Relvar Ellipta Inhaler

What is Relvar Ellipta?

Relvar Ellipta is a prescription combination inhaler used for the regular, long-term management of asthma and chronic obstructive pulmonary disease (COPD). It contains two active ingredients: fluticasone furoate, an inhaled corticosteroid (ICS) that reduces inflammation and swelling in the airways, and vilanterol, a long-acting beta-2 agonist (LABA) that relaxes the airway muscles, helping to keep the airways open.

Together, these medicines help improve breathing, reduce symptoms and support better respiratory disease control.

Indications and clinical benefits

Asthma: Relvar Ellipta is indicated for adults and adolescents aged 12 years and over whose asthma is not adequately controlled with inhaled corticosteroids and a short-acting reliever, or who are already appropriately controlled on an ICS/LABA combination. In accordance with GINA asthma management principles, treatment should include an inhaled corticosteroid to reduce airway inflammation and the risk of exacerbations. Relvar Ellipta provides convenient once-daily maintenance treatment and may help improve lung function, reduce breathlessness, wheezing and chest tightness, and support improved asthma control.

COPD: Relvar Ellipta is indicated for adults aged 18 years and over with COPD. It may improve lung function, reduce breathlessness and help prevent exacerbations in appropriately selected patients. However, GOLD guidelines generally favour long-acting bronchodilator combinations containing a LABA and a long-acting muscarinic antagonist (LAMA) as the initial treatment for many patients with COPD. An inhaled corticosteroid-containing treatment may be considered where there is a history of exacerbations, evidence suggesting a greater likelihood of response to ICS, or co-existing asthma. Treatment should be individualised according to symptoms, exacerbation history, blood eosinophil count and pneumonia risk.

How and when to use Relvar Ellipta

Relvar Ellipta is designed for once-daily maintenance treatment, taken regularly at approximately the same time each day, even when symptoms are well controlled.

• For asthma, the prescribed strength is selected according to disease severity and response to treatment. Available strengths include 92/22 micrograms and 184/22 micrograms.
• For COPD, the licensed dose is one inhalation of Relvar Ellipta 92/22 micrograms once daily. The higher 184/22 microgram strength is not indicated for COPD.
• The inhaler should be used according to the manufacturer’s instructions, with inhaler technique checked regularly by a healthcare professional.
• Patients should rinse their mouth with water after inhalation and spit it out, rather than swallowing, to reduce the risk of oral thrush.

Relvar Ellipta should not be used as an as-needed reliever or to treat sudden breathlessness, an acute asthma attack or a COPD exacerbation. Patients should continue to carry and use their prescribed rescue inhaler or follow their personalised action plan when acute symptoms occur.

Importantly, Relvar Ellipta contains vilanterol rather than formoterol. It is therefore not suitable for maintenance-and-reliever therapy (MART), which requires an appropriate ICS/formoterol combination inhaler.

Safety, precautions and potential side effects

Relvar Ellipta is generally well tolerated when prescribed appropriately, but patients should be informed about possible side effects.

Common side effects include:

• Headache.
• Sore throat or hoarseness.
• Oral thrush (a fungal infection in the mouth).
• Cough.
• Tremor or palpitations.

The inhaled corticosteroid component may increase the risk of oral thrush and, particularly with higher doses or prolonged treatment, systemic corticosteroid effects. Rinsing the mouth after each dose helps reduce local side effects.

Patients should seek medical advice if they experience worsening respiratory symptoms, recurrent chest infections, persistent oral symptoms or other concerning side effects. Severe allergic reactions, significant breathing difficulties or sudden worsening of symptoms require urgent medical attention.

Relvar Ellipta should not be used in patients with a known allergy to fluticasone furoate, vilanterol or any of its ingredients. Caution may be required in patients with certain cardiovascular conditions, diabetes, thyroid disorders or significant liver impairment.

When Relvar Ellipta may not be appropriate

Relvar Ellipta may not be the most suitable treatment in the following circumstances:

• Acute asthma symptoms or COPD exacerbations: It is not a rescue treatment and should not replace an appropriate reliever inhaler or emergency management.
• COPD without a clear indication for inhaled corticosteroids: GOLD generally favours LABA/LAMA therapy for many patients, particularly where exacerbations are absent and there are no features of asthma.
• Patients with recurrent pneumonia or significant infection risk: The potential benefits and risks of ICS-containing treatment should be reviewed.
• Patients with poorly controlled symptoms despite treatment: Inhaler technique, adherence, smoking, comorbidities and alternative diagnoses should be assessed before treatment is escalated.
• Patients who may benefit from a different inhaler strategy: Some patients with asthma may be better suited to an ICS/formoterol-based maintenance-and-reliever regimen, depending on their clinical circumstances and current guidance.

Treatment should never be stopped, increased or changed without appropriate clinical review.

Patient information leaflet:

Relvar Ellipta, INN-fluticasone furoate/vilanterol