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Trelegy Ellipta Disease Interactions

There are 13 disease interactions with Trelegy Ellipta (fluticasone / umeclidinium / vilanterol).

Major

Inhaled anticholinergic bronchodilators (applies to Trelegy Ellipta) milk protein allergies

Major Potential Hazard, Moderate plausibility. Applicable conditions: Lactose Intolerance

Some inhaled anticholinergic bronchodilators such as aclidinium and umeclidinium are contraindicated in patients with severe hypersensitivity to milk proteins. There have been reports of anaphylactic reactions on these patients after inhalation of other powder products containing lactose, therefore patients with severe milk protein allergy should not use these products.

References

  1. "Product Information. Tudorza Pressair (aclidinium)." Forest Pharmaceuticals (2012):
  2. "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):
Moderate

Beta- 2 adrenergic bronchodilators (applies to Trelegy Ellipta) cardiovascular

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hypertension, Hyperthyroidism, Heart Disease

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

References

  1. Maruchin JE, Chazan R, Droszcz W "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol 26 (1988): 385-7
  2. Larsson S "Long-term treatment with beta2-adrenostimulants in asthma. Side effects, selectivity, tolerance, and routes of administration." Acta Med Scand Suppl 608 (1977): 1-40
  3. Burgess JH, Rouleau JL, Mettauer B "Detrimental arrhythmogenic and sustained beneficial hemodynamic effects of oral salbutamol in patients with chronic congestive heart failure." Am Heart J 109 (1985): 840-7
  4. Svedmyr N, Larsson S "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis 116 (1977): 861-9
  5. Ebden P, Wharrad HJ, Britton JR, Cookson JB, Vathenen AS, Tattersfield AE "High-dose inhaled albuterol in severe chronic airflow limitation." Am Rev Respir Dis 138 (1988): 850-5
  6. Godfrey S "Worldwide experience with albuterol (salbutamol)." Ann Allergy 47 (1981): 423-6
  7. Finch JS "Cardiovascular toxicity: clinical evaluation of albuterol, isoproterenol and placebo in rising dose tolerance trial." Ann Allergy 47 (1981): 402-4
  8. Gibson GJ, Nariman S, Vivian J, Corris PA, Neville E "Nebulised salbutamol and angina." Br Med J (Clin Res Ed) 285 (1982): 796-7
  9. Safirstein BH, Breeden CC "Albuterol and spacer-induced atrial fibrillation." Chest 98 (1990): 762-3
  10. Biedermann AA, Yamate M, Chu TJ, Wolfe JD "Comparison of the acute cardiopulmonary effects of oral albuterol, metaproterenol, and terbutaline in asthmatics." JAMA 253 (1985): 2068-72
  11. Wong CS, Britton JR, Pavord ID, Williams J, Tattersfield AE "Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma." Lancet 336 (1990): 1396-9
  12. Shovlin CL, Tam FW "Salbutamol nebuliser and precipitation of critical cardiac ischaemia." Lancet 336 (1990): 1258
  13. Boivin JF, Ernst P, McNutt M, Rebuck AS, Buist AS, Cockcroft D, Habbick B, Suissa S, Horwitz RI, Spitzer WO "The use of beta-agonists and the risk of death and near death from asthma." N Engl J Med 326 (1992): 501-6
  14. Clissold SP, Price AH "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  15. Brogden RN, Richards DM "Pirbuterol. A preliminary review of its pharmacological properties and therapeutic efficacy in reversible bronchospastic disease." Drugs 30 (1985): 6-21
  16. Lampert MB, Hibbard J, Lang RM, Briller J, Lindheimer M, Weinert L "Peripartum heart failure associated with prolonged tocolytic therapy." Am J Obstet Gynecol 168 (1993): 493-5
  17. Al-Hillawi AH, Hayward R, Johnson NM "Incidence of cardiac arrhythmias in patients taking slow release salbutamol and slow release terbutaline for asthma." Br Med J (Clin Res Ed) 288 (1984): 367
  18. Fagerstrom PO, Bengtsson B "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
  19. "Adverse effects and complications of treatment with beta-adrenergic agonist drugs. Committee on drugs, the American Academy of Allergy and Immunology." J Allergy Clin Immunol 75 (1985): 443-9
