Trelegy Ellipta side effects and how to avoid them

In this article:

• Common side effects
• Serious side effects
• How soon do Trelegy Ellipta side effects start?
• How long do Trelegy Ellipta side effects last?
• What are the long-term side effects of Trelegy Ellipta?
• Trelegy Ellipta drug interactions
• Safety measures while using Trelegy Ellipta
• How to avoid Trelegy Ellipta side effects
• How to treat side effects of Trelegy Ellipta

In this article

• Common side effects
• Serious side effects
• How soon do Trelegy Ellipta side effects start?
• How long do Trelegy Ellipta side effects last?
• What are the long-term side effects of Trelegy Ellipta?
• Trelegy Ellipta drug interactions
• Safety measures while using Trelegy Ellipta
• How to avoid Trelegy Ellipta side effects
• How to treat side effects of Trelegy Ellipta

Trelegy Ellipta is a prescription inhaler containing one steroid and two bronchodilators: fluticasone furoate, umeclidinium, and vilanterol (a long-acting beta agonist), respectively. It is approved by the Food and Drug Administration (FDA) as a maintenance treatment for chronic obstructive pulmonary disease (COPD) or asthma. It’s important to know that Trelegy Ellipta is not approved as a rescue inhaler for active asthma attacks.

Like any drug, Trelegy Ellipta is not without side effects. Keep reading to learn more about Trelegy Ellipta side effects, how long they last, and how to avoid them.

Common side effects of Trelegy Ellipta

As is the case with all medications, some Trelegy Ellipta side effects occur more frequently than others. According to the drug label, the most common side effects are sore throat and cold-like symptoms. In asthma trials, they occurred in 15%–17% of users.”

Other common side effects include:

• Headache
• Back pain
• Diarrhea
• Upper respiratory tract infection or cough
• Dysgeusia (changes in taste)
• Bronchitis
• Sinusitis

Serious side effects of Trelegy Ellipta

Some side effects are serious. MedlinePlus says to get urgent care if you have any of the following:

• Hives, rash, or swelling of the throat or tongue (signs of a potentially life-threatening allergic reaction)
• Fast or irregular heart rate
• Chest pain
• Trouble breathing 
• Signs of infection, such as a fever, chills, or coughing up mucus that isn’t clear
• Trouble urinating or pain with urination
• White patches in the mouth or throat
• Weakness or shakiness
• Trouble seeing
• Very high blood sugar

The most important serious Trelegy Ellipta side effect people should watch for in the first few minutes after dosage is a paradoxical bronchospasm. “This means that instead of opening up their airways, the inhaler can make them close up,” says Kara Wada, MD, a board-certified allergist, immunologist, and functional medicine physician. “If this happens, I tell them to stop using the inhaler right away and get in touch with me or another doctor.”

RELATED: How much is Trelegy Ellipta without insurance?

How soon do Trelegy Ellipta side effects start?

Most side effects appear within days to a few weeks of starting Trelegy Ellipta, according to Fady Youssef, MD, a board-certified pulmonologist, internist, and critical care specialist at MemorialCare Long Beach Medical Center in Long Beach, California. “Serious reactions, such as pneumonia or heart rhythm changes, are much less common but can also appear early. Keep an eye out for side effects and connect with your physician as needed.”

How long do Trelegy Ellipta side effects last?

According to GSK, the manufacturer of Trelegy Ellipta, the positive effects of this inhaler last a full 24 hours. There is no standardized timeline for how long Trelegy side effects last. But in many cases, minor discomforts, such as a sore throat or runny nose, will gradually improve as your body adjusts to the medication. 

If any side effects become severe or don’t improve after a week or two of using a Trelegy Ellipta inhaler, consult a healthcare professional. 

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What are the long-term side effects of Trelegy Ellipta?

Drs. Wada and Youssef say that most long-term side effects from Trelegy Ellipta occur because it contains a steroid. “It’s especially important to talk to a doctor if you’ve been on steroids before you start Trelegy,” Dr. Wada says.

According to the prescribing information, potential long-term side effects include:

• Too much cortisol in the body
• Adrenal gland dysfunction 
• Immune system suppression resulting in worsening infections or increased risk of infections, such as pneumonia
• Decrease in bone mineral density (BMD), which could lead to osteoporosis and fractures
• Glaucoma, cataracts, or worsening of narrow-angle glaucoma
• Recurring Candida albicans infections of the mouth and throat (thrush)
• Trouble urinating

It’s important to seek medical advice if you start to experience symptoms of any of the above health conditions, such as recurrent infections, joint pain, eye problems (blurred vision or eye pain), or frequent urinary tract infections.  

Trelegy Ellipta drug interactions

You shouldn’t use Trelegy Ellipta if you take another inhaler containing vilanterol or similar medications, such as salmeterol, arformoterol, or formoterol. Taking two medications that contain the same active ingredient can lead to an overdose, which may cause seizures, shortness of breath, or loss of consciousness. 

According to the drug label, other drug types that may interact with Trelegy Ellipta include:

• Beta blockers: These drugs may lessen the effects of Trelegy Ellipta and increase the risk of an airway tightening.
• Diuretics: Combining this inhaler with diuretics increases the risk of heart-related side effects as well as dangerously low potassium levels.
• Antifungals: These drugs can raise the risk of Trelegy Ellipta side effects.
• MAO inhibitors (MAOIs) and tricyclic antidepressants: Combining vilanterol, one of Trelegy Ellipta’s three active ingredients, with MAOIs can increase the risk of heart-related side effects and complications.

This is not a complete list of drugs that may interact with Trelegy Ellipta. Tell your healthcare provider about all medications you take, including prescription and over-the-counter (OTC) drugs, herbal remedies, and supplements.

