Elebrato Ellipta: Uses, Dosage & Side Effects
A triple combination inhaler containing fluticasone furoate, umeclidinium, and vilanterol for maintenance treatment of COPD and asthma
Elebrato Ellipta (also marketed as Trelegy Ellipta) is a prescription triple combination inhaler that delivers fluticasone furoate (an inhaled corticosteroid), umeclidinium (a long-acting muscarinic antagonist), and vilanterol (a long-acting beta2-adrenergic agonist) in a single Ellipta dry powder device. It is used as a once-daily maintenance treatment for chronic obstructive pulmonary disease (COPD) in adults who are not adequately controlled on dual therapy, and for asthma maintenance in adults. By combining three complementary mechanisms of action, Elebrato Ellipta reduces inflammation, relaxes airway smooth muscle, and opens the airways for sustained 24-hour symptom control.
Quick Facts: Elebrato Ellipta
Key Takeaways
- Elebrato Ellipta (fluticasone furoate/umeclidinium/vilanterol 92/55/22 mcg) is a once-daily triple combination inhaler that treats COPD and asthma by combining anti-inflammatory, anticholinergic, and bronchodilator actions in a single device.
- Clinical trials (FULFIL, IMPACT, CAPTAIN) demonstrated that triple therapy significantly reduces COPD exacerbations by up to 25% compared to dual therapy and improves lung function (FEV1) and quality of life scores.
- It is not a rescue inhaler — patients must always carry a separate fast-acting bronchodilator (e.g., salbutamol) for acute symptoms.
- The most common side effects include headache, upper respiratory tract infection, oral candidiasis (thrush), and pneumonia (particularly in COPD patients). Rinsing the mouth after use helps prevent oral thrush.
- The Ellipta dry powder inhaler is designed for ease of use with a simple open-inhale-close mechanism that delivers a pre-measured dose without the need for coordination between pressing and inhaling.
What Is Elebrato Ellipta and What Is It Used For?
Elebrato Ellipta, also known as Trelegy Ellipta in the United States and several other markets, contains three active substances that work together to control the symptoms of chronic obstructive pulmonary disease (COPD) and asthma. The three active components are fluticasone furoate (92 micrograms per dose), an inhaled corticosteroid (ICS) that reduces inflammation in the airways; umeclidinium (55 micrograms per dose), a long-acting muscarinic antagonist (LAMA) that blocks acetylcholine-mediated bronchoconstriction; and vilanterol (22 micrograms per dose), a long-acting beta2-adrenergic agonist (LABA) that relaxes airway smooth muscle by stimulating beta2-receptors. All three components are delivered simultaneously through the Ellipta dry powder inhaler, a breath-actuated device designed for ease of use.
Chronic obstructive pulmonary disease is a progressive lung condition characterized by persistent airflow limitation, chronic bronchitis, and emphysema. It affects an estimated 380 million people worldwide and is the third leading cause of death globally according to the World Health Organization. COPD is most commonly caused by long-term exposure to tobacco smoke, but occupational dust, chemical fumes, and air pollution also contribute significantly. Patients with COPD experience breathlessness, chronic cough, sputum production, and frequent exacerbations (flare-ups) that accelerate disease progression and reduce quality of life.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 guidelines recommend a stepwise approach to COPD pharmacotherapy. Triple therapy with ICS/LAMA/LABA is recommended for patients who remain symptomatic or continue to experience exacerbations despite dual therapy with either ICS/LABA or LAMA/LABA. The GOLD report specifically notes that triple therapy in a single inhaler simplifies the treatment regimen and may improve adherence compared to the use of multiple separate inhalers.
In addition to COPD, Elebrato Ellipta received approval from the European Medicines Agency (EMA) in 2021 for maintenance treatment of asthma in adults who are not adequately controlled with a maintenance combination of an ICS and a LABA and who experienced one or more asthma exacerbations in the previous year. The Global Initiative for Asthma (GINA) 2024 strategy report recognizes the role of add-on LAMA therapy in patients with asthma who continue to have symptoms despite medium- or high-dose ICS/LABA treatment, particularly those with persistent airflow limitation.
Elebrato Ellipta was first approved by the U.S. Food and Drug Administration (FDA) as Trelegy Ellipta in September 2017 for COPD, and subsequently received EMA approval. It was the first once-daily single-inhaler triple therapy to reach the market for COPD. The FDA expanded the indication to include asthma maintenance in October 2020 for adults aged 18 and older. It is now approved in more than 50 countries worldwide and has become one of the most widely prescribed triple therapy inhalers, reflecting its strong clinical evidence base and the practical advantages of single-inhaler delivery.