  20. Speroff L, Johnson KA, Morton MJ, O'Grady JP, Wagner JM "Terbutaline and maternal cardiac function." JAMA 246 (1981): 2697-701
  21. Harbaugh CV, Trautlein JJ, Kinney EL, Lambert D, Zelis RF "Ventricular tachycardia after terbutaline." JAMA 240 (1978): 2247
  22. Whitsett TL, Manion CV, Wilson MF "Cardiac, pulmonary and neuromuscular effects of clenbuterol and terbutaline compared with placebo." Br J Clin Pharmacol 12 (1981): 195-200
  23. Avery GS, Brogden RN, Speight TM "Terbutaline: a preliminary report of its pharmacological properties and therapeutic efficacy in asthma." Drugs 6 (1973): 324-32
  24. Gillin M, Allegra J, Trautlein J "Aerosolized terbutaline sulfate--an evalution of efficacy and side effects in patients with reversible airway disease." J Clin Pharmacol 17 (1977): 76-80
  25. Emirgil C, Maguire GP "Bronchodilator and side effects of different modes of administration of metaproterenol: inhaled, oral, and in combination." Am J Med Sci 291 (1986): 168-74
  26. Child JS, Ho D, Ence TJ, Tashkin DP "Acute bronchial and cardiovascular effects of oral pirbuterol and metaproterenol." Ann Allergy 43 (1979): 229-36
  27. Ellis S, Sanders JP, Bee DE, Grant JA, Potter DE "Metabolic and cardiovascular effects of carbuterol and metaproterenol." J Allergy Clin Immunol 60 (1977): 174-9
  28. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
  29. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
  30. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
  31. Kradjan WA, Meyer JM, Wenzel CL "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
  32. Forster JK, Maconochie JG "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
  33. Brogden RN, Faulds D "Salmeterol xinafoate. A review of its pharmacological properties and therapeutic potential in reversible obstructive airways disease." Drugs 42 (1991): 895-912
  34. Calvarese B, Bautista M, Littner MR, Tashkin DP "Acute bronchial and cardiovascular effects of increasing doses of pirbuterol acetate aerosol in asthma." Ann Allergy 48 (1982): 14-20
  35. Tuck J, Chodosh S, Crooks LA "Comparative effects of pirbuterol acetate, metaproterenol, and placebo aerosols on pulmonary function and incidence of cardiac ectopy." J Asthma 26 (1989): 309-15
  36. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  37. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
  38. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
  39. Hibbard JU "Chronic terbutaline therapy and peripartum cardiomyopathy: a case-control study." Hypertens Pregnancy 15 (1996): 183-91
  40. Robertson PA, Creasy RK, Katz M "Cardiovascular complications associated with terbutaline treatment for preterm labor." Am J Obstet Gynecol 139 (1981): 605-8
  41. Ernst P, Blais L, Hemmelgarn B, Suissa S "Bronchodilators and acute cardiac death." Am J Respir Crit Care Med 154 (1996): 1598-602
  42. Borrello G, Grembiale RD, Pelaia G, Durante S, Naty S, Tranfa CME "Short-term cardiovascular effects of salmeterol." Chest 113 (1998): 1272-6
  43. Braden GL, Mulhern JG, Bria WF, Germain MJ, Hafer JG "Hemodynamic, cardiac, and electrolyte effects of low-dose aerosolized terbutaline sulfate in asthmatic patients." Chest 114 (1998): 380-7
  44. Jenne JW "Can oral beta(2) agonists cause heart failure?" Lancet 352 (1998): 1081-2
  45. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  46. Bronsky EA, Kemp JP, Dockhorn RJ, Nathan RA "Multicenter dose-ranging study of bitolterol mesylate solution for nebulization in children with asthma." Ann Allergy 72 (1994): 209-16
  47. Bierman CW, Kemp JP, Nathan RA "Efficacy and safety of inhaled bitolterol mesylate via metered-dose inhaler in children with asthma." Ann Allergy Asthma Immunol 76 (1996): 27-35
  48. Campbell SC, Kemp JP, Pinnas JL, Tinkelman DG, Bhatt BD "Dose-response study of nebulized bitolterol mesylate solution in asthmatic patients." Chest 91 (1987): 533-9
  49. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
  50. Gawchik SM, Reasner DS, DeGraw SS, Saccar CL, Noonan M "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol 103 (1999): 615-21
  51. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
View all 51 references
Moderate