Safety measures while using Trelegy Ellipta

Trelegy Ellipta is considered generally safe and effective when used as a once-daily maintenance treatment for COPD and asthma. That said, it’s not the right inhaler for everyone. Some people may experience better results and fewer side effects with a different inhaled medication. And for people with health conditions that Trelegy Ellipta is known to exacerbate, such as urinary retention or frequent infections, it’s important to weigh the risks versus the benefits of using this inhaler.

Specific populations

Pregnant or breastfeeding people

There is limited data on Trelegy Ellipta in individuals who are pregnant or breastfeeding. The drug label states that in animal studies, inhaled fluticasone furoate and vilanterol did not result in any fetal abnormalities or issues with labor or delivery.

The drug label for Trelegy Ellipta also states that there is no evidence that this inhaler’s ingredients affect lactation or that they can be transferred from the airway into breast milk. 

Bottom line: People who are pregnant or breastfeeding may be able to safely take Trelegy Ellipta, but it’s important to seek personalized advice from a healthcare professional.

Older adults

The drug label states that older adults do not need to adjust their Trelegy Ellipta dosage. There is no evidence that the safety or efficacy of this inhaler is compromised in older adults. However, older adults with osteoporosis may be at a greater risk of fractures due to Trelegy Ellipta causing bone density loss. Older adults may also be at greater risk of adverse effects if they have chronic conditions that involve the heart, eyes, or urinary system. 

Children

Trelegy Ellipta is not FDA approved for use in pediatric or adolescent populations. Research shows that inhaled corticosteroids like fluticasone, one of this inhaler’s ingredients, can have a mild detrimental impact on childhood growth. There is not a lot of strong data on this topic, but most healthcare professionals would recommend using an inhaler that’s FDA approved for the pediatric age group.

Other conditions

Trelegy Ellipta should not be used by people who are allergic to milk proteins. And it may not be the best medication for people with osteoporosis, urination problems, and certain eye and heart problems. People who have been exposed to infections like measles or chickenpox, or have latent infections like tuberculosis or herpes, may also be at higher risk. Talk to your prescriber about the specific risks associated with these conditions and whether the benefits outweigh these risks.

Black box warning

The black box warning for Trelegy Ellipta was removed in 2018. Before that, this inhaler carried the FDA’s most serious warning for an increased risk of asthma-related death, but later research showed that the benefits are greater than the risks for most people. Trelegy Ellipta can cause bronchospasm in some patients, so it’s essential to remain vigilant.

Overdose 

Trelegy Ellipta is intended to be inhaled once per day, at the same time each day. A second dose will not increase the benefits of the inhaler. Rather, double-dosing can cause an overdose. Anyone concerned about a potential Trelegy Ellipta overdose should seek immediate medical attention. 

How to avoid Trelegy Ellipta side effects

Here are some ways to help avoid or minimize Trelegy Ellipta side effects:

1. Pick a time of day and stick to it. Dr. Wada tells her patients to take their daily puff early in the day. “I find that using it in the morning works best because it lines up with our bodies’ natural rhythms. This seems to help the medicine work most effectively throughout the day,” she says. There’s no need to take it with food, but using it right after breakfast or your cup of coffee each morning might help you stay consistent. 
2. Inhale in one long, steady breath. Getting your full dose of Trelegy Ellipta might not prevent side effects. Still, it will ensure that you are getting the maximum benefits of the inhaler: improved lung function and easier breathing.
3. Rinse your mouth afterward. Dr. Wada suggests rinsing your mouth with water and spitting it out after inhaling Trelegy Ellipta. This helps prevent thrush caused by Candida albicans, a yeast infection of the mouth and throat.
4. Store your clean inhaler out of reach of children. It’s a good idea to wipe the inhaler mouthpiece before and after each puff to help minimize the risk of yeast infections and other infections. Storing Trelegy Ellipta away from children is also important, as this inhaler is not approved for use in pediatric patients.
5. Take the next dose on time. “Don’t stop Trelegy suddenly without talking to your healthcare provider—it can make breathing worse if stopped abruptly,” Dr. Youssef warns. Any side effects severe enough to make you want to discontinue Trelegy Ellipta should be reported to your prescriber as soon as possible.

How to treat side effects of Trelegy Ellipta

Since this inhaler may increase your risk of infections and oral yeast infections, managing Trelegy Ellipta side effects begins with maintaining good health. Some tips for overall health and side effect management include:

• Rinsing your mouth well after each use
• Keeping your inhaler mouthpiece clean
• Eating a well-balanced, healthy, anti-inflammatory diet
• Staying in touch with your prescriber about any severe or worsening side effects

Remember, sudden airway closure, irregular heartbeat, rash, or swelling of the face or tongue requires immediate medical attention. Ultimately, it’s important to tell your healthcare provider about all adverse effects you notice after starting Trelegy Ellipta. Your prescriber may opt to treat your symptoms with other prescription or over-the-counter drugs, temporarily pause the medication, switch to a different inhaler, or do something else. 

Bottom line

Trelegy Ellipta is a combination inhaler used to treat COPD symptoms and asthma symptoms. It can cause side effects such as headaches, backaches, or symptoms similar to those of a common cold. Serious side effects include sudden airway closure, fungal infections of the mouth and throat, allergic reactions, heart problems, or fragile bones. 

It’s essential to maintain close contact with your healthcare provider when starting Trelegy Ellipta and inform them of any severe or persistent side effects. In most cases, side effects are manageable and tend to improve over time. Dr. Youssef also says that for most patients, the benefits of Trelegy Ellipta (fewer flare-ups, easier breathing, and better quality of life) far outweigh the risks. Trelegy has been deemed safe and effective by the FDA, provided it is taken as directed and under the guidance of a healthcare provider.