ICS/LABA — Asthma / COPD Pregnancy: There are no or limited data in pregnant women; animal studies have shown reproductive toxicity at exposures which are not clinically relevant. Administration to pregnant women should only be considered if the expected benefit to the mother is greater than any possible risk to the foetus. Breast-feeding: insufficient information on excretion in human milk, but other corticosteroids and beta2-agonists are detected in human milk and a risk to breastfed newborns/infants cannot be excluded — decide whether to discontinue breast-feeding or the medicine.

Fluticasone Furoate / Vilanterol

Brand names: Relvar Ellipta

This is a once-daily dry-powder inhaler combining the inhaled corticosteroid fluticasone furoate with the long-acting beta2 agonist vilanterol (marketed as Relvar Ellipta), used as maintenance therapy in asthma and COPD.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One inhalation of Relvar Ellipta 92/22 micrograms once daily (starting dose); if inadequately controlled, the dose can be increased to 184/22 micrograms once daily

Route: Oral inhalation (Ellipta dry powder inhaler) — oral inhalation only — source product: Relvar Ellipta 184 micrograms/22 micrograms inhalation powder, pre-dispensed

Frequency: Once daily, at the same time of day each day

Max: Relvar Ellipta 184/22 micrograms once daily

eMC SPC §4.2 — asthma posology only was retrieved for this bundle (no COPD posology appears in the retrieved §4.2; clinician to confirm the COPD regimen separately if the page covers COPD). Adults and adolescents aged 12 years and over: 'A starting dose of one inhalation of Relvar Ellipta 92/22 micrograms once daily should be considered for adults and adolescents 12 years and over who require a low to mid dose of inhaled corticosteroid in combination with a long-acting beta2-agonist. If patients are inadequately controlled on Relvar Ellipta 92/22 micrograms, the dose can be increased to 184/22 micrograms.' 184/22 micrograms should be considered for those who require a higher ICS dose with a LABA. The maximum recommended dose is 184/22 micrograms once daily. Titrate to the lowest dose at which effective control of symptoms is maintained; reassess regularly. Potency reference given in §4.2: fluticasone furoate 100 micrograms once daily is approximately equivalent to fluticasone propionate 250 micrograms twice daily, and fluticasone furoate 200 micrograms once daily to fluticasone propionate 500 micrograms twice daily. Improvement in lung function is usually felt within 15 minutes, but regular daily use is necessary; a short-acting beta2-agonist should be used for immediate relief between doses. Children under 12 years: safety and efficacy not established for asthma — should not be used. Elderly (65 years and over): no dose adjustment. Renal impairment: no dose adjustment. Hepatic impairment: use caution — for moderate or severe hepatic impairment the maximum dose is 92/22 micrograms. Rinse the mouth with water without swallowing after inhalation. Missed dose: take the next dose at the usual time the next day. eMC §4.5 interactions was not retrieved in this bundle.

Dose adjustments

Renal

No dose adjustment is required in patients with renal impairment

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substances or to any of the excipients

Side effects

Headache (very common) and nasopharyngitis (very common) — the most commonly reported reactions
Pneumonia (common; more frequently observed in COPD), upper respiratory tract infection, bronchitis, influenza, candidiasis of the mouth and throat (common)
Oropharyngeal pain (common); dysphonia, cough, rhinitis, sinusitis, pharyngitis; paradoxical bronchospasm (rare)
Arthralgia, back pain, fractures, muscle spasms, abdominal pain, pyrexia (common)
Extrasystoles (uncommon); palpitations, tachycardia, tremor, anxiety (rare); hyperglycaemia and blurred vision (uncommon)
Hypersensitivity reactions including anaphylaxis, angioedema, rash and urticaria (rare)

Clinical monograph

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.

Reference: SUMMIT Trial (Vestbo et al. NEJM 2016); GINA 2024; NICE NG115 (COPD); SPC Relvar Ellipta; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Beclometasone / Formoterol · ICS/LABA — Asthma / COPD

Pathways