Beta- 2 adrenergic bronchodilators (applies to Trelegy Ellipta) diabetes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus

Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

References

  1. Maruchin JE, Chazan R, Droszcz W "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol 26 (1988): 385-7
  2. Hastwell G, Lambert BE "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol 85 (1978): 767-9
  3. Clissold SP, Price AH "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  4. Fagerstrom PO, Bengtsson B "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
  5. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
  6. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
  7. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
  8. Kradjan WA, Meyer JM, Wenzel CL "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
  9. Forster JK, Maconochie JG "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
  10. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  11. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
  12. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
  13. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  14. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
  15. Gawchik SM, Reasner DS, DeGraw SS, Saccar CL, Noonan M "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol 103 (1999): 615-21
  16. "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals (2001):
  17. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
View all 17 references
Moderate

Beta- 2 adrenergic bronchodilators (applies to Trelegy Ellipta) hypokalemia

Moderate Potential Hazard, Moderate plausibility.

Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.

References

  1. Addis GJ, Whitesmith R, Reid JL, Whyte KF "The mechanism of salbutamol-induced hypokalaemia." Br J Clin Pharmacol 23 (1987): 65-71
  2. Svedmyr N, Larsson S "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis 116 (1977): 861-9
  3. Allon M, Dunlay R, Copkney C "Nebulized albuterol for acute hyperkalemia in patients on hemodialysis." Ann Intern Med 110 (1989): 426-9
  4. Hastwell G, Lambert BE "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol 85 (1978): 767-9
  5. "Hypokalaemia due to salbutamol overdosage." Br Med J (Clin Res Ed) 283 (1981): 500-1
  6. Tarssanen L, Kantola I "Hypokalemia from usual salbutamol dosage ." Chest 89 (1986): 619-20
  7. Campistol JM, Almirall J, Montoliu J, Ponz E, Revert L "Treatment of hyperkalaemia in renal failure with salbutamol inhalation." J Intern Med 228 (1990): 35-7
  8. Wong CS, Britton JR, Pavord ID, Williams J, Tattersfield AE "Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma." Lancet 336 (1990): 1396-9
  9. Clissold SP, Price AH "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  10. Gross TL, Sokol RJ "Severe hypokalemia and acidosis: a potential complication of beta- adrenergic treatment." Am J Obstet Gynecol 138 (1980): 1225-6
  11. Hurlbert BJ, David K, Edelman JD "Serum potassium levels during and after terbutaline." Anesth Analg 60 (1981): 723-5
  12. Fagerstrom PO, Bengtsson B "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
  13. Balmes JR, Gelmont DM, Yee A "Hypokalemia induced by inhaled bronchodilators." Chest 94 (1988): 763-6
  14. Ellis S, Sanders JP, Bee DE, Grant JA, Potter DE "Metabolic and cardiovascular effects of carbuterol and metaproterenol." J Allergy Clin Immunol 60 (1977): 174-9
  15. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
  16. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
  17. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
  18. Kradjan WA, Meyer JM, Wenzel CL "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
  19. Forster JK, Maconochie JG "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
  20. Crane J, Grainger J, Beasley R, Windom H, Burgess C, Pearce N "A comparison of the haemodynamic and hypokalaemic effects of inhaled pirbuterol and salbutamol." N Z Med J 103 (1990): 259-61
  21. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  22. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
  23. Egstrup K, Djurhuus MS, Klitgaard NAH, Tveskov C "Potassium and magnesium distribution, ECG changes, and ventricular ectopic beats during beta(2)-adrenergic stimulation with terbutaline in healthy subjects." Chest 106 (1994): 1654-9
  24. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
  25. Braden GL, Haag BL, Watson DJ, vonOeyen PT, Germain MJ "Ritodrine- and terbutaline-induced hypokalemia in preterm labor: Mechanisms and consequences." Kidney Int 51 (1997): 1867-75
  26. Farrar HC, Rakhmanina NY, Kearns GL "Hypokalemia in an asthmatic child from abuse of albuterol metered dose inhaler." Pediatr Emerg Care 14 (1998): 145-7
  27. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  28. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
  29. Gawchik SM, Reasner DS, DeGraw SS, Saccar CL, Noonan M "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol 103 (1999): 615-21
  30. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
View all 30 references
Moderate

Beta- 2 adrenergic bronchodilators (applies to Trelegy Ellipta) seizures

Moderate Potential Hazard, Moderate plausibility.

Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

References

  1. Svedmyr N, Larsson S "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis 116 (1977): 861-9
  2. Clissold SP, Price AH "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  3. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
  4. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
  5. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
  6. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  7. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
  8. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
  9. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  10. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
  11. "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals (2001):
  12. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
View all 12 references
Moderate

Inhaled anticholinergic agents (applies to Trelegy Ellipta) anticholinergic effects

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Urinary Retention, Glaucoma (Narrow Angle)

Aclidinium, ipratropium, umeclidinium, and tiotropium are anticholinergic agents. Although systemic effects are uncommon due to the poor absorption of quaternary ammonium compounds from gastrointestinal and nasal mucosa, worsening of urinary retention or angle-closure glaucoma has been reported. Increased intraocular pressure and precipitation or exacerbation of angle-closure glaucoma may also occur due to inadvertent contact of the eye with aerosolized or nebulized drug. Accordingly, therapy with quaternary ammonium compounds should be administered cautiously in patients with urinary retention/obstruction or angle-closure glaucoma. Measures should be taken whenever possible to minimize ocular exposure to these drugs, such as keeping eyes closed during oral inhalation or use of a mouthpiece rather than face mask during nebulization. Patients should be advised to contact their physician if they experience urinary difficulty (especially in patients with prostatic hyperplasia or bladder neck obstruction); or signs and symptoms of angle-closure glaucoma (e.g., eye pain or discomfort; blurred vision; visual halos; colored images in association with red eyes from conjunctival congestion or corneal edema).

References

  1. Gross NJ "Ipratropium bromide." N Engl J Med 319 (1988): 486-94
  2. Mugliston TA, Lund VJ, Mackay IS, Milford CA "Long-term safety and efficacy study of intranasal ipratropium bromide." J Laryngol Otol 104 (1990): 123-5
  3. Lozewicz S "Bladder outflow obstruction induced by ipratropium bromide." Postgrad Med J 65 (1989): 260-1
  4. Pinkhas J, Pras E, Sidi Y, Stienlauf S "Urinary retention associated with ipratropium bromide." DICP 25 (1991): 939-40
  5. Massey KL, Gotz VP "Ipratropium bromide." Drug Intell Clin Pharm 19 (1985): 5-12
  6. Avery GS, Brogden RN, Heel RC, Pakes GE, Speight TM "Ipratropium bromide: a review of its pharmacological properties and therapeutic efficacy in asthma and chronic bronchitis." Drugs 20 (1980): 237-66
  7. "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim (2002):
  8. "Product Information. Atrovent nasal spray (ipratropium nasal)." Boehringer-Ingelheim, Ridgefield, CT.
  9. "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
  10. "Product Information. Tudorza Pressair (aclidinium)." Forest Pharmaceuticals (2012):
  11. "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):
View all 11 references
Moderate

Inhaled corticosteroids (applies to Trelegy Ellipta) hepatic impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Corticosteroids are predominantly cleared by hepatic metabolism and impairment of the liver function may lead to their accumulation. Patients with hepatic disease should be closely monitored.

References

  1. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
  2. "Product Information. Asmanex Twisthaler (mometasone)." Schering-Plough Corporation (2005):
  3. "Product Information. Beconase AQ (beclomethasone nasal)." GlaxoSmithKline (2015):
  4. "Product Information. Pulmicort Flexhaler (budesonide)." A-S Medication Solutions (2016):
View all 4 references
Moderate

Inhaled corticosteroids (applies to Trelegy Ellipta) hyperadrenocorticism

Moderate Potential Hazard, Moderate plausibility.

The use of inhaled and nasal corticosteroids may rarely precipitate or aggravate conditions of hyperadrenocorticism. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during inhaled or nasal corticosteroid therapy may indicate excessive use.

