Trelegy Formulation
Trelegy (fluticasone furoate/umeclidinium/vilanterol) is a dry powder inhaler, not an aerosol. 1, 2
Device Description and Mechanism
Trelegy ELLIPTA is delivered via a dry powder inhaler (DPI) device, specifically described as "a light grey and pale blue plastic inhaler containing 2 foil blister strips" that dispenses medication as a white powder blend. 1
The medication is contained in two separate foil blister strips within the ELLIPTA inhaler: one strip contains micronized fluticasone furoate mixed with lactose monohydrate, and the other contains micronized vilanterol trifenatate with magnesium stearate and lactose monohydrate. 1, 2
After activation, the powder within both blisters is exposed and ready for dispersion into the airstream created by the patient inhaling through the mouthpiece, distinguishing it from aerosol-based delivery systems like metered dose inhalers or nebulizers. 1
Clinical Implications of Powder Delivery
The actual amount of drug delivered to the lung depends on patient factors, such as inspiratory flow profile, with mean peak inspiratory flows ranging from 60.6 L/min in pediatric patients (ages 5-11) to 96.6 L/min in adults with severe asthma. 1, 2
Patients with severely compromised lung function (COPD with FEV1 <30% predicted) can still generate adequate inspiratory flow (mean 66.5 L/min, range 43.5-81.0 L/min) through the ELLIPTA dry powder inhaler. 1
Under standardized testing conditions at 60 L/min flow rate, the ELLIPTA inhaler delivers 46,92, or 184 mcg of fluticasone furoate and 22 mcg of vilanterol per dose, confirming consistent powder dispersion. 1, 2
Key Distinction from Aerosol Devices
Unlike nebulizers that generate liquid aerosols or metered dose inhalers that use propellants to create aerosol sprays, Trelegy relies on patient inspiratory effort to disperse the dry powder formulation. 1, 3
The lactose monohydrate carrier in the powder formulation contains milk proteins, which is relevant for patients with severe milk protein allergies. 1