Using a single inhaler for triple therapy offers several advantages over separate inhalers: it simplifies the daily treatment routine, reduces the likelihood of incorrect inhaler technique, and improves medication adherence. Studies have shown that patients using multiple inhalers are more likely to miss doses or make errors in technique, which can lead to suboptimal disease control and increased exacerbation risk.
What Should You Know Before Taking Elebrato Ellipta?
Contraindications
Elebrato Ellipta must not be used by anyone with a known hypersensitivity (allergy) to fluticasone furoate, umeclidinium, vilanterol, or any of the excipients, including lactose monohydrate and magnesium stearate. Since the powder contains milk protein (lactose), patients with severe milk protein allergy should not use this medicine. Hypersensitivity reactions, including anaphylaxis, angioedema, rash, and urticaria, have been reported with the individual components and must be taken seriously.
Elebrato Ellipta is intended only for regular maintenance treatment and must never be used as a rescue inhaler to relieve sudden breathing problems (acute bronchospasm). Patients must always have a separate fast-acting rescue bronchodilator, such as salbutamol (albuterol), available for immediate relief of acute symptoms. If your breathing suddenly worsens, use your rescue inhaler and seek medical attention if symptoms do not improve.
Warnings and Precautions
Before starting Elebrato Ellipta, patients should inform their healthcare provider about all existing medical conditions. Several conditions require special caution or monitoring during treatment:
- Pneumonia: Inhaled corticosteroids, including fluticasone furoate, increase the risk of pneumonia in patients with COPD. The IMPACT trial showed pneumonia occurred in approximately 8% of patients on triple therapy versus 5% on LAMA/LABA alone. COPD patients should be aware of pneumonia symptoms (fever, increased sputum, chest pain, worsening breathlessness) and report them promptly.
- Cardiovascular disease: Beta2-agonists (vilanterol) and anticholinergics (umeclidinium) should be used with caution in patients with severe cardiovascular disease, including coronary artery disease, cardiac arrhythmias, and hypertension. These medications can cause increases in heart rate, blood pressure, and QTc interval prolongation at supratherapeutic doses.
- Diabetes mellitus: Inhaled corticosteroids may cause increases in blood glucose levels. Patients with diabetes should monitor their blood glucose more frequently when starting this medication.
- Narrow-angle glaucoma: Umeclidinium (the anticholinergic component) may worsen narrow-angle glaucoma. Patients should be advised to seek immediate medical attention if they develop eye pain, blurred vision, visual halos, or red eyes.
- Urinary retention: Anticholinergic medicines can worsen urinary retention. Patients with prostatic hyperplasia or bladder-neck obstruction should use Elebrato Ellipta with caution.
- Hepatic impairment: Fluticasone furoate is primarily metabolized in the liver. Patients with moderate to severe hepatic impairment may have increased systemic exposure and should be monitored for corticosteroid-related side effects.
- Osteoporosis: Long-term use of inhaled corticosteroids may reduce bone mineral density. Patients with risk factors for osteoporosis should have bone density monitored and should take appropriate preventive measures.
- Tuberculosis and infections: Inhaled corticosteroids may mask infections and should not be initiated in patients with active or quiescent tuberculosis, or untreated fungal, bacterial, or viral infections.
Pregnancy and Breastfeeding
There is limited data on the use of Elebrato Ellipta in pregnant women. Animal studies with the individual components have shown effects typical of corticosteroids and beta2-agonists at high doses, including teratogenicity with fluticasone furoate, but the relevance to human therapeutic doses delivered by inhalation is uncertain. Elebrato Ellipta should only be used during pregnancy if the expected benefit to the mother justifies the potential risk to the fetus. Uncontrolled asthma and COPD during pregnancy carry their own risks (preeclampsia, low birth weight, premature delivery), so maintaining adequate respiratory disease control is important.
It is not known whether fluticasone furoate, umeclidinium, or vilanterol pass into human breast milk. A risk to the breastfed infant cannot be excluded. The decision to continue or discontinue breastfeeding versus treatment should consider the benefit of breastfeeding to the child and the benefit of therapy to the mother. Women who are pregnant, planning to become pregnant, or breastfeeding should discuss their treatment options with their healthcare provider.
Do not suddenly stop using Elebrato Ellipta without consulting your doctor, even if you feel better. Abrupt discontinuation can lead to worsening of symptoms, exacerbations, and potentially life-threatening bronchospasm. If your doctor decides to discontinue triple therapy, the dose should be reduced gradually under medical supervision.