References

  1. Kimmerle R, Rolla AR "Iatrogenic Cushing's syndrome due to dexamethasone nasal drops." Am J Med 79 (1985): 535-7
  2. Cunliffe WJ, Layton AM, Monk B, Rhodes DJ "Acne induced by inhaled corticosteroids." Clin Exp Dermatol 18 (1993): 148-50
  3. Avery GS, Brogden RN, Heel RC, Speight TM "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs 28 (1984): 99-126
  4. Clark TJ "Safety of inhaled corticosteroids." Eur J Respir Dis Suppl 122 (1982): 235-42
  5. Messerli C, Scherrer M, Studer H "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
  6. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
  7. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
  8. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
  9. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
  10. Bronsky E, Meltzer E, Ratner P, Reed C, Grossman J, van As A "Dose tolerance study of fluticasone propionate aqueous nasal spray in patients with seasonal allergic rhinitis." Ann Allergy 67 (1991): 156-62
  11. Stevens DJ "Cushing's syndrome due to the abuse of betamethasone nasal drops." J Laryngol Otol 102 (1988): 219-21
  12. Lingandersson A, Brundin RM, Eckernas SA, Grahnen A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  13. Andersson KE, Edsbacker S, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  14. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
  15. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
  16. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  17. Geddes DM, Robinson DS "Inhaled corticosteroids: benefits and risks." J Asthma 33 (1996): 5-16
  18. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  19. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
  20. Thorsson L, Kallen A, Wiren JE, Dahlstrom K, Edsbacker S, Paulson J "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  21. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  22. Benfield P, Wiseman LR "Intranasal fluticasone propionate: A reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis." Drugs 53 (1997): 885-907
  23. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  24. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  25. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
  26. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
  27. McDowell P, Wales D, Makker H, ODriscoll BR, Kane J "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
  28. Derom E, Schoor JV, Vincken W, Pauwels R, Verhaeghe W "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
  29. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
  30. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
View all 30 references
Moderate

Inhaled corticosteroids (applies to Trelegy Ellipta) infections

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral, Tuberculosis -- Latent

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis infection of the respiratory tract or any untreated systemic fungal, bacterial, parasitic, or viral infection. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Horton DJ, Spector SL "Clinical pulmonary tuberculosis in an asthmatic patient using a steroid aerosol." Chest 71 (1977): 540-2
  2. Carrel TP, Bauer EP, Schmid ER, Schneider J, Laske A, Schaffner A, Turina MI, von Segesser LK "Fatal fungal pericarditis after cardiac surgery and immunosuppression." J Thorac Cardiovasc Surg 101 (1991): 161-4
  3. Vogt FC "The incidence of oral candidiasis with use of inhaled corticosteroids." Ann Allergy 43 (1979): 205-10
  4. Crompton GK, Milne LJ "Beclomethasone dipropionate and oropharyngeal candidiasis." Br Med J 3 (1974): 797-8
  5. Chuang L, Greenway RW, Jennings B, Toogood JH "Candidiasis and dysphonia complicating beclomethasone treatment of asthma." J Allergy Clin Immunol 65 (1980): 145-53
  6. Webb EL "Nasal candidiasis in a patient on long-term topical intranasal corticosteroid therapy." J Allergy Clin Immunol 91 (1993): 680-1
  7. Shaikh WA "Pulmonary tuberculosis in patients treated with inhaled beclomethasone." Allergy 47 (1992): 327-30
  8. Hyland RH, Kortan PP, Pruzanski WR, Kesten S "Esophageal candidiasis associated with beclomethasone dipropionate aerosol therapy." Drug Intell Clin Pharm 22 (1988): 568-9
  9. Avery GS, Brogden RN, Heel RC, Speight TM "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs 28 (1984): 99-126
  10. Messerli C, Scherrer M, Studer H "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
  11. Executive Committee American Academy of Allergy and Immunology "Inhaled corticosteroids and severe viral infections." J Allergy Clin Immunol 92 (1993): 223-8
  12. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
  13. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
  14. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
  15. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
  16. Lingandersson A, Brundin RM, Eckernas SA, Grahnen A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  17. Andersson KE, Edsbacker S, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  18. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
  19. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  20. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  21. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
  22. Thorsson L, Kallen A, Wiren JE, Dahlstrom K, Edsbacker S, Paulson J "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  23. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  24. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  25. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  26. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
  27. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
  28. McDowell P, Wales D, Makker H, ODriscoll BR, Kane J "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
  29. Derom E, Schoor JV, Vincken W, Pauwels R, Verhaeghe W "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
  30. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
  31. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
View all 31 references
Moderate

Inhaled corticosteroids (applies to Trelegy Ellipta) ocular herpes simplex

Moderate Potential Hazard, Moderate plausibility.

