Trelegy Ellipta (fluticasone furoate) alternatives: What can I take instead of Trelegy Ellipta?

Compare Trelegy Ellipta alternatives | Advair Diskus | Symbicort | Breo Ellipta | Dulera | Anoro Ellipta | Natural alternatives | How to switch meds

Trelegy Ellipta is the brand name for GSK’s prescription medicine approved by the U.S. Food and Drug Administration (FDA) for maintenance treatment of adult patients (18 and older) with chronic obstructive pulmonary disease (COPD) or asthma. It is a combination of three medicines in one inhaler: the corticosteroid medicine fluticasone furoate, the anticholinergic medicine umeclidinium, and the long-acting beta2-adrenergic agonist (LABA) medicine vilanterol. 

Trelegy is not to be used for treating acute bronchospasm (i.e., sudden symptoms of asthma). Trelegy Ellipta is dispensed with a disposable plastic inhaler, one foil strip with 30 blisters of fluticasone furoate (either 100 mcg per blister or 200 mcg per blister), and a second foil strip that contains a blend of umeclidinium  (62.5 mcg per blister) and vilanterol (25 mcg per blister). A blister from each foil strip is used to create one dose. Trelegy should be taken once a day, at the same time each day.

Trelegy Ellipta has three different classes of medicines: 

• Inhaled corticosteroid (ICS) medicines such as fluticasone furoate are anti-inflammatory drugs that help prevent symptoms of asthma by reducing inflammation which can make airways more sensitive and more narrow than usual, causing breathing problems. 
• Muscarinic antagonists (or anticholinergic) medicines such as umeclidinium help the muscles around the airways in the lungs stay relaxed to prevent symptoms such as wheezing, cough, chest tightness, and shortness of breath.
• Long-acting beta2-agonist (LABA) medicines such as vilanterol work similarly to anticholinergics by relaxing and opening air passages in the lungs, making it easier to breathe.

While Trelegy Ellipta is an effective treatment for many people suffering from lung disease, it may not be the best option for all those who have COPD, such as emphysema or chronic bronchitis, or for those with asthma symptoms. For various reasons, such as cost, side effect profile, allergy to milk proteins or other ingredients in the inhaler, or difficulties with the use of the single inhaler, it may be necessary to discuss an alternative medicine with one’s healthcare provider.

What can I take in place of Trelegy Ellipta?

There are several other inhalers available that contain the same corticosteroid ingredient (fluticasone) as Trelegy Ellipta as well as inhalers that contain umeclidinium and vilanterol in various combinations. There are also other combination inhalers containing different corticosteroid, anticholinergic, and LABA drugs. These alternative combination inhalers may be considered for the management of COPD or asthma for those looking to switch from Trelegy Ellipta.

It is important to note that Trelegy Ellipta and the alternatives discussed below are for the maintenance treatment of COPD or asthma. They are not recommended to be used as rescue inhalers, such as albuterol, for COPD exacerbations or for asthma attacks. 

Other alternatives to Trelegy Ellipta

In addition to the combination medicine inhalers listed above, there are many single-drug COPD and asthma inhaler medicines:

• Corticosteroids
  • Arnuity Ellipta (fluticasone furoate inhalation powder)
  • Alvesco (ciclesonide) 
  • Asmanex HFA (mometasone furoate) 
  • Qvar RediHaler (beclomethasone dipropionate)
  • Pulmicort Flexhaler (budesonide)

• Anticholinergics
  • Spiriva Respimat (tiotropium bromide)
  • Incruse Ellipta (umeclidinium)

• Short-acting beta-agonists (SABAs)
  • Ventolin HFA (albuterol)
  • Xopenex (levalbuterol)
  • Atrovent HFA (ipratropium)

• Long-acting beta agonists (LABAs)  
  • Serevent Diskus (salmeterol) 
  • Perforomist (formoterol)

Top 5 Trelegy Ellipta alternatives

The following are some of the most common alternative prescription drugs to Trelegy Ellipta.

