Are Ellipta and Flovent the Same Class of Medication?
No, Ellipta (fluticasone furoate/vilanterol) and Flovent (fluticasone propionate) are not the same class of medication—Ellipta is a combination inhaled corticosteroid/long-acting beta-agonist (ICS/LABA), while Flovent is an inhaled corticosteroid (ICS) alone. 1
Key Differences Between the Two Medications
Medication Components
- Ellipta contains two active ingredients: fluticasone furoate (an inhaled corticosteroid) and vilanterol (a long-acting beta2-agonist), making it a fixed-dose combination therapy 1
- Flovent contains only one active ingredient: fluticasone propionate, which is an inhaled corticosteroid monotherapy 2
Pharmacological Classification
- Ellipta belongs to the ICS/LABA combination class, which includes both anti-inflammatory and bronchodilator components that work through different mechanisms 1, 3
- Flovent belongs to the ICS monotherapy class, providing only anti-inflammatory effects without bronchodilation 2
Mechanism of Action Differences
- Fluticasone furoate (in Ellipta) is a synthetic trifluorinated corticosteroid with enhanced affinity for the glucocorticoid receptor—approximately 1.7 times that of fluticasone propionate—though the clinical relevance is unknown 1
- Vilanterol (in Ellipta) is a long-acting beta2-agonist that stimulates intracellular adenyl cyclase, causing bronchial smooth muscle relaxation and inhibition of mediator release from mast cells 1
- Fluticasone propionate (in Flovent) provides only corticosteroid anti-inflammatory activity without the added bronchodilator component 2
Clinical Implications of the Difference
Indications and Use
- Ellipta is approved for once-daily maintenance treatment of asthma and COPD, combining anti-inflammatory and bronchodilator effects in a single inhaler 3, 4
- Flovent is used as ICS monotherapy for asthma control, typically requiring additional bronchodilator therapy if needed 2
When Combination Therapy Is Preferred
- The Journal of Allergy and Clinical Immunology recommends that for patients with moderate persistent asthma requiring more than low-dose ICS, adding a long-acting beta2-agonist to low-to-medium doses of inhaled corticosteroids is the preferred treatment for adults and children older than 5 years 2
- This makes Ellipta (ICS/LABA combination) appropriate for patients who need both components, while Flovent alone would be insufficient for those requiring combination therapy 2
Dosing Schedule Advantage
- Ellipta offers once-daily dosing, which may improve treatment adherence compared to twice-daily regimens 3, 4
- Flovent typically requires twice-daily administration for most formulations 2
Important Safety Considerations
Shared Corticosteroid Risks
- Both medications carry the typical ICS class effects including oral/oropharyngeal candidiasis, dysphonia, and potential growth effects in children (though minimal at recommended doses) 2, 4
- Long-term use of both can increase pneumonia risk, particularly in COPD patients 3
Additional LABA-Related Risks with Ellipta
- Ellipta carries additional risks from the vilanterol component including tachycardia, skeletal muscle tremor, hypokalemia, and potential cardiac effects 1
- LABAs should never be used as monotherapy for asthma and must always be combined with an ICS, which Ellipta accomplishes in a single device 2
- There is a potential risk of uncommon severe life-threatening or fatal exacerbations associated with LABAs 2
Common Pitfall to Avoid
- Do not assume these medications are interchangeable simply because they both contain a form of fluticasone—the addition of vilanterol in Ellipta fundamentally changes the medication class, indications, and risk profile 1
- Patients switching from Flovent to Ellipta are adding a LABA component, which requires appropriate patient selection and counseling about the different medication class 2