Pharmacologic dosages of corticosteroids may increase the risk of corneal perforation in patients with ocular herpes simplex. Therapy with inhaled and nasal corticosteroids should be administered cautiously in such patients.

References

  1. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
  2. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
  3. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
  4. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
  5. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
  6. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  7. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
  8. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  9. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  10. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
  11. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
  12. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
  13. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
View all 13 references
Moderate

Inhaled corticosteroids (applies to Trelegy Ellipta) ocular toxicities

Moderate Potential Hazard, Low plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension, Cataracts

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with inhaled and nasal corticosteroids has only rarely produced these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Fraunfelder FT, Meyer SM "Posterior subcapsular cataracts associated with nasal or inhalation corticosteroids." Am J Ophthalmol 109 (1990): 489-90
  2. Jacob TJ, Karim AK, Thompson GM "Steroid aerosols and cataract formation." BMJ 299 (1989): 918
  3. Allen MB, Ray SG, Cullen B, Dhillon B, Leitch AG "Steroid aerosols and cataract formation." BMJ 299 (1989): 432-3
  4. Kewley GD "Possible association between beclomethasone diproprionate aerosol and cataracts." Aust Paediatr J 16 (1980): 117-8
  5. Messerli C, Scherrer M, Studer H "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
  6. Ghanchi F "Young patients on inhaled steroids and cataract." Lancet 342 (1993): 1306-7
  7. Dreyer EB "Inhaled steroid use and glaucoma." N Engl J Med 329 (1993): 1822
  8. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
  9. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
  10. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
  11. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
  12. Rodrigues MM, Weinreb S, Spaeth GL "Steroid-induced glaucoma: A. Persistent elevation of intraocular pressure B. Histopathological aspects." Trans Am Ophthalmol Soc 75 (1977): 353-81
  13. Lingandersson A, Brundin RM, Eckernas SA, Grahnen A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  14. Andersson KE, Edsbacker S, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  15. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
  16. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
  17. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  18. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  19. Boivin JF, LeLorier J, Garbe E, Suissa S "Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma." JAMA 277 (1997): 722-7
  20. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
  21. Thorsson L, Kallen A, Wiren JE, Dahlstrom K, Edsbacker S, Paulson J "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  22. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  23. Mitchell P, Cumming RG, Leeder SR "Use of inhaled corticosteroids and the risk of cataracts." N Engl J Med 337 (1997): 8-14
  24. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  25. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
  26. Agertoft L, Larsen FE, Pedersen S "Posterior subcapsular cataracts, bruises and hoarseness in children with asthma receiving long-term treatment with inhaled budesonide." Eur Resp J 12 (1998): 130-5
  27. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
  28. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
  29. McDowell P, Wales D, Makker H, ODriscoll BR, Kane J "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
  30. Derom E, Schoor JV, Vincken W, Pauwels R, Verhaeghe W "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
  31. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
  32. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
View all 32 references
Moderate

Inhaled corticosteroids (applies to Trelegy Ellipta) osteoporosis

Moderate Potential Hazard, Moderate plausibility.

