Home Drug Guide Fluticasone Furoate; Umeclidinium Bromide; Vilanterol Trifenatate

Drug Guide

Generic Name

Fluticasone Furoate; Umeclidinium Bromide; Vilanterol Trifenatate

Brand Names Trelegy Ellipta

Classification

Therapeutic: Long-acting combination therapy for COPD and asthma

Pharmacological: Inhaled corticosteroid, long-acting muscarinic antagonist, long-acting beta2-adrenergic agonist

FDA Approved Indications

Prevention and management of chronic obstructive pulmonary disease (COPD)

Mechanism of Action

Fluticasone Furoate is an inhaled corticosteroid that reduces inflammation; Umeclidinium Bromide is a long-acting muscarinic antagonist that relaxes airway muscles; Vilanterol Trifenatate is a long-acting beta2-adrenergic agonist that relaxes airway smooth muscle, leading to bronchodilation.

Dosage and Administration

Adult: One inhalation once daily

Pediatric: Not approved for pediatric use

Geriatric: Adjust dose as needed based on clinical response, no specific age-based adjustments generally required

Renal Impairment: No specific adjustment recommended

Hepatic Impairment: No specific adjustment recommended

Pharmacokinetics

Absorption: Rapid absorption following inhalation

Distribution: Localized action primarily in lungs, minimal systemic absorption

Metabolism: Metabolized in liver via CYP enzymes (Vilanterol)

Excretion: Excreted primarily in feces, minimal renal excretion

Half Life: Vilanterol approximately 21 hours, other components variable

Contraindications

Hypersensitivity to any component

Precautions

Use with caution in patients with active infection in lungs, osteoporosis, glaucoma, or cataracts; monitor for systemic corticosteroid effects

Adverse Reactions - Common

Oral candidiasis (Common)
Cough (Common)
Headache (Common)

Adverse Reactions - Serious

Pneumonia (COPD patients) (Less common)
Hypersensitivity reactions (rash, swelling) (Rare)

Drug-Drug Interactions

CYP3A4 inhibitors (may increase levels of Vilanterol)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor lung function, signs of infection, and for adverse reactions

Diagnoses:

Impaired gas exchange
Risk for infection

Implementation: Administer inhaler as prescribed, rinse mouth after use to prevent oral thrush, monitor for adverse effects

Evaluation: Assess improvements in pulmonary function, symptom control

Patient/Family Teaching

Use inhaler correctly, rinse mouth after use, report worsening symptoms or side effects, do not stop abruptly

Special Considerations

Black Box Warnings:

Risk of asthma-related death with LABAs when used without inhaled corticosteroids

Genetic Factors: Genetic variations may affect drug metabolism

Lab Test Interference: Inhaled corticosteroids may cause false readings of certain lab tests (e.g., blood glucose)

Overdose Management

Signs/Symptoms: Tachycardia, tremors, hypokalemia, hypoglycemia

Treatment: Supportive care, beta-blockers may be used cautiously under medical supervision

Storage and Handling

Storage: Store at room temperature away from moisture and heat

Stability: Stable until expiration date on package