1. Advair Diskus

Advair Diskus is a dry powder inhaler approved for both asthma and COPD. It contains two active ingredients: fluticasone, a corticosteroid, and salmeterol, a LABA, that are different from the corticosteroid and LABA in Trelegy Ellipta (fluticasone and vilanterol). Advair Diskus does not contain an anticholinergic as does Trelegy Ellipta. Advair Diskus is approved for use in adults and children as young as four years of age while Trelegy Ellipta is only approved for use in adults 18 years and older. Because both contain a corticosteroid and a LABA, they have a similar side effect profile that includes upper respiratory infection, headache, sinus pain, and oral thrush (a fungal infection of the mouth). Advair Diskus is given at a dose of one inhalation twice daily, while Trelegy Ellipta is one inhalation once daily. 

There is a lower-cost generic containing the same ingredients as Advair Diskus called Wixela Inhub, making it a good alternative to Trelegy Eillipta if cost is a concern.

2. Symbicort

The Symbicort inhaler also contains a combination of two active ingredients: budesonide and formoterol. Budesonide is a corticosteroid and formoterol  is a LABA. Again, these are different from the corticosteroids and LABA in Trelegy Ellipta. Symbicort is approved for the maintenance of COPD and asthma in adults and children as young as six years of age. Because of the similar drug categories, the side effects are similar to those of Trelegy Ellipta and include upper respiratory infection, headache, sinus pain, and oral thrush. Symbicort is administered as two inhalations twice daily compared to Trelegy Ellipta’s one inhalation once daily.

3. Breo Ellipta

Breo Ellipta contains a combination of the same corticosteroid and LABA as Trelegy Ellipta (fluticasone and vilanterol) but does not contain the anticholinergic medicine umeclidinium. Breo Ellipta is approved for the maintenance of COPD in adults and children as young as five years of age. Because it contains two of the same drugs, the side effects are similar to those of Trelegy Ellipta and include upper respiratory infection, headache, sinus pain, and oral thrush. Just like Trelegy Ellipta,  Breo Ellipta is administered as one inhalation once daily.

4. Dulera

Dulera contains the corticosteroid mometasone and the LABA formoterol, which are different from the corticosteroid and LABA in Trelegy Ellipta. While Trelegy Ellipta is approved for the maintenance of  COPD and asthma, Dulera is only indicated for the treatment of asthma in adults and children as young as five years of age. Dulera and Trelegy Ellipta have similar side effect profiles that include upper respiratory infection, headache, sinus pain, and oral thrush. Dulera is dosed with two inhalations twice daily compared to Trelegy Ellipta’s one inhalation once daily. 

5. Anoro Ellipta

Anoro Ellipta contains the same anticholinergic and LABA ingredients as Trelegy Ellipta (umeclidinium and vilanterol) but does not have a steroid. It is only approved for the maintenance treatment of COPD symptoms in adults and is not recommended for use in children. Because Anoro Ellipta does not contain a corticosteroid, common side effects are somewhat different than Trelegy Ellipta but do include sore throat, upper and lower respiratory infection, and common cold symptoms. Like Trelegy Ellipta, it is dosed as one inhalation once daily. 

Natural alternatives to Trelegy Ellipta

Although most people experiencing COPD or asthma symptoms must rely on prescription medications, some natural therapies may help reduce the symptoms. Natural relaxation exercises like deep breathing, progressive muscle relaxation, guided imagery, and yoga may help relieve stress that might otherwise lead to an attack.

Although studies on alternative treatments for COPD and asthma have been limited, certain diets, such as the Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension) diet, may help alleviate COPD and asthma symptoms by reducing inflammation in the body. Weight loss may improve lung function, and avoiding foods that trigger allergies may reduce symptoms. Caffeine is a mild bronchodilator and may help to open airways. 

How to switch to a Trelegy Ellipta alternative

Because of the number of different medication options, those with COPD or asthma may make the decision to switch inhalers. Reasons for changing inhalers include allergic reactions, worsening symptoms, adherence issues, poor inhaler technique, adverse effects, patient preferences, and cost considerations. The decision to switch from Trelegy Ellipta to another medication should be made in consultation with the prescribing healthcare professional to ensure getting the appropriate medical advice and proper training on the use of the new inhaler.