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Breo Ellipta: What is it and How Much Does it Cost?

Breo Ellipta is a prescription inhalation powder that is used as an asthma control maintenance treatment in people whose asthma is not well controlled by inhaled corticosteroids and is also used for the long term treatment of chronic obstructive pulmonary disease, or COPD.

More than 25 million Americans are estimated to suffer from asthma and an additional 16 million Americans struggle with a condition known as chronic obstructive pulmonary disease, which makes it difficult to breath. Patients who have chronic obstructive pulmonary disease or severe asthma that is not controlled by the use of typical asthma medications may be able to manage their symptoms and prevent breathing issues through the use of a prescription drug called Breo Ellipta. Breo Ellipta is a preventative inhalation powder that can help people with asthma or chronic obstructive pulmonary disease manage their condition and minimize breathing difficulties.

What is Breo Ellipta?

Breo Ellipta is a prescription inhalation powder that is used as an asthma control maintenance treatment in people whose asthma is not well controlled by inhaled corticosteroids and is also used for the long term treatment of chronic obstructive pulmonary disease, or COPD.  The medication was first approved for the treatment of asthma by the U.S. Food and Drug Administration (FDA) in 2013, when it became available by prescription. Breo Ellipta is approved for the once-daily treatment of asthma and COPD in patients ages 18 and older and is not intended for use in children, and should be stored at room temperature in a dry place. 

Breo Ellipta has two active ingredients: fluticasone, which belongs to a class of drugs called corticosteroids, and vilanterol, which belongs to a class of drugs called long-acting beta-2 agonists, or LABA. Corticosteroids reduce inflammation and are used by many people to manage their asthma symptoms, but some people require the addition of a LABA in order to reliably manage their symptoms. The medications are not intended for use during asthma attacks or sudden breathing problems associated with COPD, as they do not work quickly enough to provide relief in an emergency. Instead, they are to be used as maintenance/preventative medications.

What Conditions is Breo Ellipta Used to Treat?

Breo Ellipta is available in two forms. Breo Ellipta is used to treat asthma in adults ages 18 and older whose condition is not well controlled on other asthma medications, such as inhaled corticosteroids. Breo Ellipta 100/25 is used for the treatment of chronic obstructive pulmonary disease in adults ages 18 and older. 

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Asthma

Asthma is a common chronic illness that causes the narrowing and inflammation of the air passages in conjunction with the excess production of mucus, which makes it challenging to breathe. Asthma occurs on a spectrum and while some people have a minor form of the disorder and experience symptoms only rarely, others have a serious, life-threatening form of the disease.  Healthcare professionals typically diagnose asthma by a physical exam, lung function tests, and a chest or sinus x-ray. Symptoms of asthma include wheezing,  coughing, shortness of breath, and chest tightness, and in some cases, it is a medical emergency. Asthma is triggered by environmental and internal factors like pollen, chemicals, smoke, extreme weather changes, exercise, dust mites, and stress, and each person’s triggers are different. People with asthma must learn to identify their triggers and avoid them as much as possible in order to manage their symptoms. 

Chronic Obstructive Pulmonary Disease 

Chronic obstructive pulmonary disease is a chronic lung disease that is characterized by the presence of refractory asthma, chronic bronchitis, and/or emphysema. Refractory asthma is irreversible asthma that doesn’t respond to normal asthma medications. The most common symptoms of chronic bronchitis are shortness of breath, lingering cough, and excess mucus production that occurs at least three months per year for two years in a row. Emphysema is a condition that occurs when the alveoli in the lungs become damaged and are unable to absorb as much oxygen, causing shortness of breath. Depending on the severity of hte symptoms, COPD is delineated by four different stages. However, it is common for many people not to notice symptoms until their condition is advanced. The most common symptoms of COPD include wheezing, fatigue, a lingering cough, a productive cough, blue lips or fingernails, frequent colds, shortness of breath, chest tightness, and more. 

How Much Does Breo Ellipta Cost?

As a prescription medication that is relatively new to the market, there is no generic version of Breo Ellipta available. Because the medication is still produced by the original manufacturer under their exclusive patent, there is no competition for Breo Ellipta on the market, which drives up prices. As a result, prices are higher than they might otherwise be if a generic competitor was released. The medication is available in different strengths, but the most common strength is 100 mcg/25 mcg, which represents 100 mcg of fluticasone furoate and 25 mcg of vilanterol. Thirty blisters of 100 mcg/25 mcg, which are provided preloaded in an inhaler form, costs approximately 162 dollars, representing a one month refill. Depending on your insurance coverage, you may or may not have prescription coverage for Breo Ellipta.  However, regardless of your insured status, it is possible to receive savings on Breo Ellipta by using a pharmacy discount card, which provides savings on all FDA-approved medications. Brand name and generic drugs are covered by a prescription discount card as long as the medication has been approved by the FDA.

What Risks are Associated With Breo Ellipta?

