What is Fluticasone and Vilanterol: Uses, Dosage, Side Effects and More

Fluticasone and vilanterol is a combination inhaler medication that helps control asthma and chronic obstructive pulmonary disease (COPD). This dual-action medicine combines a corticosteroid (fluticasone) with a long-acting bronchodilator (vilanterol) to reduce inflammation and keep your airways open for easier breathing.

You might know this medication by its brand name Breo Ellipta. It's designed as a once-daily maintenance treatment that works around the clock to help prevent breathing problems before they start.

What is Fluticasone and Vilanterol Used For?

This combination medication treats two main respiratory conditions: asthma in adults and teenagers 18 years and older, and COPD in adults. For asthma, it helps prevent attacks and reduces the frequency of symptoms like wheezing, shortness of breath, and chest tightness.

In COPD patients, fluticasone and vilanterol helps manage chronic bronchitis and emphysema symptoms. The medication reduces flare-ups and makes daily activities easier by keeping your airways more open and less inflamed.

It's important to understand that this is a maintenance medication, not a rescue inhaler. You'll use it every day to prevent symptoms, but you'll still need a quick-relief inhaler like albuterol for sudden breathing emergencies.

How Does Fluticasone and Vilanterol Work?

This medication works through two different but complementary mechanisms. Fluticasone is a corticosteroid that reduces inflammation in your airways, much like how anti-inflammatory medication reduces swelling in other parts of your body.

Vilanterol is a long-acting beta2-agonist (LABA) that relaxes the muscles around your airways. Think of it as helping your breathing passages stay open wider, making it easier for air to flow in and out of your lungs.

Together, these two ingredients create a powerful combination that addresses both the inflammation and muscle constriction that make breathing difficult. The effects last for 24 hours, which is why you only need to use it once daily.

This is considered a moderately strong medication. It's more powerful than using a corticosteroid alone but less intensive than some other combination treatments that require multiple daily doses.

How Should I Take Fluticasone and Vilanterol?

Take this medication exactly once every day at the same time, preferably in the morning. You don't need to take it with food, and you can use it on an empty stomach without any problems.

The medication comes in a dry powder inhaler called Ellipta. After inhaling your dose, rinse your mouth thoroughly with water and spit it out. This simple step helps prevent thrush, a fungal infection that can develop in your mouth from corticosteroid use.

Before using your inhaler, make sure you understand the proper technique. Hold the inhaler upright, slide the cover down until you hear a click, breathe out fully, then place your lips around the mouthpiece and take one strong, deep breath.

Never use this medication more than once in 24 hours, even if you feel like you need extra relief. If you're having breathing problems that aren't controlled by your daily dose, use your rescue inhaler and contact your healthcare provider.

How Long Should I Take Fluticasone and Vilanterol For?

This is typically a long-term medication that you'll use for months or years, depending on your condition. Most people with asthma or COPD need ongoing treatment to keep their symptoms well-controlled and prevent their condition from worsening.

Your doctor will regularly evaluate how well the medication is working for you. They might adjust your dose or switch you to a different treatment if your symptoms aren't adequately controlled or if you're experiencing bothersome side effects.

Never stop taking this medication suddenly without talking to your healthcare provider first. Your breathing symptoms will likely return, and stopping abruptly could potentially trigger a serious flare-up of your condition.

Some people may be able to step down to a lower dose or switch to a different medication over time, but this decision should always be made with medical guidance based on how stable your condition has become.

What Are the Side Effects of Fluticasone and Vilanterol?

Like all medications, fluticasone and vilanterol can cause side effects, though many people tolerate it well. Understanding what to expect can help you feel more confident about your treatment.

The most common side effects are generally mild and tend to improve as your body adjusts to the medication:

• Headache
• Throat irritation or sore throat
• Upper respiratory tract infections like colds
• Oral thrush (white patches in your mouth)
• Hoarseness or voice changes
• Cough
• Back pain
• Diarrhea

These common side effects usually don't require medical attention unless they become severe or persistent. Rinsing your mouth after each use significantly reduces your risk of developing thrush.

