Fluticasone Furoate / Vilanterol

How it works

Fluticasone furoate suppresses airway inflammation through glucocorticoid receptor activation, while vilanterol provides prolonged bronchodilation by stimulating beta2 adrenoceptors on airway smooth muscle.

Prescribing in practice

• In asthma a long-acting beta2 agonist must never be used without the inhaled corticosteroid and is not for acute relief, so a separate short-acting reliever is always required.
• Inhaled corticosteroid use increases pneumonia risk in COPD and can cause oral candidiasis and dysphonia.
• Beta2 agonist effects include tremor, palpitations and hypokalaemia, with caution in cardiovascular disease.

Monitoring

Monitor asthma or COPD control, inhaler technique, growth in children on long-term corticosteroid, and watch for pneumonia in COPD.

Counselling the patient

• Use once daily for prevention, not to relieve sudden attacks.
• Rinse the mouth after each dose to limit thrush and hoarseness.
• Always carry a reliever inhaler and report worsening symptoms.

Evidence & guidelines

Established once-daily inhaled corticosteroid/long-acting beta2 agonist combination supported by asthma and COPD trial programmes and reflected in UK respiratory guidance.