Is it better to take Trelegy in the morning or at night?

In this article:

• How Trelegy works and why timing matters
• Benefits of taking Trelegy in the morning
• Benefits of taking Trelegy at night
• Is it better to take Trelegy in the morning or at night?
• Tips for choosing the best time to take Trelegy
• When to talk to your healthcare provider about Trelegy dosing

In this article

• How Trelegy works and why timing matters
• Benefits of taking Trelegy in the morning
• Benefits of taking Trelegy at night
• Is it better to take Trelegy in the morning or at night?
• Tips for choosing the best time to take Trelegy
• When to talk to your healthcare provider about Trelegy dosing

Combination therapy is one of the key components of managing asthma and chronic obstructive pulmonary disease (COPD). Trelegy Ellipta is a prescription inhaled medication that combines three types of medications: fluticasone furoate, umeclidinium bromide, and vilanterol trifenatate. It’s approved by the Food and Drug Administration (FDA) for maintenance treatment of COPD and asthma in adults 18 and older. Trelegy Ellipta is taken once daily, and timing matters. Here’s what respiratory specialists want patients to know. 

How Trelegy works and why timing matters 

Trelegy is a triple therapy medication that contains two long-acting bronchodilators and a corticosteroid. Fluticasone furoate is a corticosteroid. Umeclidinium bromide is a long-acting muscarinic antagonist (LAMA), and vilanterol trifenatate is a long-acting beta agonist (LABA). These ingredients work to keep the airways in the lungs open for long periods of time.

Compared to short-acting beta agonists (SABAs), such as Ventolin HFA (albuterol sulfate HFA), LABAs have effects that last longer. SABAs start to work within five minutes, last from three to six hours, and are used as needed. That’s why they’re called rescue inhalers. In contrast, LABAs can work for up to 24 hours, which is why most of them have a once daily dosing schedule. 

According to its prescribing information, Trelegy Ellipta is taken once daily, every 24 hours. It should be used at the same time every day and shouldn’t be taken more than once in 24 hours. Elizabeth Rubin Ribak, MD, physician and clinical adviser at Embers Recovery in Phoenix, Arizona, explains, “Consistency is important because Trelegy contains three medicines to keep the airways open and reduce inflammation for 24 hours. If doses are taken at irregular times, the medication levels in the lungs may fluctuate. This can lead to less stable control of symptoms and a higher risk of flare-ups.”

Benefits of taking Trelegy in the morning 

For many people, taking Trelegy in the morning offers consistency and convenience. It’s often easier to remember when tied to an existing routine, such as after brushing your teeth or taking other medications.

Taking Trelegy in the morning can also help people better manage their asthma or COPD symptoms that flare up during the daytime. Elizabeth Moffett, registered respiratory therapist (RRT) and expert adviser for Omhale, says, “Trelegy has a bronchodilator effect that can help performance during the day. In other words, it’s far more likely that taking it at 8 a.m. versus 8 p.m. will get the lungs the support they need when they need it most: during activity, conversation, walking up stairs, simply sitting upright.”

In addition, taking Trelegy in the morning may give people a chance to have more comfortable treatment. Dr. Rubin Ribak says, “Taking it in the morning allows patients to notice and address any side effects during waking hours rather than overnight.”

Morning dosing may also help reduce the chance of possible sleep disturbances caused by the medication. While uncommon, inhaled corticosteroids have been linked to wakefulness, anxiety, and vivid dreams in some people. Research is also exploring whether inhaled corticosteroids can increase the risk of sleep apnea, but more evidence is needed. Overall, sleep-related side effects from combination inhalers like Trelegy are uncommon and still under investigation.

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Benefits of taking Trelegy at night  

Taking Trelegy at night can help keep symptoms under control during sleep and may fit better into some people’s daily routines. Tying the dose to an evening routine like getting ready for bed can be helpful for people who have a consistent bedtime. 

Nighttime dosing may also be helpful for those who tend to have worse COPD or asthma symptoms in the morning. Taking Trelegy before bed allows the medication to maintain steady levels in the body overnight, so breathing may feel easier upon waking.

In addition, using Trelegy at night can help keep symptoms under control while you sleep. People with severe asthma and COPD are more likely to have sleep issues like insomnia and restless leg syndrome (RLS). Stable symptom relief throughout the night reduces the likelihood of waking up from coughing, wheezing, or shortness of breath. 

Is it better to take Trelegy in the morning or at night?

There isn’t a single best time of day to use Trelegy that works for everyone. Your ideal timing may depend on several factors, such as when your symptoms tend to flare up, your daily routine, and which part of the day you’re more likely to remember your dose. Some people feel better taking Trelegy in the morning to support daytime activities, while others benefit from nighttime use to help ease morning symptoms and sleep more soundly. 

Most of all, finding a time you can stick with every day can mean steady levels of medication and symptom control. Moffett shares an example of how inconsistent dosing affected some of her patients: “I’ve worked with patients who take it very irregularly (7 a.m. one day, 2 p.m. the next day), then ask why their lung function has dropped and they’re wheezing again. Routine timing leads to a routine degree of airflow.”

“The key is really consistency, so as long as it’s taken at the same time each day, it really doesn’t matter,” Dr. Rubin Ribak says.

Tips for choosing the best time to take Trelegy 

Here are some things to consider when choosing when to take Trelegy, according to experts we interviewed: 

• Link your dose to something you already do every day at the same time, for example, brushing your teeth, taking other medications, or making coffee.
• Keep your inhaler device in a visible, convenient spot, such as on the kitchen or bathroom counter.
• Set a phone alarm. 
• Use a medication reminder app.

“It only takes 5 seconds to inhale Trelegy, but the consequences of missing a dose are way more extensive,” Moffett says. 

When to talk to your healthcare provider about Trelegy dosing

Like with any medication, it’s important to work with your healthcare provider to minimize risks of side effects and make sure your treatment is effective. Even with consistent use, there may be new symptoms or uncontrolled symptoms of COPD or asthma that continue. “If someone starts wheezing more, coughing more, or waking up breathless more than two days per week, you don’t just ‘shrug it off,’” Moffett says. “I think if symptoms are increasing, not decreasing, and it’s been more than 72 hours of no improvement, or instead a gradual downhill, better to reach out than wait until the patient is on an oxygen tank,” she says.

Be sure to discuss your dosing schedule, any potential roadblocks to consistent dosing, and any remaining symptoms you may still experience. In addition, tell your healthcare provider about any other prescription drugs you’re taking and when you’re taking them. Your healthcare provider may adjust your dosing based on this information. 

Look out for common side effects of Trelegy, such as mouth thrush (which could look like a thick white coating on the tongue), shakiness, or feeling tightness in the chest, says Moffett. Even if mild, these symptoms are not normal, she explains. 

Dr. Rubin Ribak recommends contacting your healthcare provider right away if you notice any serious side effects of Trelegy and if there are worsening breathing problems, signs of pneumonia (fever, chills, increased cough, or colored mucus), eye problems (blurred vision or eye pain), or signs of an allergic reaction (rash, swelling of the face or throat, difficulty breathing). 

Bottom line: Consistency is key

Trelegy Ellipta is an inhaled medication that works for 24 hours to control COPD and asthma symptoms. It’s important to consistently take this medication at the same time every day to get steady levels of medication in the lungs. Taking it in the morning versus evening has different benefits, so it’s best to pick a time that works for you and that you can remember. 

Work with your healthcare provider to help you choose the best time for you, especially if you’re taking other medications or have new or uncontrolled symptoms.