Prolonged use of inhaled corticosteroids may be associated with a reduction in bone density. This effect appears to be dose-related and has been reported primarily with high dosages (>= 800 mcg/day of beclomethasone or equivalent for >= 1 year). Reduced levels of total body calcium have also been demonstrated in patients receiving lower dosages. Long-term therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with osteoporosis. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Lingandersson A, Brundin RM, Eckernas SA, Grahnen A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  2. Crilly RG, Jones G, Toogood JH, Wells GA, Nadeau J "Effect of high-dose inhaled budesonide on calcium and phosphate metabolism and the risk of osteoporosis." Am Rev Respir Dis 138 (1988): 57-61
  3. Andersson KE, Edsbacker S, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  4. Douglass B, Cervantes C, Levine C, Allen S, Johnson L, Hillman L, Konig P, Maloney C "Bone metabolism in children with asthma treated with inhaled beclomethasone dipropionate." J Pediatr 122 (1993): 219-26
  5. Kinberg KA, Gallagher JC, Biven RE, Hopp RJ "Bone mineral density in normal and asthmatic children." J Allergy Clin Immunol 94 (1994): 490-7
  6. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
  7. Baskerville JC, Hodsman AB, Drost D, Fraher LJ, Haddad RG, Jennings B, Markov AE, Toogood JH "Bone mineral density and the risk of fracture in patients receiving long-term inhaled steroid therapy for asthma." J Allergy Clin Immunol 96 (1995): 157-66
  8. Chapman KR, Hanania NA, Kesten S, Sturtridge WC, Szalai JP "Dose-related decrease in bone density among asthmatic patients treated with inhaled corticosteroids." J Allergy Clin Immunol 96 (1995): 571-9
  9. Bertoldo F, Boner AL, Gasperi E, Micelli S, Martinati LC "Effect on cortical and trabecular bone mass of different anti-inflammatory treatments in preadolescent children with chronic asthma." Am J Respir Crit Care Med 153 (1996): 232-6
  10. Douglas JG, McDonald AF, Packe GE, Reid DM, Robins SP "Bone density in asthmatic patients taking high dose inhaled beclomethasone diproprionate and intermittent systemic corticosteroids." Thorax 47 (1992): 414-7
  11. Reid DM, Higgins B, Nicoll JJ, Smith MA, Tothill P, Nuki G "Corticosteroids and bone mass in asthma: comparisons with rheumatoid arthritis and polymyalgia rheumatica." BMJ 293 (1986): 1463-6
  12. Ali NJ, Capewell S, Ward MJ "Bone turnover during high dose inhaled corticosteroid treatment." Thorax 46 (1991): 160-4
  13. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  14. Douglas JG, Packe GE, Reid DM, Robb O, Robins SP "Bone density in asthmatic patients taking inhaled corticosteroids: comparison of budesonide and beclomethasone dipropionate." J R Coll Physicians Lond 30 (1996): 128-32
  15. Thorsson L, Kallen A, Wiren JE, Dahlstrom K, Edsbacker S, Paulson J "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  16. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  17. Benfield P, Wiseman LR "Intranasal fluticasone propionate: A reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis." Drugs 53 (1997): 885-907
  18. delRio L, Luengo M, Picado C, Pons F "Bone mineral density in asthmatic patients treated with inhaled corticosteroids: a case-control study." Eur Respir J 10 (1997): 2110-3
  19. Burrell H, Lewis SA, Green DJ, Maslanka W, Tattersfield AE, Wisniewski AF "Cross sectional investigation of the effects of inhaled corticosteroids on bone density and bone metabolism in patients with asthma." Thorax 52 (1997): 853-60
  20. Derom E, Schoor JV, Vincken W, Pauwels R, Verhaeghe W "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
  21. Cawte S, Lewis SA, Green DJ, Hubbard R, Wong CA, Pringle M, Smith CJP, Tattersfield AE, Walsh LJ, Wisniewski AF "Inhaled corticosteroid use and bone-mineral density in patients with asthma." Lancet 355 (2000): 1399-403
  22. Banerjee TR, Israel E, LaHive K, Fitzmaurice GM, LeBoff MS, Kotlov TV "Effects of inhaled glucocorticoids on bone density in premenopausal women." N Engl J Med 345 (2001): 941-7
  23. Kumar N, Malhotra S, Sharma PK, Pandhi P "Effect of inhaled steroids on bone mineral density: a meta-analysis." J Clin Pharmacol 43 (2003): 193-7
  24. Boulet LP, Brown J, Poubelle PE, Gagnon L, Milot J "Long-term influence of inhaled corticosteroids on bone metabolism and density. Are biological markers predictors of bone loss?" Am J Respir Crit Care Med 159 (1999): 838-44
View all 24 references
Moderate

Umeclidinium (applies to Trelegy Ellipta) severe liver impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Patients with moderate hepatic impairment showed no relevant increases in Cmax or AUC when using umeclidinium, when compared with healthy subjects. However, studies have not been performed in patients with severe hepatic impairment.

References

  1. "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):

Trelegy Ellipta drug interactions

There are 497 drug interactions with Trelegy Ellipta (fluticasone / umeclidinium / vilanterol).

Trelegy Ellipta alcohol/food interactions

There is 1 alcohol/food interaction with Trelegy Ellipta (fluticasone / umeclidinium / vilanterol).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.