Anyone who suffers from shortness of breath , asthma , or chronic obstructive pulmonary disease (COPD ) knows how challenging it can be to live with. Feeling like your chest is tight all day long, and feeling dizzy even when doing small tasks can be a big obstacle to your daily life. So today we are talking about a special type of inhaler that doctors prescribe to control such conditions. Maybe you are one of those who use this inhaler.
What is this inhaler? To be precise...
This is a special dry powder inhaler that contains a combination of three medications. The three medications are fluticasone, umeclidinium, and vilanterol . Your doctor may call it by the brand name `TRELEGY ELLIPTA`.
Simply put, these three medications work together to provide relief to your lungs.
1. Fluticasone: This is an inhaled steroid that reduces swelling in the airways . Think of it like your airways are inflamed and swollen. This medicine works by reducing the swelling and opening up your airways.
2. Umeclidinium: This is an anticholinergic drug that relaxes the muscles around the airways . It is when these muscles tighten that breathing becomes difficult. This drug works by relaxing that tightness and widening the airways.
3. Vilanterol: This is also a long-acting bronchodilator that helps keep the airways wide .
When all three of these come together, they control your shortness of breath and help you breathe easier throughout the day.
Important: This is called a “controller inhaler.” This means that it is used to control your symptoms on a daily basis and prevent asthma or COPD flare-ups. It is not intended for use during a sudden asthma attack or when your COPD is getting worse. Your doctor may have given you a “rescue inhaler” for emergencies like this.
Things you need to tell your doctor before using this medicine
Before prescribing this inhaler to you, your doctor should take a complete medical history . This is because some conditions require special care when using this medication. If you have any of the conditions listed below, be sure to tell your doctor.
| Your medical condition or condition | Why should I notify? (in brief) |
|---|---|
| Diabetes | This medicine may affect blood sugar levels. |
| Heart disease or high blood pressure | Heart rate or blood pressure may change. |
| Eye diseases (especially glaucoma) | Eye pressure may increase. |
| An infectious condition in the body | Since it contains steroids, it may affect infection control. |
| Osteoporosis | Long-term use can affect bones. |
| Thyroid, seizure, kidney, or prostate problems | The symptoms of these conditions can vary. |
| Being pregnant or trying to get pregnant | You should talk to your doctor about the possible effects on the fetus. |
| Breastfeeding | It is important to know whether the medicine passes to the baby through milk. |
| Allergy to milk or lactose | The powder in this inhaler contains lactose. |
How to use this inhaler correctly?
The way this is used is very important. If used incorrectly, you will not get the full benefit of the medicine.
1. At the same time every day: Use this at the same time every day, as prescribed by your doctor. Make this a habit.
2. Preparing the inhaler: Push the cover of the inhaler to one side. You need to push it until you hear a “click”. The inhaler is now ready to use.
3. Exhaling: Before putting the inhaler in your mouth, exhale deeply. But do not exhale into the inhaler.
4. Inhaling the medicine: Now close the mouthpiece of the inhaler tightly with your lips and take a deep, long breath in through your mouth.
5. Breath holding: Remove the inhaler from your mouth and hold your breath for 3-4 seconds or as long as you can.
6. Exhalation: Now exhale.
7. Closing the cover: When finished using, close the cover as it was.
8. Rinse your mouth (required!): This is the most important step. Immediately after using the inhaler, rinse your mouth thoroughly with water and spit it out. Never swallow the water. This is to prevent the development of a fungal infection (thrush) in the mouth.
What do I do if I miss a dose?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose (e.g., within a few hours), skip the missed dose and take your next dose at the scheduled time. Do not take two doses at once for any reason.
What if I take too much medicine?
If you think you have taken more medicine than you think, immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other drugs that may interact with this medicine (Drug Interactions)
It is very important to tell your doctor about all the medications you are taking, including prescription medications, over-the-counter medications, herbs, and vitamins. Some medications can interact with this inhaler and cause side effects or reduce the effectiveness of the inhaler.
| Drug category | Examples |
|---|---|
| Medicines that should never be taken together | |
| Some heart rhythm control medications | Cisapride, Dronedarone, Pimozide, Thioridazine |
| MAOI-type antidepressants | Marplan, Nardil, Parnate |
| Other drugs that should be used with caution | |
| Beta-blockers (used for heart disease/blood pressure) | Metoprolol, Propranolol |
| Some fungicides and antibiotics | Ketoconazole, Itraconazole, Clarithromycin |
| Drugs used for HIV/AIDS | Drugs like Ritonavir |
| Inhalers used for other respiratory diseases | Ipratropium, Tiotropium |
Things to be careful about when using
- Pay attention to symptoms: If your symptoms do not improve, or if they seem to be getting worse, tell your doctor immediately.
- Be prepared for emergencies: As we mentioned earlier, this is not an emergency medicine. Always keep your rescue inhaler with you. If you find yourself needing to use it more often, it could be a sign that your condition is not under control. If this happens, talk to your doctor.
- Shortness of breath immediately after use: Very rarely, some people may experience increased shortness of breath immediately after using this inhaler. If this happens, stop using this inhaler immediately, use your reliever inhaler, and talk to your doctor.
- Protect yourself from infections: This medicine may slightly affect your immune system. Therefore, try to stay away from people who have a fever or cold . Tell your doctor if you develop symptoms such as fever, body aches, or sore throat.
What side effects might I experience?
Like all medications, this one can have side effects, but most people don't experience serious side effects.
| Allergic Reactions | Skin rash, itching, swelling of the face, lips, tongue. |
| Changes in heart rate | Feeling like your heart is beating fast, chest pain, dizziness. |
| Vision changes | Blurred vision, sudden eye pain, seeing rings around lights. |
| White spots in the mouth (Thrush) | A fungal infection in the mouth or throat (can be prevented by rinsing the mouth). |
| Difficulty urinating | Difficulty or pain when urinating. |
| Headache | Sore throat or hoarseness |
| Dry mouth | Cough |
| Difficulty falling asleep | Tremors (subtle tremors) in the hands |
Take-Home Message
- This inhaler is a "controller inhaler" used to control the disease daily, not a "reliever inhaler" used for sudden attacks.
- After each use, rinse your mouth thoroughly with water and discard the water. This is mandatory.
- Tell your doctor about all other medications you are taking and any other medical conditions you have.
- Seek medical advice immediately if your symptoms worsen or if you experience any unusual side effects.
- This inhaler is prescribed for you only. Never share it with others.
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