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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Adrenergics in combination with anticholinergics incl. triple combinations with corticosteroids
vilanterol, umeclidinium bromide and fluticasone furoate
R03AL08
Forms & Strengths
- Inhalation powder (Ellipta): fluticasone furoate/umeclidinium/vilanterol 100/62.5/25 mcg per actuation
Adult Dosing
- Chronic obstructive pulmonary disease (COPD): 1 inhalation of 100/62.5/25 mcg once daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients (< 18 years)
Indications
- Maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD)
- Reduction of exacerbations in COPD patients
Mechanism of Action
- Fluticasone furoate: synthetic trifluorinated corticosteroid with anti-inflammatory activity
- Umeclidinium: long-acting muscarinic antagonist (LAMA) blocking M3 receptors on airway smooth muscle
- Vilanterol: long-acting beta2-adrenergic agonist (LABA) stimulating intracellular adenylate cyclase to relax airway smooth muscle
Contraindications
- Primary treatment of status asthmaticus or other acute episodes of COPD requiring intensive measures
- Hypersensitivity to fluticasone furoate, umeclidinium, vilanterol, or any excipients (including lactose)
Adverse Reactions
- Nasopharyngitis
- Upper respiratory tract infection
- Headache
- Cough
- Oral candidiasis
- Back pain
- Pneumonia
- Urinary tract infection
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): increase systemic exposure of fluticasone furoate and vilanterol
- Adrenergic agents: concurrent use may potentiate sympathetic nervous system effects
- Beta-blockers: may weaken or antagonize the effect of vilanterol
- Anticholinergic agents: concurrent use with other long-acting muscarinic antagonists may lead to additive anticholinergic effects
- Diuretics (non-potassium-sparing): may potentiate ECG changes and/or hypokalemia from beta-agonists
Curated Content: Needs Vetting Before Put to Clinical Use