How long does it take for Trelegy to leave your system?

In this article:

• How does Trelegy work?
• How long does Trelegy stay in your system?
• Factors that affect how long Trelegy stays in your body
• What happens if you stop taking Trelegy?
• When to see a doctor about Trelegy side effects

In this article

• How does Trelegy work?
• How long does Trelegy stay in your system?
• Factors that affect how long Trelegy stays in your body
• What happens if you stop taking Trelegy?
• When to see a doctor about Trelegy side effects

Trelegy Ellipta (fluticasone furoate, umeclidinium, vilanterol) is a brand-name prescription inhaler that’s approved by the Food and Drug Administration to treat chronic obstructive pulmonary disease (COPD) and asthma in adults. It helps to know how long it takes for Trelegy to leave your system if you’re concerned about side effects, running out of medication, or safely switching inhalers. This guide will cover how long Trelegy works, how it’s eliminated from the body, and what you can expect when stopping the medication.  

How does Trelegy work?

To understand how long Trelegy lasts, it helps to know how Trelegy works.

“Trelegy contains three types of medicine, all of which help decrease airway swelling, keep airways open, and make breathing easier over time,” says Pamela Tambini, the Medical Director at Engage Wellness in Massachusetts. Those three medications are:

• Fluticasone furoate, an inhaled corticosteroid (ICS)
• Vilanterol, a long-acting beta2-adrenergic agonist (LABA)
• Umeclidinium, a long-acting muscarinic antagonist (LAMA)

“ICSs reduce inflammation inside the airways to help prevent flare-ups, reduce mucus production, and make airways less sensitive to triggers,” Dr. Tambini says. Meanwhile, LAMAs and LABAs cause the airway muscles to relax, widen, and stay open, making it easier for air to move in and out of the lungs. This leads to improved airflow and reduced shortness of breath. Trelegy is not intended for use as a rescue inhaler. 

How long does Trelegy stay in your system? 

Each ingredient in Trelegy has a half-life, which is the amount of time it takes for half of the dose to leave the body. 

Fluticasone furoate has a half-life of 24 hours, while umeclidinium and vilanterol each have a half-life of 11 hours. We’ll use the longer half-life to determine how long Trelegy stays in your system.

The maximum dose of Trelegy is 200/62.5/25 mcg (fluticasone furoate/umeclidinium/vilanterol) once daily for asthma and 100/62.5/25 mcg once daily for COPD. If you’re taking a 100 microgram (mcg) dose of fluticasone furoate, 50 mcg will remain in your system 24 hours later. That 50 mcg amount gets cut in half in another 24 hours, leaving 25 mcg in your body after 48 hours. By 72 hours, or the third half-life, the amount reaches 12.5 mcg. 

RELATED: Trelegy 100 vs. Trelegy 200

It takes four or five half-lives to eliminate most of a drug from your body. Two Trelegy ingredients, umeclidinium and vilanterol, will be gone from your system after about 44 to 55 hours, or about two days after the last dose. The anti-inflammatory fluticasone furoate takes about four or five days to leave.

Factors that affect how long Trelegy stays in your body 

The half-life of a drug is an average measurement. Some people eliminate Trelegy faster or slower than the average half-life based on how well their body metabolizes each ingredient. Annie DePasquale, MD, a board-certified family medicine physician based in Washington, DC, says age and genetics can also play a role, but that the difference “usually isn’t dramatic” and may mean someone metabolizes Trelegy one day faster or slower than another.  

Trelegy is mostly metabolized through the liver and kidneys. If you have medical conditions affecting these organs, Trelegy may linger in the body longer than usual.  

Taking certain types of drugs with Trelegy, especially strong cytochrome P450 3A4 inhibitors, may increase the amount of Trelegy that enters the bloodstream, which could cause it to stay in your system for a longer period of time. Tell your healthcare provider about all the over-the-counter and prescription drugs and supplements you currently take so they can screen for potential drug interactions. 

What happens if you stop taking Trelegy? 

When you stop taking Trelegy, three things are likely to happen:

• Breathing problems can return after 24 hours, but may take longer to appear.
• Most Trelegy side effects fade within four or five days.
• New symptoms can occur temporarily if Trelegy is stopped too quickly.

“Most side effects of Trelegy Ellipta, like throat pain or irritation, hoarseness, or a mild cough, resolve within a few days of stopping. However, steroid-related effects such as oral thrush or mild immune suppression can take a little longer to clear up,” Dr. DePasquale says. 

Talk to a healthcare professional before you stop taking Trelegy. You may need to slowly taper the dose to gradually stimulate your body’s natural production of cortisol, the so-called stress hormone. The corticosteroid in Trelegy mimics cortisol, so the body decreases cortisol production in the adrenal glands. 

Stopping Trelegy cold-turkey doesn’t give the body enough time to increase natural cortisol to healthy levels. This can lead to symptoms of adrenal insufficiency, such as fatigue, weakness, poor appetite, weight loss, abdominal pain, and other gastrointestinal symptoms, low blood sugar, poor mental health, and more. 

“If Trelegy was used at high doses for an extended time, it can take several weeks for the body’s hormone balance and airway inflammation to fully normalize,” Dr. DePasquale says. 

On the other hand, if Trelegy causes severe side effects, your healthcare provider may need you to stop taking the medication immediately. The best way to do this safely is under medical guidance. 

It’s also important to make a plan for managing your COPD or asthma symptoms without Trelegy when stopping this medication. “Stopping suddenly without a replacement plan can cause symptoms to rebound or worsen. The danger isn’t from withdrawal. It’s from losing the control that Trelegy provided. Patients should always talk with their prescribing clinician before discontinuing because the safest approach may be switching to another inhaler,” Dr. DePasquale advises.

When to see a doctor about Trelegy side effects

If you stop taking Trelegy due to adverse side effects, seek medical advice if the following occurs: 

• Worsening shortness of breath
• Side effects persist for several days after your last Trelegy dose.
• Side effects get worse after stopping Trelegy.
• COPD or asthma symptoms quickly resurface.
• You want to use a different type of inhaler after Trelegy.

Trelegy can cause pneumonia, a fungal infection in the mouth called thrush, and a weakened immune system, among other side effects. Stopping Trelegy may not be enough to treat these issues. Talk to a healthcare provider about safe and effective treatments that won’t interact with Trelegy as it leaves your system.  

If you think you may have taken too much Trelegy, call your healthcare provider or the Poison Control Hotline 1-800-222-1222. right away. Seek emergency care if you notice signs of a heart problem, including chest pain, difficulty breathing, and a rapid heartbeat.  

Bottom line

Trelegy is a once-daily inhaler that provides therapeutic benefits for 24 hours, but a decreasing amount of medication remains in the body for several days. Expect your COPD and asthma symptoms to increase and Trelegy inhaler side effects to disappear within two to five days of stopping the medication. 

Don’t stop taking Trelegy without talking to a healthcare provider. New side effects may appear as your body reacts to a drop in cortisol, and your healthcare provider can help you feel comfortable during this time.