How Does Elebrato Ellipta Interact with Other Drugs?
Elebrato Ellipta contains three active substances, each with its own pharmacokinetic and pharmacodynamic profile. Understanding potential drug interactions is important for safe prescribing. Fluticasone furoate is metabolized primarily by CYP3A4 in the liver, while umeclidinium and vilanterol are substrates of CYP2D6 and P-glycoprotein. The most important interactions involve medications that affect these metabolic pathways or have opposing pharmacological effects.
Major Interactions
| Interacting Drug | Effect | Recommendation |
|---|---|---|
| Ketoconazole, Itraconazole (strong CYP3A4 inhibitors) | Significantly increases fluticasone furoate systemic exposure; risk of Cushing syndrome and adrenal suppression | Avoid concomitant use; if unavoidable, monitor closely for corticosteroid side effects |
| Ritonavir, Cobicistat (HIV protease inhibitors) | Potent CYP3A4 inhibition; can cause severe adrenal suppression and Cushing syndrome with inhaled corticosteroids | Co-administration not recommended; consider alternative corticosteroid or alternative antiretroviral |
| Non-selective beta-blockers (propranolol, carvedilol) | Blocks bronchodilator effect of vilanterol; may provoke severe bronchospasm | Avoid in patients with COPD/asthma; use cardioselective beta-blockers if essential |
| Other LABAs (formoterol, salmeterol, indacaterol) | Risk of additive beta2-agonist effects including tachycardia, tremor, and QTc prolongation | Do not use other LABAs concurrently with Elebrato Ellipta |
Minor Interactions
| Interacting Drug | Effect | Recommendation |
|---|---|---|
| Verapamil, Diltiazem (moderate CYP3A4 inhibitors) | May modestly increase fluticasone furoate exposure | Generally safe; monitor for corticosteroid side effects with long-term use |
| Other anticholinergic medicines (ipratropium, tiotropium, glycopyrronium) | Additive anticholinergic effects (dry mouth, urinary retention, constipation, glaucoma) | Avoid concurrent use with other inhaled anticholinergics |
| QTc-prolonging drugs (certain antiarrhythmics, macrolides, fluoroquinolones) | Beta2-agonists may increase QTc interval; additive risk with other QTc-prolonging agents | Use with caution; monitor ECG in high-risk patients |
| Hypokalaemia-inducing drugs (diuretics, theophylline, systemic corticosteroids) | Beta2-agonists and corticosteroids can lower potassium; additive risk of hypokalaemia | Monitor potassium levels, particularly in patients at risk of arrhythmias |
It is important to inform your healthcare provider and pharmacist about all medications you are currently taking, including prescription medicines, over-the-counter drugs, vitamins, and herbal supplements, before starting Elebrato Ellipta. Drug interactions can change how your medications work and may increase the risk of serious side effects.
What Is the Correct Dosage of Elebrato Ellipta?
Adults
COPD & Asthma Maintenance
The recommended and maximum dose is one inhalation once daily of Elebrato Ellipta 92/55/22 micrograms (delivering fluticasone furoate 92 mcg, umeclidinium 55 mcg, and vilanterol 22 mcg). The dose should be taken at the same time each day to maintain consistent drug levels. If a dose is missed, it should be taken as soon as remembered, but not doubled up — take the next dose at the regular time.
The Ellipta inhaler contains 30 doses. A new inhaler should be started when the dose counter reaches zero. Patients should be trained in proper inhaler technique by a healthcare professional before starting treatment. The simple open-inhale-close mechanism does not require coordination between pressing a canister and inhaling, making it easier to use correctly than pressurized metered dose inhalers (pMDIs).
Children
Pediatric Use
Elebrato Ellipta is not approved for use in children or adolescents under 18 years of age. The safety and efficacy of this medication have not been established in the pediatric population. Children with asthma or other respiratory conditions should be treated with age-appropriate medications as recommended by their healthcare provider.
Elderly
Geriatric Patients
No dose adjustment is required for elderly patients. Clinical trial data included a significant proportion of patients aged 65 years and older, and no clinically meaningful differences in safety or efficacy were observed between older and younger adults. However, elderly patients may be more susceptible to certain adverse effects, including pneumonia (with inhaled corticosteroids), urinary retention (with anticholinergics), and cardiovascular effects (with beta2-agonists), and should be monitored accordingly.
