Arnuity Ellipta: Generic Name and Dosing Instructions
Arnuity Ellipta's generic name is fluticasone furoate, and it is dosed as one inhalation once daily in the evening for asthma maintenance treatment.
Generic Name
- Arnuity Ellipta contains fluticasone furoate, an inhaled corticosteroid (ICS) formulated as a dry powder inhaler for once-daily administration 1
Standard Dosing by Age and Severity
Adults and Adolescents (≥12 years)
- Low-dose therapy (mild persistent asthma): Fluticasone furoate 100 mcg once daily in the evening 1
- Medium-dose therapy (moderate persistent asthma): Fluticasone furoate 200 mcg once daily in the evening 1
- High-dose therapy (severe persistent asthma): Fluticasone furoate 400 mcg once daily in the evening 1
Children (5-11 years)
- Fluticasone furoate 50 mcg once daily in the evening for all severities 2
Children (4 years)
- Fluticasone furoate 50 mcg once daily is the starting dose, always administered with proper technique 2
Administration Technique
- Timing: Administer once daily in the evening for optimal 24-hour asthma control 1
- Mouth rinsing: Rinse mouth with water and spit after each use to reduce risk of oral candidiasis 2
- No spacer needed: Dry powder inhalers do not require a spacer device, unlike metered-dose inhalers 2
Dose Selection Algorithm
- Step 2 care (mild persistent asthma): Start with fluticasone furoate 100 mcg once daily 2
- Step 3 care (moderate persistent asthma): Use fluticasone furoate 200 mcg once daily or consider adding a long-acting beta-agonist to low-dose ICS 2
- Step 4-5 care (severe persistent asthma): Fluticasone furoate 400 mcg once daily, typically combined with a LABA 2
Reassessment Timeline
- Evaluate asthma control every 2-6 weeks after initiating or adjusting therapy 2
- Discontinue if no clear benefit within 4-6 weeks despite proper technique and adherence 2
- Step down to the minimum effective dose after 2-4 months of sustained control 2
Key Clinical Evidence
- All doses of fluticasone furoate (100-400 mcg) once daily demonstrated significantly greater improvements in lung function compared to placebo, with increases exceeding 200 mL in FEV1 1
- Once-daily fluticasone furoate 100-200 mcg showed efficacy similar to or greater than twice-daily fluticasone propionate 250 mcg in patients with moderate asthma 1
- The 100 mcg and 200 mcg doses are considered the most clinically applicable for patients uncontrolled on low-dose ICS 1
Common Pitfalls to Avoid
- Never use as rescue therapy: Fluticasone furoate is maintenance therapy only, not for acute symptom relief 3
- Never use LABA monotherapy: If stepping up therapy, always combine LABA with ICS due to increased risk of severe exacerbations and death with LABA alone 2
- Do not continue indefinitely without reassessment: The goal is to find the minimum effective dose through regular monitoring 2