol)?

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Correct Prescription for Trelegy Ellipta

Trelegy Ellipta should be prescribed as: "Trelegy Ellipta 100-62.5-25 mcg, inhale 1 inhalation orally once daily," with a 30-day supply dispensed (1 inhaler containing 30 doses) and appropriate refills authorized. 1

Prescription Components

Medication Strength and Formulation

  • Trelegy Ellipta contains three active ingredients: fluticasone furoate 100 mcg (inhaled corticosteroid), umeclidinium 62.5 mcg (long-acting muscarinic antagonist), and vilanterol 25 mcg (long-acting beta2 agonist) per inhalation 1
  • The device is a dry powder inhaler delivered via the ELLIPTA breath-activated mechanism 2

Dosing Instructions

  • Administer once daily at the same time each day 1, 3
  • The single daily dose regimen makes it ideal for patients who struggle with complex inhaled therapy regimens 2
  • Each ELLIPTA inhaler contains 30 doses, providing exactly one month of therapy when used once daily 2

Proper Prescription Format

The prescription should specify:

  • Drug name: Trelegy Ellipta 100-62.5-25 mcg/actuation
  • Route: Inhalation (oral inhalation)
  • Dose: 1 inhalation
  • Frequency: Once daily
  • Duration: 30 days (or ongoing for chronic therapy)
  • Dispense: 1 inhaler (30 doses)
  • Refills: As appropriate for chronic COPD management 1

Device-Specific Considerations

ELLIPTA Inhaler Advantages

  • The ELLIPTA device has medium resistance and delivers a consistent dose across a range of inspiratory flow rates 2
  • Significantly fewer patients make critical errors with ELLIPTA after reading the patient information leaflet compared to other inhaler devices (only 5-14% error rate versus 44-60% with comparator devices) 4
  • Most patients (57-70%) make no errors using ELLIPTA and do not require additional instruction 4

Patient Education Points

  • Patients should be instructed to inhale forcefully and deeply through the device to activate the breath-activated mechanism 2
  • The device does not require coordination between actuation and inhalation like metered-dose inhalers 4
  • Patients should be advised to rinse their mouth after use to reduce local corticosteroid side effects, though this is less emphasized with once-daily dosing 5

Common Prescribing Pitfalls

Avoid These Errors

  • Do not prescribe "1 puff" - the correct terminology is "1 inhalation" for dry powder inhalers 2
  • Do not write "MCG/ACT Aerosol Powder" - this is redundant; simply write the strength followed by "per inhalation" 1
  • Do not prescribe twice-daily dosing - Trelegy Ellipta is specifically formulated for once-daily administration only 1, 3
  • Do not dispense multiple inhalers for a 30-day supply - one inhaler contains exactly 30 doses 2

Indication Verification

  • Trelegy Ellipta is licensed for moderate to severe COPD in patients not adequately controlled on ICS/LABA combination 1
  • It should not be used as rescue therapy or for acute bronchospasm 1
  • The medication is for maintenance treatment only 1

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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