Renal and Hepatic Impairment
Special Populations
Renal impairment: No dose adjustment is required for patients with mild, moderate, or severe renal impairment. Minimal amounts of the active substances are excreted renally.
Hepatic impairment: No dose adjustment is necessary for patients with mild to moderate hepatic impairment. In patients with severe hepatic impairment, data are limited and Elebrato Ellipta should be used with caution. Fluticasone furoate is extensively metabolized in the liver, and severe hepatic impairment may lead to increased systemic corticosteroid exposure. These patients should be monitored for corticosteroid-related side effects such as adrenal suppression.
Missed Dose
If you forget to take your daily dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and take the next dose at the usual time. Do not take a double dose to make up for a missed one. Do not take more than one inhalation per day. If you are unsure about what to do, consult your pharmacist or doctor.
Overdose
There is limited clinical data on overdose with Elebrato Ellipta. An overdose would be expected to produce effects consistent with the pharmacology of the individual components. Fluticasone furoate overdose may cause adrenal suppression and potentially Cushingoid features with chronic excessive use. Umeclidinium overdose may lead to anticholinergic effects including dry mouth, visual disturbance, and urinary retention. Vilanterol overdose may cause tachycardia, tremor, headache, hypertension, and hypokalaemia. In the event of suspected overdose, supportive and symptomatic treatment is recommended. Cardioselective beta-blockers may be considered for significant cardiac effects from beta2-agonist overdose, but should be used with extreme caution due to the risk of provoking bronchospasm.
The effectiveness of any inhaled medication depends heavily on correct inhaler technique. Studies show that up to 70-80% of patients make at least one error when using their inhaler. Common errors with the Ellipta device include: not fully opening the cover (which loads the dose), breathing out into the mouthpiece before inhaling, not inhaling forcefully enough, and not holding the breath after inhalation. Ask your healthcare provider or pharmacist to demonstrate correct technique and review it at each visit.
What Are the Side Effects of Elebrato Ellipta?
Like all medicines, Elebrato Ellipta can cause side effects, although not everybody gets them. The following side effects have been reported in clinical trials and post-marketing surveillance. The frequencies are based on pooled data from the pivotal clinical trials (FULFIL, IMPACT, and CAPTAIN) and the Summary of Product Characteristics.
Very Common
May affect more than 1 in 10 people
- Headache
- Nasopharyngitis (common cold, upper respiratory tract infection)
Common
May affect up to 1 in 10 people
- Pneumonia (especially in COPD patients)
- Oral candidiasis (thrush)
- Upper respiratory tract infection
- Bronchitis
- Back pain
- Arthralgia (joint pain)
- Urinary tract infection
- Sinusitis
- Influenza
- Pharyngitis (sore throat)
- Rhinitis (runny nose)
- Cough
- Dysphonia (hoarseness)
- Abdominal pain (upper)
- Constipation
Uncommon
May affect up to 1 in 100 people
- Supraventricular tachycardia (fast heart rate)
- Atrial fibrillation
- Tachycardia
- Tremor
- Blurred vision
- Glaucoma
- Eye pain
- Dry mouth
- Oropharyngeal pain
- Fractures
- Urinary retention
- Dysuria (painful urination)
Rare
May affect up to 1 in 1,000 people
- Anaphylaxis (severe allergic reaction)
- Angioedema (swelling of the face, lips, tongue, or throat)
- Paradoxical bronchospasm (sudden worsening of breathing)
- Cushing syndrome / Cushingoid features
- Adrenal suppression
- Hyperglycaemia (increased blood sugar)
- Anxiety, sleep disorders
- Palpitations
Not Known
Frequency cannot be estimated from available data
- Growth retardation in children (class effect of inhaled corticosteroids)
- Decreased bone mineral density (with long-term use)
Pneumonia risk in COPD: The IMPACT study, which enrolled over 10,000 COPD patients, found that pneumonia occurred in approximately 8% of patients using triple therapy (ICS/LAMA/LABA) over 52 weeks compared to about 5% on LAMA/LABA alone. Risk factors for pneumonia include current smoking, older age, lower BMI, and a history of prior pneumonia or severe COPD exacerbations. Despite the increased pneumonia risk, triple therapy demonstrated a significant reduction in moderate-to-severe exacerbations and all-cause mortality compared to dual bronchodilator therapy.
Oral candidiasis prevention: Rinsing the mouth with water after each inhalation and spitting it out (not swallowing) significantly reduces the risk of developing oral thrush and hoarseness. This simple step should be part of the daily routine for all patients using Elebrato Ellipta. If oral thrush develops, it can be treated with topical antifungal medicines without the need to stop the inhaler.
