Relvar Ellipta 184micrograms / dose / 22micrograms / dose dry powder inhaler (GlaxoSmithKline UK Ltd) 30 dose

Type Dry powder inhaler (DPI)
Medicine Fluticasone furoate 184micrograms/dose + Vilanterol 22micrograms/dose
Adult steroid dose High adult steroid dose
Activation mechanism Breath actuated
Dose counter Has dose counter
Price £29.50 / 30 days
(based on 1 puffs / day)
Inhaled corticosteroid information For adults, a total of 1 puff/day gives a high dose of ICS
Steroid safety card recommendation (for adults) Steroid safety card required
Licences
  • Adult Asthma Licence
  • Adolescent Asthma Licence (12 to adult)

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

Asthma - prophylaxis

Type Age Range Dose Licensed
Maintenance From 12 years 1 actuation - DAILY - inhalation - using a metered dose device

Safety Advice Warnings

Adverse effects (report/action)

  • During transfer from oral steroids allergic conditions may be unmasked
  • High doses may cause adrenal suppression/bone metabolism changes
  • If growth in children is slowed, consider referral to a paediatrician
  • If visual disturbances occur, perform ophthalmic evaluation
  • May reduce serum potassium levels
  • Systemic effects possible with any inhaled corticosteroid

Advice concerning formulation

  • Not all available strengths are licensed for all indications
  • Not all strengths are suitable for use in children under 18 years

Advice on possible excipients

  • Contains lactose

Discontinue due to test or exam

  • Discontinue if paradoxical bronchospasm occurs

Dose changes (other conditions)

  • Maintain treatment at the lowest effective dose

Patient Counselling

  • Advise patient not to reduce steroid therapy without medical advice
  • 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 asthma seems to be worsening
  • Advise patients to avoid chickenpox, measles etc - see doctor if exposed
  • Advise visual disturbances may affect ability to drive or operate machinery
  • Consider need for patient to carry a Steroid Treatment Card
  • Ensure patient has a fast acting bronchodilator available
  • Patient should seek medical advice if signs of pulmonary infection develop
  • Use regularly to maintain freedom from symptoms

Recommended monitoring

  • Check patient is using correct inhaler technique
  • Consider adrenal suppression when transferring from systemic steroid
  • Monitor adrenal function in stressed patients e.g.surgery/intensive care
  • Monitor blood glucose closely in patients with diabetes mellitus
  • Monitor for signs/symptoms of pneumonia in patients at risk
  • Monitor regularly the height of children receiving prolonged treatment
  • Re-evaluate therapy in active or quiescent pulmonary tuberculosis

Safety/advice in other condition

  • Systemic corticosteroids may be needed during elective surgery
  • Systemic corticosteroids may be needed during periods of stress

Drug Interactions

With Risk Severity
RITONAVIR Increased risk of systemic corticosteroid adverse effects High Risk: Avoid combination. Risk outweighs benefits.
ATAZANAVIR WITH COBICISTAT Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
CLARITHROMYCIN Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
COBICISTAT Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
DARUNAVIR WITH COBICISTAT Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
DARUNAVIR, COBICISTAT, EMTRICITABINE AND TENOFOVIR ALAFENAMIDE Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
ELVITEGRAVIR, COBICISTAT, EMTRICITABINE AND TENOFOVIR ALAFENAMIDE Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
ELVITEGRAVIR, COBICISTAT, EMTRICITABINE AND TENOFOVIR DISOPROXIL Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
IDELALISIB Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
INDINAVIR Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
ITRACONAZOLE Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
KETOCONAZOLE Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
NEFAZODONE Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
NELFINAVIR Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
OMBITASVIR, PARITAPREVIR AND RITONAVIR Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
POSACONAZOLE Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
RIBOCICLIB Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
SAQUINAVIR Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
TELITHROMYCIN Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
TIPRANAVIR Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
VORICONAZOLE Increased risk of systemic corticosteroid adverse effects Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
AMPRENAVIR / FOSAMPRENAVIR Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
APREPITANT / FOSAPREPITANT Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
ATAZANAVIR Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CICLOSPORIN Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CIMETIDINE Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CIPROFLOXACIN Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CRIZOTINIB Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
DARUNAVIR Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
DILTIAZEM Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
DRONEDARONE Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
ERYTHROMYCIN Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
FLUCONAZOLE Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
IMATINIB Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
ISAVUCONAZOLE Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
MICONAZOLE (ORAL AND PARENTERAL) Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
MIFEPRISTONE Corticosteroid effect may be reduced for 3 to 4 days after treatment Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
NETUPITANT Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
NILOTINIB Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
STIRIPENTOL Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
VERAPAMIL Increased risk of systemic corticosteroid adverse effects Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
ALPRAZOLAM Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
AMIODARONE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
AMLODIPINE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
ATORVASTATIN Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
AZITHROMYCIN Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
BICALUTAMIDE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
BOCEPREVIR plasma level 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.
CILOSTAZOL Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
COMBINED ORAL CONTRACEPTIVES Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
DACLATASVIR Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
ELBASVIR WITH GRAZOPREVIR Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
EVEROLIMUS Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
FLUVOXAMINE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
ISONIAZID Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
IVACAFTOR Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
LACIDIPINE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
LINAGLIPTIN Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
LOMITAPIDE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PALBOCICLIB Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PAZOPANIB Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PEPPERMINT OIL Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PROPIVERINE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
RANITIDINE / NIZATIDINE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
RANOLAZINE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
SIMEPREVIR Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
TACROLIMUS (ORAL AND PARENTERAL) Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
TELAPREVIR plasma level 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.
TERIFLUNOMIDE Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
TOLVAPTAN Increased risk of systemic corticosteroid adverse effects Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.

Precautions

  • Adrenal insufficiency
  • Body mass index less than 25kg per square metre
  • Cardiac arrhythmias
  • Children aged 12 to 18 years
  • Diabetes mellitus
  • Elderly
  • Glucose-galactose malabsorption syndrome
  • Hepatic impairment
  • Hypokalaemia
  • Lactose intolerance
  • Major risk factors for decreased bone mineral content
  • Pregnancy
  • Pulmonary tuberculosis
  • Recent history of pneumonia
  • Severe cardiovascular disorder
  • Thyrotoxicosis
  • Tobacco smoking
  • Uncontrolled systemic infection

Contraindications

  • Breastfeeding
  • Children under 12 years
  • Galactosaemia

Side Effects

  • Abdominal pain
  • Adrenal suppression
  • Aggression in children
  • Anaphylaxis
  • Angioedema
  • Anxiety
  • Arthralgia
  • Back pain
  • Behavioural disturbances
  • Blurred vision
  • Bronchitis
  • Candidiasis (mouth or throat)
  • Cataracts
  • Cough
  • Cushing's syndrome
  • Cushingoid facies
  • Decrease in bone mineral density
  • Depression
  • Dysphonia
  • Extrasystoles
  • Fractures
  • Glaucoma
  • Growth retardation (children)
  • Headache
  • Hyperglycaemia
  • Hypersensitivity reactions
  • Influenza
  • Muscle spasm
  • Nasopharyngitis
  • Oropharyngeal pain
  • Palpitations
  • Paradoxical bronchospasm (on inhalation)
  • Pharyngitis
  • Pneumonia
  • Psychological changes
  • Psychomotor hyperactivity
  • Pyrexia
  • Rash
  • Rhinitis
  • Sinusitis
  • Sleep disturbances
  • Tachycardia
  • Tremor
  • Upper respiratory tract infection
  • Urticaria
  • Visual disturbances