Fluticasone Furoate/VilanterolFluticasone furoate / Vilanterol

About Fluticasone Furoate/Vilanterol

Fluticasone furoate is a corticosteroid with anti-inflammatory activity in the airways, and vilanterol is a long-acting beta2 agonist (LABA) that relaxes the airway muscles. The label approves the combination for the maintenance treatment of chronic obstructive pulmonary disease (COPD), at one inhalation of 100/25 mcg once a day, and of asthma in patients aged 5 and older: 50/25 mcg for children aged 5 to 11, 100/25 mcg for ages 12 to 17, and 100/25 or 200/25 mcg for adults, with 200/25 mcg the maximum, for adults who need more than 100/25. It is taken as one inhalation at the same time each day, never more than once in 24 hours, and the mouth is rinsed with water, without swallowing, afterward.

There is no boxed warning. LABAs used alone for asthma, without an inhaled corticosteroid, increase the risk of asthma-related death; with a corticosteroid, as here, large trials found no significant increase in serious asthma-related events compared with the corticosteroid alone. It is not started during a rapidly worsening attack, is not used with another LABA such as salmeterol or formoterol, and must not be used by anyone with a severe milk protein allergy or as the primary treatment of status asthmaticus or other acute episodes needing intensive treatment. Pneumonia is more common in people with COPD who use it. Other warnings cover thrush in the mouth and throat, infections and weakened immunity, adrenal suppression (including when switching from steroid tablets), paradoxical bronchospasm, allergic reactions, heart effects, bone thinning, slower growth in children, glaucoma and cataracts, and high blood sugar or low potassium. Common side effects include colds, upper respiratory infections, headache and thrush, and in asthma also flu, bronchitis, sinusitis, sore throat, hoarseness and cough.

Long-term inhaled corticosteroids can lower bone density, so the label recommends assessing it before starting and periodically after; children’s growth is monitored, and an eye referral is considered for eye symptoms or long-term use. In moderate or severe liver disease more of the corticosteroid reaches the blood, so it is used with caution. The 50/25 mcg strength for children was approved in 2023. Each inhaler stays sealed in its foil tray until first use and is thrown away six weeks after it is taken out, or when the counter reads zero, whichever comes first.

Taking Fluticasone Furoate/Vilanterol

How to take it

One inhalation once a day at the same time each day, never more than once in 24 hours, even on days you feel well. Rinse your mouth with water without swallowing after each dose to help prevent thrush. It does not relieve sudden symptoms; use your rescue inhaler for those, and get medical help if breathing worsens quickly.

If you miss a dose

Use it as soon as you remember, unless the next dose is nearly due; then skip it. Do not use extra to make up for a missed dose.

Storage

At room temperature, away from moisture, heat and light, sealed in its foil tray until first use. Throw it away six weeks after taking it out of the tray, or when the counter reads zero, whichever comes first.

Interactions to know about

Ketoconazole, ritonavir, clarithromycin and other strong CYP3A4 inhibitors can increase corticosteroid and heart side effects, so they are combined with caution. MAO inhibitors and tricyclic antidepressants can strengthen vilanterol’s effects on the heart, beta blockers can block its effect and cause bronchospasm, and diuretics that are not potassium-sparing can add to low potassium. Do not use another LABA such as salmeterol or formoterol with it.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Fluticasone Furoate/Vilanterol differs from pharmacy to pharmacy

Breo Ellipta is priced as a brand, and with no generic from another company, quotes differ mainly in each pharmacy’s margin and in whether it can get the authorized generic, the same inhaler at its own acquisition cost. A prescription for Breo cannot be filled with a different combination inhaler without the prescriber, and a pharmacy that does not stock your strength, particularly the 50/25 mcg strength for children, may need to order it.

Ways to pay less for Fluticasone Furoate/Vilanterol without insurance

• Ask whether the pharmacy can supply the authorized generic, labeled fluticasone furoate and vilanterol, for the 100/25 or 200/25 mcg strength.
• Ask GSK, the maker, whether its savings or patient assistance program applies to someone paying cash; many copay cards require commercial insurance.
• If the quote is high, ask the prescriber whether another inhaled corticosteroid and long-acting bronchodilator combination, such as fluticasone with salmeterol or budesonide with formoterol, would suit you; a pharmacist cannot make that switch alone.
• Compare quotes for the same strength and number of inhalers at more than one pharmacy.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Fluticasone Furoate/Vilanterol

1. 1.Is the authorized generic available here for my strength?
2. 2.Which inhaler do I use for sudden symptoms, and when should I call about needing it more often?
3. 3.When do I throw this inhaler away, and how do I read its counter?
4. 4.Do any of my antifungal, HIV, heart or antidepressant medicines interact with it?

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