How does this medication work? What will it do for me?

This medication contains two active ingredients that are used to treat chronic obstructive pulmonary disease (COPD), including chronic bronchitis or emphysema. The two active ingredients are vilanterol and fluticasone. Vilanterol belongs to a group of medications called bronchodilators. These medications relax the muscles in the walls of the small air passages in the lung, keeping the air passage open and making it easier to breathe. Fluticasone belongs to a group of medications known as corticosteroids. Corticosteroids reduce inflammation in the lungs and help reduce the swelling and irritation in the walls of the small air passages in the lungs. This helps open the airways and improve breathing.

Fluticasone - vilanterol may also be used to treat asthma for certain people. It should only be used for people whose asthma is not well controlled using inhaled corticosteroids along with occasional use of bronchodilators.

It is important to remember that fluticasone - vilanterol is intended for long-term relief and is not intended for immediate relief. Inhalers that contain "reliever" medications with fast action (e.g., salbutamol, terbutaline) will still be needed while using this medication.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

100 µg/25 µg
This medication is provided in two strips of foil blisters. On one strip, each blister contains a white dry powder mixture of micronized fluticasone furoate equivalent to 100 µg and lactose monohydrate for inhalation. On the other strip, each blister contains a white dry powder mixture of micronized vilanterol trifenatate equivalent to 25 µg of vilanterol, magnesium stearate, and lactose monohydrate for inhalation administration.

200 µg/25 µg
This medication is provided in two strips of foil blisters. On one strip, each blister contains a white dry powder mixture of micronized fluticasone furoate equivalent to 200 µg and lactose monohydrate for inhalation. On the other strip, each blister contains a white dry powder mixture of micronized vilanterol trifenatate equivalent to 25 µg of vilanterol, magnesium stearate, and lactose monohydrate for inhalation administration.

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How should I use this medication?

The recommended adult dose of fluticasone - vilanterol is one inhalation once daily, at the same time every day. After inhaling the dose of medication, rinse your mouth with water and spit it out, to reduce the chances of developing thrush.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor.

Read the package insert or speak with your pharmacist for instructions on using the dispenser properly.

To make sure the medication remains effective, it is very important to use it regularly once a day, exactly as prescribed by your doctor, even when you are not experiencing symptoms of COPD. To prevent side effects, do not use this medication more often than prescribed.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to fluticasone, vilanterol, or any ingredients of the medication
  • are allergic to lactose or milk protein
  • are having an asthma attack with sudden shortness of breath or wheezing
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What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • anxiety
  • back pain
  • cough
  • dizziness
  • fever
  • headache
  • itchy, runny, or blocked nose
  • nausea
  • tremor
  • voice hoarseness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • bone pain or fractures (osteoporosis)
  • flu-like symptoms (sudden lack of energy, fever, cough, sore throat) that includes rash, pins and needles sensation, worsening breathing problems
  • increased blood pressure
  • increased or irregular heartbeat
  • signs of electrolyte imbalance (e.g., muscle pain or cramps, weakness, irregular heart beat)
  • sinus or throat infections
  • signs of pneumonia (e.g., fever, chills, shortness of breath, cough)
  • signs of too much corticosteroid (e.g., rapid weight gain, sweating, thinning skin, dry skin, muscle weakness)
  • symptoms of cataracts (e.g., clouding in the eye, blurry vision, eye pain)
  • symptoms of a common cold (e.g., sinus congestion, runny nose, sore throat, general feeling of being unwell)
  • symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
  • symptoms of glaucoma (increased pressure in the eye; e.g., blurred vision, seeing halos of bright colours around lights, red eyes, increased pressure in your eyes, eye pain or discomfort)
  • symptoms of thrush (sore, raised patches in the mouth)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • sudden worsening or shortness of breath and wheezing immediately after using the medication
  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

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Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Asthma-related deaths: When used for asthma treatment, another medication in the same class as vilanterol has been linked to an increase in asthma-related deaths. Although this has not been demonstrated with vilanterol, this concern may apply to vilanterol. If you experience worsening symptoms or your "rescue" medications are not as effective as usual, contact your doctor or seek medical attention immediately.