If you experience any side effects, including any not listed above, talk to your doctor, pharmacist, or nurse. You can also report suspected adverse reactions through your national pharmacovigilance system. Reporting side effects helps to provide more information on the safety of this medicine.
Severe allergic reaction (difficulty breathing, swelling of the face/lips/tongue/throat, skin rash or hives); sudden worsening of breathing after using the inhaler (paradoxical bronchospasm); chest pain, very fast or irregular heartbeat; or signs of pneumonia (high fever, increasing yellow/green sputum, worsening breathlessness, chest pain when breathing). These are serious but uncommon side effects that require urgent medical evaluation.
How Should You Store Elebrato Ellipta?
Proper storage of Elebrato Ellipta is essential to ensure the medication remains effective throughout its use. The inhalation powder is sensitive to moisture, and exposure to humid environments can affect the quality of the powder and the accuracy of the delivered dose.
- Before first use: Store in the original sealed foil tray at a temperature below 25°C (77°F). The sealed tray protects the inhaler from moisture. Do not open the tray until you are ready to start using the inhaler.
- After opening the tray: The inhaler can be kept for a maximum of 6 weeks after removal from the tray. Write the date you open the tray on the inhaler label so you know when to discard it. Discard the inhaler 6 weeks after opening the tray or when the dose counter reads “0,” whichever comes first.
- Do not refrigerate or freeze: Cold temperatures and condensation can damage the dry powder formulation.
- Keep the cover closed: Always close the cover of the Ellipta inhaler after each use to protect the internal mechanism from moisture and debris.
- Keep out of reach and sight of children: Store the inhaler in a safe place where children cannot access it.
- Do not use after the expiry date: Check the expiry date on the carton and foil tray. Do not use the inhaler after this date.
Dispose of used or expired inhalers according to your local waste disposal regulations. Do not throw inhalers into household waste or flush them down the toilet. Ask your pharmacist about how to dispose of medicines you no longer need.
What Does Elebrato Ellipta Contain?
Elebrato Ellipta delivers three active substances from two separate powder strips within the Ellipta inhaler device. One strip contains a blend of fluticasone furoate and vilanterol (as trifenatate), and the second strip contains umeclidinium (as bromide). When the patient inhales, both strips are drawn upon simultaneously to deliver all three active ingredients in a single breath.
Active Ingredients
| Active Substance | Delivered Dose | Pharmacological Class | Role |
|---|---|---|---|
| Fluticasone furoate | 92 micrograms | Inhaled Corticosteroid (ICS) | Reduces airway inflammation |
| Umeclidinium bromide | 55 micrograms | Long-Acting Muscarinic Antagonist (LAMA) | Blocks bronchoconstriction via M3 receptors |
| Vilanterol trifenatate | 22 micrograms | Long-Acting Beta2-Agonist (LABA) | Relaxes airway smooth muscle via beta2-receptors |
Excipients
The only excipient in the powder formulation is lactose monohydrate, which serves as the carrier for the active substances. Lactose monohydrate also contains trace amounts of milk proteins. This is clinically relevant for patients with severe milk protein allergy (not lactose intolerance), as allergic reactions have been reported in patients with severe milk protein allergy after inhalation of other products containing lactose.
The Ellipta Inhaler Device
The Ellipta inhaler is a multi-dose dry powder inhaler made from light grey polypropylene plastic and stainless steel components. It contains 30 pre-measured doses and features a dose counter that counts down from 30 to 0. The device is breath-actuated, meaning it does not require propellants or coordination between pressing a canister and inhaling. When the cover is opened, it loads one dose from each powder strip and makes it available for inhalation. The inhaler should not be washed — it can be wiped clean with a dry tissue if necessary.
Frequently Asked Questions About Elebrato Ellipta
Elebrato Ellipta and Trelegy Ellipta are the same medication containing identical active ingredients (fluticasone furoate 92 mcg, umeclidinium 55 mcg, and vilanterol 22 mcg) in the same Ellipta dry powder inhaler device. The only difference is the brand name: Trelegy Ellipta is used in the United States and certain other markets, while Elebrato Ellipta is the trade name used in parts of Europe and other regions. The manufacturer (GlaxoSmithKline), formulation, dosage, and clinical evidence are exactly the same for both.
