Trelegy Ellipta 92micrograms / dose / 55micrograms / dose / 22micrograms / dose dry powder inhaler (GlaxoSmithKline UK Ltd) 30 dose

Type Dry powder inhaler (DPI)
Medicine Fluticasone Furoate 92micrograms / dose + umeclidinium 55micrograms / dose + vilanterol 22micrograms / dose
Adult steroid dose Low adult steroid dose
Medium adult steroid dose
Activation mechanism Breath actuated
Dose counter Has dose counter
Price £44.50 / 30 days
(based on 1 puffs / day)
Inhaled corticosteroid information For adults, a total of 1 puff/day gives medium dose of ICS
Steroid safety card recommendation (for adults) Steroid safety card not normally required
Licences
  • COPD Licence

Training material

Pathways

The use of each medicine included in Right Breathe has been considered in relation to international, national, and regional prescribing pathways. The pathway points at which this medicine is considered a viable prescribing option are included below. If you wish to view the entire pathway, click on its heading, from where you can also access all the prescribing options for each pathway and each pathway point.

Prescribing

Detailed prescribing information is provided below. This content has not been generated by the RightBreathe team, but has been integrated from a 3rd party solution: Multilex (provided by FirstDataBank). Use of this prescribing content is subject to the FirstDataBank disclaimer, which is set out in the "About" section of RightBreathe.

As RightBreathe is a bespoke decision support tool, it covers each and every individual known inhaler option on the UK market to a high level of specificity. Multilex, as a more general resource, does not offer the same level of specificity. There are therefore a small number of medicines for which there are discrepancies between RightBreathe and Multilex content, most notably in relation to licensed particulars and associated licensed doses.

Given the high level of specificity the RightBreathe team work to, details of the individual inhaler licence are most likely to be summarised accurately in the content provided at the top of this page, rather than in the Multilex content below. Where there is ambiguity, users may also wish to refer to individual summaries of product characteristics prior to prescribing.

Dosing

Chronic obstructive pulmonary disease

Type Age Range Dose Licensed
Maintenance From 18 years 1 actuation - ONCE a DAY - inhalation - using a metered dose device

Safety Advice Warnings

Adverse effects (report/action)

  • If visual disturbances occur, perform ophthalmic evaluation
  • May reduce serum potassium levels
  • Systemic effects possible with any inhaled corticosteroid

Advice on drug withdrawal

  • Do not withdraw this drug suddenly

Advice on possible excipients

  • Contains lactose

Discontinue due to test or exam

  • Discontinue if paradoxical bronchospasm occurs
  • Discontinue if symptoms of acute angle closure glaucoma occur

Patient Counselling

  • Advise patient not to use for relief of acute attacks
  • Advise patient to rinse mouth with water after each dose
  • Advise patient to seek medical advice if treatment is ineffective
  • Advise visual disturbances may affect ability to drive or operate machinery
  • Consider issuing Steroid Treatment/Steroid Emergency Card
  • Ensure patient has a fast acting bronchodilator available
  • High dose:Advise patient to avoid chickenpox,measles etc; see Dr if exposed
  • Use regularly to maintain freedom from symptoms

Recommended monitoring

  • Check patient is using correct inhaler technique
  • Monitor blood glucose closely in patients with diabetes mellitus
  • Monitor for signs/symptoms of pneumonia in patients at risk

Drug Interactions

With Risk Severity
METHACHOLINE Methacholine effect reduced; review dosing, see product literature Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
AMANTADINE Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
ANTIHISTAMINES - SEDATIVE Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CODEINE Antimuscarinic side effects may be increased/risk of paralytic ileus Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CYCLIZINE (IN COMBINATION WITH STRONG OPIOIDS) Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
DISOPYRAMIDE Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
MAOIS Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
NEFOPAM Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
TRICYCLIC ANTIDEPRESSANTS Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
TRICYCLIC ANTIDEPRESSANTS AND PHENOTHIAZINES (COMBINED PRODUCT) Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
(OXYPERTINE) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
(REMOXIPRIDE) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
(TRIFLUPERIDOL) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
(ZOTEPINE) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
AMISULPRIDE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
ARIPIPRAZOLE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
BENPERIDOL Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
CLOZAPINE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
DROPERIDOL Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
FLUSPIRILENE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
HALOPERIDOL Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
LOXAPINE (INHALED) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
LOXAPINE (ORAL) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
MEMANTINE effect may be increased by Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
OLANZAPINE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PALIPERIDONE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PHENOTHIAZINES Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PIMOZIDE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
QUETIAPINE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
SERTINDOLE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
SULPIRIDE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
ZIPRASIDONE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.

Precautions

  • Benign prostatic hyperplasia
  • Chronic infection
  • Diabetes mellitus
  • Epileptic disorder
  • Glucose-galactose malabsorption syndrome
  • Hypokalaemia
  • Lactose intolerance
  • Moderate hepatic impairment
  • Narrow angle glaucoma
  • Pregnancy
  • Pulmonary tuberculosis
  • Recent history of pneumonia
  • Severe cardiovascular disorder
  • Thyrotoxicosis
  • Uncontrolled systemic infection
  • Unstable cardiac disorder
  • Urinary retention

Contraindications

  • Breastfeeding
  • Children under 18 years
  • Galactosaemia

Side Effects

  • Anaphylaxis
  • Angioedema
  • Arthralgia
  • Atrial fibrillation
  • Back pain
  • Blurred vision
  • Bronchitis
  • Candidiasis (mouth or throat)
  • Constipation
  • Cough
  • Dry mouth
  • Dysphonia
  • Fractures
  • Headache
  • Hypersensitivity reactions
  • Influenza
  • Nasopharyngitis
  • Oropharyngeal pain
  • Pharyngitis
  • Pneumonia
  • Rash
  • Respiratory tract infection
  • Rhinitis
  • Sinusitis
  • Supraventricular tachycardia
  • Tachycardia
  • Upper respiratory tract infection
  • Urinary tract infections
  • Urticaria