Diabetes: This medication may cause an increase in blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Eye problems: Fluticasone may increase the risk of developing cataracts or glaucoma. If you are at risk of developing either of these conditions, have your eyes checked by your doctor before starting long-term treatment with this medication. You should have your eyes monitored at regular intervals while using this medication.

Heart conditions: Vilanterol may cause increased blood pressure, rapid heart rate or irregular heart rhythms, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, angina, low potassium or magnesium levels), high blood pressure or other heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infections: This medication, like other corticosteroids, may prevent the early signs of a serious infection from being noticed. Try to limit the amount of time you spend around others who have recently had infections such as chickenpox or measles. If you do come into contact with someone who has one of these infections, contact your doctor for advice.

Oral hygiene: Fluticasone may cause thrush infection in the mouth and throat. Adequate oral hygiene is very important in minimizing the overgrowth of microorganisms such as candidiasis (thrush). To reduce the risk of infection, gargle with water after each use of this medication.

Osteoporosis: Long term use of medications like fluticasone may increase your risk of developing osteoporosis.  If you have osteoporosis or are at risk for developing osteoporosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause fluticasone to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Seizures: People with seizure disorders may be more likely to experience side effects of vilanterol. If you have a seizure disorder, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Steroid medication use: If you have taken or are still taking oral steroid medications over the last several months, consult with your doctor before using this medication. In times of stress or during a severe asthma attack, your doctor may want you to start your oral steroid medication again.

Thyroid problems: People with thyroid conditions may be more likely to experience side effects of vilanterol. If you have an overactive thyroid gland, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Wheezing: This medication may cause the airways to spasm immediately after using the inhaler. If this happens, use your rescue inhaler as soon as possible to relieve the symptoms, then call your doctor as soon as possible.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if fluticasone - vilanterol passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: This medication is not intended for use by children. The safety and effectiveness of using this medication have not been established for children or people under the age of eighteen.

What other drugs could interact with this medication?

There may be an interaction between fluticasone – vilanterol and any of the following:

  • aldesleukin
  • alfuzosin
  • amiodarone
  • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
  • amphotericin B
  • anaesthetics (e.g., halofantrine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • aprepitant
  • atomoxetine
  • "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • BCG vaccine
  • beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
  • betahistine
  • bicalutamide
  • boceprevir
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • chloramphenicol
  • chloroquine
  • cimetidine
  • cisapride
  • clotrimazole
  • cobicistat
  • conivaptan
  • cyclosporine (systemic)
  • dasatinib
  • decongestants (e.g., pseudoephedrine, phenylephrine, xylometazoline)
  • deferasirox
  • diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, nateglinide, rosiglitazone)
  • disopyramide
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
  • dofetilide
  • domperidone
  • dronedarone
  • echinacea
  • flecainide
  • flupentixol
  • formoterol
  • fusidic acid
  • grapefruit juice
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (atazanavir, darunavir, lopinavir, ritonavir)
  • hyaluronidase
  • imatinib
  • leflunomide
  • other long-acting beta2-agonists (e.g., formoterol, indacaterol, salmeterol)
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • methadone
  • methylphenidate
  • mifepristone
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • nabilone
  • natalizumab
  • nefazodone
  • nelfinavir
  • nilotinib
  • paliperidone
  • pentamidine
  • pimecrolimus
  • pimozide
  • primaquine
  • procainamide
  • quinidine
  • quinine
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • rilpivirine
  • romidepsin
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)  
  • simeprevir
  • sunitinib
  • tacrolimus
  • telaprevir
  • tetrabenazine
  • theophylline
  • trazodone
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • vaccines
  • vandetanib
  • vemurafenib

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.