No. Elebrato Ellipta is a maintenance inhaler designed for once-daily use to provide long-term symptom control. It does not provide rapid relief of acute breathlessness or bronchospasm. You must always carry a separate fast-acting rescue inhaler (such as salbutamol/albuterol) for sudden breathing problems. If you find that you are using your rescue inhaler more frequently than before, contact your healthcare provider as this may indicate that your condition is worsening and your treatment plan may need to be adjusted.
The bronchodilator components (umeclidinium and vilanterol) begin to open the airways within 15-25 minutes after inhalation, with peak bronchodilatory effect occurring within 2-4 hours. However, the full anti-inflammatory benefit from the corticosteroid component (fluticasone furoate) develops gradually over days to weeks. It may take several days to a few weeks of regular daily use before you notice the maximum improvement in breathing, reduction in symptoms, and decrease in exacerbation frequency. Do not stop taking the medication because you do not feel an immediate difference — consistent daily use is essential for optimal benefit.
If you forget a dose, take it as soon as you remember. However, if it is nearly time for your next scheduled dose, skip the missed dose and take the next one at the usual time. Never take two doses at once or take an extra dose to make up for a missed one. It is helpful to take your daily dose at the same time every day to establish a routine and minimize the chance of forgetting. Setting a daily alarm or associating the dose with a regular activity (such as brushing your teeth in the morning) can help.
Yes, inhaled corticosteroids (including fluticasone furoate in Elebrato Ellipta) are associated with an increased risk of pneumonia in patients with COPD. The large IMPACT trial showed pneumonia rates of approximately 8% over one year in patients on triple therapy versus about 5% on LAMA/LABA without an ICS. Risk factors include older age, lower BMI, current smoking, history of prior pneumonia, and severe COPD. However, the same study also demonstrated that triple therapy significantly reduced the rate of moderate-to-severe exacerbations and all-cause mortality compared to dual therapy. Your doctor will weigh these benefits against the pneumonia risk when prescribing this medicine. It is important to be aware of pneumonia symptoms and report them promptly.
The Ellipta inhaler should not be washed with water. If the mouthpiece needs cleaning, wipe it with a dry tissue or cloth and close the cover. The inhaler is designed to stay clean with normal use. Avoid exposing the device to water or moisture, as this can damage the dry powder formulation and affect the accuracy of the delivered dose. Always keep the cover closed when not in use to protect the internal mechanism.
References
- European Medicines Agency (EMA). Trelegy Ellipta (Elebrato Ellipta) – Summary of Product Characteristics. Last updated 2025. Available from: EMA EPAR.
- U.S. Food and Drug Administration (FDA). Trelegy Ellipta – Prescribing Information. Revised 2024. Available from: FDA Label.
- Lipson DA, Barnhart F, Brealey N, et al. Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD (IMPACT). N Engl J Med. 2018;378(18):1671-1680. doi:10.1056/NEJMoa1713901.
- Lipson DA, Crim C, Criner GJ, et al. Reduction in All-Cause Mortality with Fluticasone Furoate/Umeclidinium/Vilanterol in Patients with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2020;201(12):1508-1516.
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of COPD: 2024 Report. Available from: GOLD.
- Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention: 2024 Update. Available from: GINA.
- Rabe KF, Martinez FJ, Ferguson GT, et al. Triple Inhaled Therapy at Two Glucocorticoid Doses in Moderate-to-Very-Severe COPD (FULFIL). N Engl J Med. 2017;378(13):1671-1680.
- Lee LA, Bailes Z, Barnes N, et al. Efficacy and safety of once-daily single-inhaler triple therapy (FF/UMEC/VI) versus FF/VI in patients with inadequately controlled asthma (CAPTAIN). Lancet Respir Med. 2021;9(1):69-84.
- World Health Organization (WHO). Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet. 2023. Available from: WHO.
- British National Formulary (BNF). Fluticasone furoate with umeclidinium and vilanterol. Updated 2025. Available from: BNF.
Editorial Team
This article has been researched, written, and reviewed by the iMedic Medical Editorial Team in accordance with our Editorial Standards and Medical Review Process.
Medical Writer
iMedic Clinical Pharmacology Team — specialists in respiratory medicine and inhaled drug delivery
Medical Reviewer
iMedic Medical Review Board — independent panel of pulmonologists and clinical pharmacologists
Evidence Standards
GRADE framework — Level 1A evidence from systematic reviews and RCTs (IMPACT, FULFIL, CAPTAIN)
Guideline Adherence
Content aligned with GOLD 2024, GINA 2024, EMA SmPC, FDA Prescribing Information, and BNF guidelines