Breo Ellipta alternatives: What can I take instead of Breo Ellipta?

In this article:

• Compare Breo Ellipta alternatives
• Advair
• Symbicort
• Dulera
• AirDuo RespiClick
• Trelegy Ellipta
• Natural alternatives
• How to switch meds

In this article

• Compare Breo Ellipta alternatives
• Advair
• Symbicort
• Dulera
• AirDuo RespiClick
• Trelegy Ellipta
• Natural alternatives
• How to switch meds

Breo Ellipta is the brand name of an inhaler that contains two medications used to control asthma and COPD (chronic obstructive pulmonary disease). This combination inhaler is also available as a generic medicine called fluticasone furoate and vilanterol, which are the names of the two medicines in the inhaler. Fluticasone furoate is a corticosteroid and vilanterol is a long-acting beta agonist (LABA). Working together, these medicines help to reduce inflammation and open airways in the lungs to help breathing problems. Breo Ellipta can help people with persistent asthma or COPD symptoms like wheezing, coughing, chest tightness or difficulty breathing. This inhaler is used once daily as a maintenance inhaler. As a combination medication, Breo Ellipta can be a more convenient inhaler option compared to using two single inhalers.

While an effective treatment for some people, Breo Ellipta may not be the best option for all people managing persistent asthma or COPD symptoms. Not all people with asthma will require a maintenance inhaler or a combination maintenance inhaler, and not all people with COPD will require a combination maintenance inhaler. Those with less persistent asthma may only need a rescue inhaler like albuterol (Ventolin) or only an inhaled steroid like fluticasone (Arnuity Ellipta). On the other hand, some people with more severe asthma may need a few prescription drug therapies. Some maintenance treatments for asthma are only FDA-approved in certain ages, limiting use in children. Breo Ellipta is approved for use in people 5 years and older.

RELATED: COPD vs. asthma: Which is worse?

What can I take in place of Breo Ellipta?

There are other options available to treat asthma and COPD symptoms that do not improve with Breo Ellipta. Other combinations of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) include Advair Diskus, Advair HFA, AirDuo RespiClick, Dulera, and Symbicort. And like Breo Ellipta, a few brand-name inhalers (Advair, AirDuo RespiClick, and Symbicort) have become available as more affordable generics that include fluticasone propionate/salmeterol and budesonide/formoterol. These alternative inhalers share common side effects of oral thrush, hoarse voice, headache, upper respiratory infections, and sinus infections. Although, it’s important to consider that some alternatives have additional adverse effects.

RELATED: Breo Ellipta side effects and how to avoid them

Other alternatives to Breo Ellipta

Alternative asthma maintenance and COPD treatment exist depending on the condition being treated. The severity of asthma or COPD will help determine the most appropriate alternative medications. Other alternatives include single-medication inhalers, nebulizer solutions, oral tablets, and injectables.

Inhaled Corticosteroids:

•  Alvesco (ciclesonide)
•  Arnuity Ellipta (fluticasone furoate)
•  Asmanex Twisthaler/Asmanex HFA (mometasone furoate)
•  Fluticasone propionate (former brand name Flovent HFA)
•  Pulmicort Flexhaler (budesonide)
•  Qvar RediHaler (beclomethasone dipropionate)

Long Acting Anticholinergic (LAMAs):

• Incruse Ellipta (umeclidinium) 
• Spiriva Respimat (tiotropium bromide)
• Tudorza Pressair (aclidinium)

Long Acting Beta Agonists (LABAs):

• Brovana (arformoterol)
• Perforomist (formoterol)
• Serevent Diskus (salmeterol)
• Striverdi Respimat (olodaterol)

Leukotriene Inhibitors:

• Accolate (zafirlukast) tablets
• Singulair (montelukast) tablets
• Zyflo (zileuton) tablets

Biologics:

• Dupixent (dupilumab) injection
• Fasenra (benralizumab) injection
• Nucala (mepolizumab) injection
• Xolair (omalizumab) injection

Top 5 Breo Ellipta alternatives

The following are some of the most common alternatives to Breo Ellipta.

1. Advair (fluticasone/salmeterol)

Advair is a brand name of an inhaled medication that is also available as a generic called fluticasone/salmeterol. Like Breo Ellipta, Advair contains two medications (corticosteroid and long-acting beta agonist) to help open and relax the airways. Advair is available as an metered dose inhaler (Advair HFA) and as a dry powder inhaler (Advair Diskus). These devices differ in how they are administered, so it is important to learn the correct technique. Advair can be used to help manage asthma and COPD. For people who require two medications, having them in one inhaler can help improve compliance. This may be a suitable alternative for those seeking a generic combination medication with choices between types of inhalers.

RELATED: 12 things to know about Advair

2. Symbicort (budesonide/formoterol)

Symbicort is a brand name of an inhaled medication that has a generic called Breyna or budesonide/formoterol. Symbicort is also made up of a combination of a corticosteroid and LABA. This medication can be used to manage asthma and COPD symptoms like wheezing and shortness of breath. Combination medications, like Symbicort, can help reduce COPD exacerbations that could lead to hospitalizations. This inhaler is a metered dose inhaler that may be a suitable alternative for those who need a combination treatment.

