Key Points

One alternative to the Trelegy Ellipta triple therapy inhaler would be to combine the use of two separate inhalers - Breo Ellipta (fluticasone/vilanterol) and Incruse Ellipta (umeclidinium). However, this would require that you have two prescription inhalers on hand for maintenance treatment of your asthma or COPD, instead of just one. You would also need to keep a fast-acting inhaler, such as albuterol (ProAir, Proventil, Ventolin), close by for sudden symptoms.

• Trelegy Ellipta is an orally inhaled medicine that contains three medications in one inhaler.
• Trelegy combines the inhaled corticosteroid fluticasone with two long-acting bronchodilators: vilanterol, a long-acting beta-2 agonist (LABA), and umeclidinium, a long-acting muscarinic antagonist (anticholinergic).
• Trelegy is the first FDA-approved, single inhaler, triple therapy for once-daily maintenance treatment of both asthma and chronic obstructive pulmonary disease (COPD) in adults.

There are also a number of other medicines in the same classes of drugs found in Trelegy. These inhalers contain the same or similar ingredients to Trelegy, but you may require two inhalers instead of one, which may be inconvenient or more expensive. Your doctor can advise you on which option may be best for you based on your diagnosis.

Other Options

• List of bronchodilator combinations
• List of anticholinergic bronchodilators
• List of short-acting and long-acting beta2 agonists
• List of inhaled corticosteroids

Using long-acting beta agonist (LABA) medicines together may lead to an excessive dose and an increased risk for high blood pressure, altered heart rate, or changes in heart rhythm. Do not combine LABAs due to this risk.

In addition, for patients with asthma, LABAs should always be used with inhaled corticosteroids. Orally inhaled corticosteroid medicines (for example, fluticasone or budesonide) help decrease inflammation in the lungs that can lead to breathing problems.

How do the 3 drugs in Trelegy Ellipta work?

Trelegy Ellipta is administered by oral inhalation once daily. The three drugs found in Trelegy Ellipta are:

• Fluticasone furoate: an inhaled corticosteroid (ICS) which works to help to decrease inflammation in the lungs.
• Umeclidinium: a long-acting muscarinic antagonist (anticholinergic) which works by acting as a bronchodilator to open the airways.
• Vilanterol: a long-acting beta2-adrenergic agonist (LABA) which also works by acting as a bronchodilator to open the airways.

These medicines reduce the number of flare-ups by lowering lung inflammation and relaxing the airways in patients with either asthma or COPD. They are not used to control sudden breathing problems. It may take several weeks for Trelegy Ellipta to fully work.

You should use a rescue inhaler, such as albuterol (brand names: ProAir HFA, Proventil HFA, Ventolin HFA) or levalbuterol (brand name: Xopenex HFA) for sudden breathing symptoms. If you do not have a rescue inhaler, speak with your doctor as soon as possible about getting one. Seek emergency medical treatment or call 911 if your breathing problems get worse quickly.

In Trelegy clinical studies, the most common side effects occurring in greater than or equal to 1% of patients (at least 1 out of every 100 patients) included: headache, back pain, dysgeusia (altered taste), diarrhea, cough, throat pain, and upset stomach.

What triple therapy options are available in one inhaler?

Trelegy Ellipta and Breztri Aerosphere are inhalers that contain three medicines in one inhaler. Trelegy Ellipta is approved ffor the maintenance treatment of both asthma and COPD in adults, while Breztri Aerosphere is only approved for COPD.

Trelegy Ellipta (fluticasone furoate/umeclidinium/vilanterol) was FDA-approved in September 2017. It is a dry-powder oral inhaler approved for the treatment of adults with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema, or asthma.

• Trelegy Ellipta, from GSK, is used for either those on a fixed-dose combination of fluticasone/vilanterol (Breo Ellipta) who need additional bronchodilation, or those who are already using Breo Ellipta and Incruse Ellipta.
• It is a dry powder inhaled corticosteroid, long-acting muscarinic antagonist (LAMA) and long-acting beta2-adrenergic agonist (LABA) combination
• Trelegy is not used for the treatment of acute bronchospasm.

Breztri Aerosphere (budesonide, glycopyrrolate, and formoterol fumarate), a metered dose inhaler for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD), was approved in July 2020.

• Breztri, from AstraZeneca, combines an inhaled corticosteroid (budesonide) with an anticholinergic agent (glycopyrrolate) and a long-acting beta2-adrenergic agonist (formoterol fumarate) per inhalation. It is given as two inhalations twice daily.
• Breztri Aerosphere is not approved for the treatment of asthma or acute bronchospasm.

Bottom Line

• One alternative to the Trelegy Ellipta triple therapy inhaler would be to combine the use of two separate inhalers - Breo Ellipta (fluticasone/vilanterol) and Incruse Ellipta (umeclidinium).
• You would also need to keep a fast-acting inhaler, such as albuterol, close by for sudden symptoms.
• There are also a number of other medicines in the same classes of drugs found in Trelegy. These inhalers contain the same or similar ingredients as found in Trelegy, but you may require two inhalers instead of one.
• Your doctor can advise you on the best and most affordable options for your treatment

This is not all the information you need to know about Trelegy Ellipta or alternatives for safe and effective use. Review the full Trelegy Ellipta information here, and discuss this information and alternatives with your doctor or other health care provider.