LAMA + LABA Pregnancy: There are no data on use in pregnant women; studies in animals have shown reproductive toxicity with vilanterol at exposures which are not clinically relevant. Umeclidinium/vilanterol should be used during pregnancy only if the expected benefit to the mother justifies the potential risk to the foetus. Breast-feeding: it is unknown whether umeclidinium or vilanterol are excreted in human milk (other beta2-adrenergic agonists are detected in human milk) and a risk to newborns/infants cannot be excluded — a decision must be made whether to discontinue breast-feeding or therapy. Fertility: no human data; animal studies indicate no effects on fertility.

Umeclidinium with vilanterol

Brand names: Anoro Ellipta

Umeclidinium with vilanterol is a fixed-dose once-daily maintenance inhaler pairing a long-acting muscarinic antagonist (LAMA) with a long-acting beta-2 agonist (LABA) for COPD. It is taken regularly for symptom control rather than as a reliever.

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 once daily (umeclidinium 55 micrograms / vilanterol 22 micrograms per inhalation)

Route: Inhalation use only (ELLIPTA pre-dispensed dry powder inhaler) — source product: ANORO ELLIPTA 55 micrograms/22 micrograms inhalation powder, pre-dispensed — source product: Anoro Ellipta 55 micrograms/22 micrograms inhalation powder, pre-dispensed

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

Max: One inhalation once daily — this is stated as both the recommended and the maximum dose

Source: UK SPC (eMC) §4.2 for ANORO ELLIPTA 55 micrograms/22 micrograms inhalation powder (https://www.medicines.org.uk/emc/product/5423/smpc). Verbatim: 'The recommended and maximum dose is one inhalation once daily. ANORO ELLIPTA should be administered at the same time of the day each day to maintain bronchodilation.' The 55/22 micrograms strength is taken from the product name in the source; §4.2 itself states only 'one inhalation once daily'. MISSED DOSE: if a dose is missed the next dose should be inhaled at the usual time the next day. ELDERLY: no dose adjustment required in patients 65 years of age or older. HEPATIC: no dose adjustment in mild or moderate hepatic impairment; not studied in severe hepatic impairment — use with caution. PAEDIATRIC: 'There is no relevant use of ANORO ELLIPTA in the paediatric population (under 18 years of age) for the indication of COPD' — no paediatric dose is stated, so paedDose is null; verify any under-18 use against a children's formulary. ADMINISTRATION: the inhaler contains pre-dispensed doses and is ready to use; the 'Discard by' date is 6 weeks from the date of opening the tray; if the cover is opened and closed without inhaling, the dose is lost. §4.4: should NOT be used in asthma (not studied in that population) and is not indicated for the treatment of acute episodes of bronchospasm. Contains lactose.

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 listed in section 6.1

Side effects

Nasopharyngitis (9%) — the most frequently reported adverse reaction; also urinary tract infection, sinusitis, pharyngitis and upper respiratory tract infection (common)
Headache (common); tremor and dysgeusia (uncommon); dizziness (not known)
Cough and oropharyngeal pain (common); dysphonia (uncommon); paradoxical bronchospasm (rare)
Constipation and dry mouth (common); muscle spasms (uncommon)
Uncommon: atrial fibrillation, supraventricular tachycardia, idioventricular rhythm, tachycardia, supraventricular extrasystoles, palpitations; rare: urinary retention, dysuria, bladder outlet obstruction, glaucoma, increased intraocular pressure, blurred vision, anaphylaxis, angioedema and urticaria

Interactions

§4.4: caution should be exercised when umeclidinium/vilanterol is used with other medicinal products that also have the potential to cause hypokalaemia (beta2-adrenergic agonists may produce significant hypokalaemia)
Note: the §4.5 text was truncated at the source-fetch limit ('Clinically significant interactions mediated by…') — the interactions section was not retrieved; verify against the complete SPC

Clinical monograph

How it works

Umeclidinium blocks muscarinic receptors to limit cholinergic bronchoconstriction and vilanterol activates beta-2 adrenoceptors to relax airway smooth muscle, giving complementary long-acting bronchodilatation.

Prescribing in practice

Avoid the umeclidinium component in angle-closure glaucoma and use cautiously in significant bladder-outflow obstruction or prostatic disease because of antimuscarinic effects.
Caution applies with the vilanterol LABA in cardiovascular disease, arrhythmias and hyperthyroidism, and hypokalaemia may be worsened by steroids and diuretics.
It is a maintenance treatment only, so a separate short-acting bronchodilator is required for acute breathlessness.

Monitoring

Monitor symptom control, exacerbation frequency, inhaler technique and antimuscarinic or cardiovascular adverse effects.

Counselling the patient

Take it once daily at the same time for prevention, not for sudden symptoms.
Report eye pain or visual halos, or difficulty passing urine, promptly.

Evidence & guidelines

This LAMA/LABA combination is supported by COPD trial evidence and NICE guidance favouring dual bronchodilation for persistent symptoms.

Reference: NICE NG115; 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

Tiotropium with olodaterol · LAMA + LABA

Pathways