RELATED: 6 ways to save money on Symbicort

3. Dulera (mometasone/formoterol)

Dulera is a brand-name inhaler that is currently not available as a generic medication. This inhaler contains a combination of a corticosteroid (mometasone) and a LABA (formoterol). Dulera is FDA-approved to manage asthma and has been used off-label for the maintenance of COPD. Combination inhalers, like Dulera, are typically used when symptoms are not adequately controlled with just an inhaled corticosteroid or the severity of asthma warrants combination treatment. Dulera is a metered dose inhaler (MDI) and may be a well-suited alternative for adults or children 5 years and older.

RELATED: How much is Dulera without insurance?

4. AirDuo RespiClick (fluticasone/salmeterol)

AirDuo RespiClick is a brand-name combination inhaler that can help manage asthma and is available as a generic medicine. This inhaler contains a combination of a corticosteroid (fluticasone) and a LABA (salmeterol). This alternative contains the same two active ingredients as Advair, but has some key differences. AirDuo inhalers contain lower doses of salmeterol and have a unique inhaler device mechanism. This inhaler is described as an inhalation-driven, multi-dose dry powder inhaler (MDPI). Despite a different dose of salmeterol, separate clinical studies for AirDuo and Advair appear to show relatively similar effectiveness. AirDuo RespiClick may be a lower cost alternative.

5. Trelegy Ellipta (fluticasone/umeclidinium/vilanterol)

Trelegy Ellipta is a triple combination inhaler that can be used for either asthma or COPD maintenance. This inhaler is made up of three different medications that include an ICS (fluticasone furoate), a long acting anticholinergic (umeclidinium bromide), and a LABA (vilanterol trifenatate). Currently, Trelegy Ellipta does not have a generic medication available. With the addition of a third medicine, Trelegy Ellipta has more reported side effects including altered taste, nausea, bronchitis, nasal congestion, diarrhea, constipation, urinary tract infection, musculoskeletal pain, back pain, pneumonia, and vomiting. This alternative may be a great option for people who need additional treatment support when dual combination inhalers aren’t properly maintaining their lung condition.

Natural alternatives to Breo Ellipta

It’s important for those managing asthma or COPD to know that while there aren’t any well supported natural alternatives, like vitamins or supplements, there are alternative remedies that are essential to practice. According to the American Lung Association, it’s important to recognize and minimize asthma triggers that can worsen asthma symptoms. By instilling lifestyle changes or diet modifications, people with asthma can control their asthma symptoms.

Common asthma triggers include:

• Air pollution
• Animal dander
• Aspirin
• Cigarette smoke
• Dust mites
• Exercise
• Fireplace or campfire smoke
• Food allergies such as peanuts or shellfish
• High humidity
• Mold
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Respiratory infections (colds, flu, sinus infections)
• Stressed emotions including crying too hard or anger
• Strong odors including cleaning products, scented candles, and air fresheners
• Sudden or extreme changes in temperature
• Trees or grass

In addition, learning and utilizing breathing techniques may be a useful alternative remedy for asthmay. Practicing pursed lip breathing and belly breathing exercises for 5 to 10 minutes daily may help increase oxygen levels and rid the lungs of accumulated stale air. For COPD, keeping up with physical activity is essential for all levels of disease severity and lung function. People may consider pulmonary rehabilitation as this remedy can improve shortness of breath, health status and exercise tolerance.

RELATED: 7 home remedies for asthma—and what to do if they don’t work

How to switch to a Breo Ellipta alternative

1. Do not suddenly stop taking Breo Ellipta

Before stopping Breo Ellipta, make an asthma or COPD maintenance plan with a healthcare professional to make sure to avoid worsening lung symptoms. After a plan has been set in place, Breo Ellipta can be safely discontinued and replaced with the new treatment.

2. Learn how to use the new inhaler

If the alternative medication is an inhaler, it’s important to learn the proper way to use it as there are a variety of different devices with different directions. Improper technique could prevent the medicine from being delivered. Healthcare professionals, such as pharmacists, can teach the proper technique for inhalers and communicate if and how often the specific brand of inhaler needs to be primed. Priming makes sure the dosing chamber of an inhaler is filled with the correct amount of medicine. It’s important to review the prescribing information that comes with the inhaler and ask for medical advice if needed.

3. Do not use maintenance medications for sudden asthma attacks

Rescue inhalers are the treatment for sudden asthma symptoms like wheezing, trouble breathing, tightness in the chest, or coughing. Rescue inhalers work fast to relieve symptoms, whereas maintenance medications like Breo Ellipta are not used for acute attacks. Examples of rescue inhalers for the treatment of asthma include albuterol (Ventolin HFA) and levalbuterol (Xopenex).

4. Discuss all medications with a healthcare provider

Prior to switching from Breo Ellipta to an alternative, it’s important that a healthcare provider has reviewed a medication list including prescription drugs, over-the-counter (OTC) medications, and supplements. Certain alternatives have drug interactions that must be avoided.

5. Continue proper oral care with inhaled corticosteroid (ICS) alternatives

Breo Ellipta and alternatives that contain a corticosteroid (such as Advair, Dulera, and Symbicort) have an important step to remember when using. It’s important to rinse the mouth with water, without swallowing, and spit out. This step can prevent the increased risk of a fungal infection called oral candidiasis (oral thrush).