Use of Breo Ellipta does carry some risks, and the medication is not right for everyone. Although Breo Ellipta is an asthma medication, it should not be used to treat sudden symptoms of asthma, as the Ellipta inhaler does not function as a short-acting rescue inhaler or bronchodilator. People with a severe allergy to milk proteins also should not use Breo Ellipta, and people who are allergic to fluticasone furoate or any other ingredients in Breo Ellipta should not take the medication.  It’s important to give your doctor a complete medical history prior to using Breo Ellipta, particularly if you meet or have increased risk to any of the following criteria or have any of the following medical conditions:

  • Have heart problems
  • Have seizures
  • Have diabetes or have ever had high blood sugar
  • Have weak bones and low bone mineral density (osteoporosis)
  • Have eye problems, including glaucoma, cataracts, increased pressure in the eye, or changes in vision
  • Have any type of viral, parasitic, fungal, or bacterial infection
  • Are pregnant, planning to become pregnant, or are currently breastfeeding, as this drug can transfer into breast milk
  • Have high blood pressure
  • Have thyroid problems
  • Have liver problems 
  • Have a weak immune system or are immunocompromised
  • Are allergic to milk proteins
  • Are exposed to measles or chickenpox

What Side Effects are Associated With Breo Ellipta?

Common side effects of Breo Ellipta vary depending on whether the patient is using the medication for the treatment of asthma or COPD. When taken for asthma, common side effects include:

  • Runny nose
  • Headache
  • Thrush or candidiasis in the throat or mouth (can be treated with an antifungal)
  • Flu
  • Sore throat
  • Breathing problems (bronchitis)
  • Respiratory tract infection
  • Inflammation of the sinuses
  • Hoarseness and voice changes
  • Cough
  • Mouth and throat pain
  • Nasopharyngitis 

When taken for the treatment of COPD, common side effects associated with Breo Ellipta include:

  • Runny nose 
  • Sore throat
  • Headache
  • Back pain
  • Bronchitis
  • Cough
  • Joint pain
  • Flu
  • Upper respiratory tract infection
  • Thrush in the mouth or throat
  • Pneumonia
  • Inflammation of the sinuses
  • Mouth and throat pain
  • Increased blood pressure
  • Fever

Rarely, Breo Ellipta causes serious side effects that require medical attention, including allergic reactions and infections. Serious side effects of Breo Ellipta used for either COPD or asthma that may require you immediately seek a healthcare provider include:

  • Fungal infection in the mouth or throat (thrush)
  • Weakened immune system and increased susceptibility to infections (immunosuppression) 
  • Sudden breathing problems immediately after inhaling the medication
  • Serious allergic reactions to the medication or its ingredients, as evidenced by:
    • Rash
    • Swelling of the face, tongue, or mouth
    • Hives
    • Breathing problems
  • Slow growth in children and adolescents
  • Effects on the heart, including:
    • Increased blood pressure
    • Chest pain
    • Increased heart rate, irregular heartbeat, or awareness of heartbeat
  • Reduced adrenal function or exacerbations of adrenal insufficiency syndrome, as evidenced by:
    • Feelings of exhaustion
    • Weakness
    • Low blood pressure (hypotension)
    • Lack of energy
    • Nausea
    • Vomiting
  • Bone thinning or weakness (osteoporosis)
  • Hypokalemia
  • Pneumonia, as evidenced by any of the following symptoms:
    • Increase in mucus production
    • Fever
    • Increased cough
    • Change in mucus color
    • Chills
    • Increased breathing problems
  • Eye problems, including:
    • Glaucoma
    • Cataracts
    • Increased pressure in the eye
    • Changes in vision
  • Increased blood sugar levels (hyperglycemia), causing:
    • Increased thirst
    • Unexplained tiredness
    • Frequent urination
  • Nervous system effects, such as tremor or nervousness
  • Increased risk of asthma-related death

What Drugs Does Breo Ellipta Interact With?

Breo Ellipta interacts with several different classes of prescription medications, including beta blockers in particular. Patients who are taking any prescription or over the counter drugs, as well as any vitamins, herbs, or nutritional supplements, should provide their doctor or pharmacist with a complete list of everything that they are taking prior to using Breo Ellipta. If you have any questions about drug interactions between your current medications and Breo Ellipta, speak to your doctor or pharmacist for medical advice. Breo Ellipta is known to interact with the following medications:

  • Ketoconazole
  • Ritonavir
  • Saquinavir
  • Troleandomycin
  • Conivaptan
  • Itraconazole
  • Nefazodone
  • Telithromycin
  • Voriconazole
  • Clarithromycin
  • Indinavir
  • Lopinavir
  • Nelfinavir
  • Monoamine oxidase inhibitors
  • Tricyclic antidepressants
  • Beta-adrenergic receptor blocking agents
  • Non-potassium sparing diuretics

References:

https://www.mybreo.com/ 

https://www.drugs.com/breo-ellipta.html 

https://www.webmd.com/drugs/2/drug-164644/breo-ellipta-inhalation/details 

https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Breo_Ellipta/pdf/BREO-ELLIPTA-PI-PIL-IFU.PDF#nameddest=PIL 

https://www.webmd.com/lung/copd/10-faqs-about-living-with-copd 

https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653 

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