Less common but more serious side effects require immediate medical attention. These include signs of allergic reactions like rash, itching, swelling, severe dizziness, or trouble breathing.

Some people may experience cardiovascular effects from the vilanterol component, including increased heart rate, chest pain, or tremors. While these are less common, they're important to report to your doctor.

Long-term use of corticosteroids can occasionally lead to more serious effects like increased infection risk, bone thinning, or adrenal gland problems. Your doctor will monitor you for these rare but important complications during regular check-ups.

Who Should Not Take Fluticasone and Vilanterol?

This medication isn't suitable for everyone, and certain health conditions or situations make it inappropriate or potentially dangerous. Your safety is the top priority when determining if this treatment is right for you.

You should not use this medication if you're allergic to fluticasone, vilanterol, or any other ingredients in the formulation. People with severe milk protein allergies should also avoid this medication since it contains lactose.

This combination is not approved for children under 18 years old for asthma treatment. For COPD, it's only intended for adult use. Pregnancy and breastfeeding require special consideration, and your doctor will weigh the benefits against potential risks.

People with certain heart conditions need extra caution because vilanterol can affect heart rhythm and blood pressure. This includes those with irregular heartbeats, high blood pressure, or coronary artery disease.

If you have active infections, particularly fungal infections, your doctor may want to treat these before starting this medication. The corticosteroid component can make it harder for your body to fight infections.

Liver problems can affect how your body processes this medication, so people with hepatic impairment may need dose adjustments or alternative treatments.

Fluticasone and Vilanterol Brand Names

The primary brand name for this combination medication is Breo Ellipta, manufactured by GlaxoSmithKline. This is the most widely available form and the one you'll most likely encounter at your pharmacy.

Breo Ellipta comes in a distinctive light blue and red dry powder inhaler device. The medication is available in different strengths, with your doctor choosing the appropriate dose based on your specific condition and symptom severity.

While generic versions may become available in the future, currently Breo Ellipta is the main brand available in most markets. Your insurance coverage and pharmacy may affect the specific product you receive, but the active ingredients remain the same.

Fluticasone and Vilanterol Alternatives

Several other medication options exist if fluticasone and vilanterol isn't the right fit for you. Your doctor can help you explore these alternatives based on your specific symptoms, medical history, and treatment goals.

Other combination inhalers include fluticasone with salmeterol (Advair), budesonide with formoterol (Symbicort), and mometasone with formoterol (Dulera). Each of these combinations works similarly but may have different dosing schedules or side effect profiles.

For people who prefer separate medications, you might use a corticosteroid inhaler like fluticasone (Flovent) along with a separate long-acting bronchodilator. This approach allows for more individualized dosing but requires using two different inhalers.

Some people do well with corticosteroid-only treatments, especially if their condition is primarily inflammatory rather than involving significant muscle constriction. Others might benefit from newer medication classes like leukotriene modifiers or biologic therapies.

The best alternative depends on your specific type of asthma or COPD, your lifestyle preferences, and how well you've responded to previous treatments. Your healthcare provider will work with you to find the most effective option.

Is Fluticasone and Vilanterol Better Than Advair?

Both fluticasone/vilanterol (Breo Ellipta) and fluticasone/salmeterol (Advair) are effective combination treatments, but they have some key differences that might make one more suitable for you than the other.

The main advantage of Breo Ellipta is its once-daily dosing schedule, compared to Advair's twice-daily requirement. This can significantly improve medication adherence and make your treatment routine simpler and more convenient.

Breo Ellipta also comes in a dry powder inhaler that doesn't require coordination between pressing and inhaling, unlike Advair HFA. Many people find the Ellipta device easier to use correctly, which can improve how much medication actually reaches your lungs.

However, Advair has been available longer and has more extensive long-term safety data. Some people also respond better to salmeterol (in Advair) than to vilanterol (in Breo Ellipta), though both are effective long-acting bronchodilators.

The choice between these medications often comes down to your lifestyle preferences, insurance coverage, and how well you respond to each option. Your doctor can help you determine which combination is likely to work best for your specific situation.