Trelegy Ellipta Dosage/Direction for Use

Dosing Considerations: COPD and Asthma: As with other inhaled drugs containing beta₂-adrenergic agents, TRELEGY ELLIPTA should not be used more often than recommended, at higher doses than recommended, or in conjunction with other medicines containing LABA or LAMA, as an overdose may result.
When beginning treatment with TRELEGY ELLIPTA, patients who have been taking rapid onset, short duration, inhaled beta₂-agonists on a regular basis should be instructed to discontinue the regular use of these drugs and use them only for symptomatic relief if they develop acute respiratory symptoms while taking TRELEGY ELLIPTA.
TRELEGY ELLIPTA should not be used to treat acute symptoms of COPD or asthma. Patients should be prescribed a rapid onset, short duration inhaled bronchodilator (e.g., salbutamol) to relieve acute symptoms such as shortness of breath and advised to have this available for use at all times.
Patients should be made aware that for optimum benefit, TRELEGY ELLIPTA must be used regularly, even when asymptomatic.
COPD: Counselling by healthcare professionals on smoking cessation should be the first step in treating patients with COPD who smoke, independent of the clinical presentation i.e., chronic bronchitis (with or without airflow limitation) or emphysema. Cessation of smoking produces dramatic symptomatic benefits and has been shown to confer a survival advantage.
Asthma: Patients with asthma should be regularly reassessed by a healthcare professional so that the strength of TRELEGY ELLIPTA they are receiving remains optimal and is only changed on medical advice.
Healthcare professionals should only prescribe TRELEGY ELLIPTA for patients not adequately controlled on long-term asthma control treatment with a medium or high dose inhaled corticosteroid and a LABA.
The starting dose of TRELEGY ELLIPTA should be based on the patients' previous asthma therapy including the inhaled corticosteroid dosage.
If a previously effective dose of TRELEGY ELLIPTA fails to provide adequate control of asthma symptoms, patients should seek medical advice as this indicates worsening of their underlying condition.
Recommended Dose and Dosage Adjustment: The recommended dose of TRELEGY ELLIPTA in adults 18 years of age and older is: See Table 4.

Click on icon to see table/diagram/image

COPD: The recommended and maximum dose is one inhalation of TRELEGY ELLIPTA 100/62.5/25 mcg once daily.
TRELEGY ELLIPTA 200/62.5/25 mcg is not indicated for the treatment of COPD.
Asthma: The recommended dose is one inhalation of TRELEGY ELLIPTA 100/62.5/25 mcg or 200/62.5/25 mcg once daily.
A starting dose of TRELEGY ELLIPTA 100/62.5/25 mcg should be considered for patients who require a low to mid dose of inhaled corticosteroid in combination with a LAMA and a LABA.
TRELEGY ELLIPTA 200/62.5/25 mcg should be considered for patients who require a higher dose of inhaled corticosteroid in combination with a LAMA and a LABA.
For patients who do not respond adequately to TRELEGY ELLIPTA 100/62.5/25 mcg once daily, consider increasing the dose to 200/62.5/25 mcg once daily, which may provide improvement in asthma control.
The maximum recommended dose is 1 inhalation of TRELEGY ELLIPTA 200/62.5/25 mcg once daily.
Geriatrics: No dosage adjustment is required in patients 65 years of age and older (see Pharmacology: Pharmacokinetics under Actions).
Pediatrics: TRELEGY ELLIPTA should not be used in patients under 18 years of age.
Hepatic Insufficiency: For patients with moderate or severe hepatic impairment, the maximum dose is 100/62.5/25 mcg. Caution should be exercised when dosing patients with hepatic impairment who may be more at risk of systemic adverse reactions associated with corticosteroids. Patients should be monitored for corticosteroid-related side effects (see Pharmacology: Pharmacokinetics under Actions).
Renal Insufficiency: No dose adjustment is required for patients with renal impairment (see Pharmacology: Pharmacokinetics under Actions).
Administration: TRELEGY ELLIPTA is for oral inhalation only.
TRELEGY ELLIPTA should be administered as a single dose once-daily at the same time of the day each day. After inhalation, patients should rinse their mouth with water (without swallowing).
Do not use TRELEGY ELLIPTA more than once every 24 hours.
Missed Dose: If a dose is missed, the patient should be instructed to take the next dose when it is due. The patient should be instructed not to take an extra dose.