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Drug vs. Drug

Trelegy 100 vs. Trelegy 200

Learn why your healthcare provider may prescribe Trelegy 100 versus Trelegy 200
Karen Berger medical writer and reviewer headshot
By | Sep. 10, 2024
Two inhalers with "vs." between them: Trelegy 100 vs. Trelegy 200

Key takeaways

  • Trelegy 100 mcg is prescribed as a maintenance medicine for COPD or asthma to prevent and manage symptoms.

  • Trelegy 200 mcg is used in individuals with asthma, but is not FDA approved for COPD. Trelegy 200 contains a higher dose of fluticasone furoate, and the same doses of umeclidinium and vilanterol as Trelegy 100. 

  • After using the inhaler, patients should rinse their mouth with water and spit to reduce the risk of yeast infections of the mouth or throat.

  • Healthcare providers consider factors such as disease severity, symptom control, and response to prior treatments when choosing between Trelegy 100 and 200 in people with asthma. Typically, people with severe asthma or insufficient response to the lower dosage may require Trelegy 200 for more effective symptom management.

In this article:

The Trelegy Ellipta inhaler is a prescription medication used for the maintenance treatment of asthma or chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Made by GlaxoSmithKline (GSK), Trelegy Ellipta is available in two different dosages, often referred to as Trelegy 100 or Trelegy 200. What is the difference between the two? Is one better than the other, or preferred in certain instances? The short answer is that Trelegy 100 contains a lower dose of fluticasone furoate, an inhaled corticosteroid. Also, Trelegy 100 is approved by the Food and Drug Administration (FDA) for asthma or COPD, while Trelegy 200 is only approved for asthma. Continue reading to learn more about Trelegy Ellipta dosing.

Trelegy Ellipta dosage

Trelegy Ellipta is considered triple therapy because it contains three active ingredients in a single inhaler:

  • Fluticasone furoate, an inhaled corticosteroid (ICS), which helps decrease inflammation in the airways of the lungs
  • Umeclidinium, an anticholinergic, also known as a long-acting muscarinic antagonist, which serves as a bronchodilator and helps relax and open the airways in the lungs, making it easier to breathe
  • Vilanterol, a long-acting beta agonist (LABA), which helps relax and open the airways in the lungs, making it easier to breathe

Trelegy Ellipta is not a rescue inhaler. A rescue medication such as albuterol is generally used for relief of shortness of breath or wheezing,

Trelegy Ellipta is available in two different strengths:

  • Trelegy 100 contains 100 micrograms (mcg) of fluticasone furoate, 62.5 mcg of umeclidinium, and 25 mcg of vilanterol.
  • Trelegy 200 contains 200 mcg of fluticasone furoate, 62.5 mcg of umeclidinium, and 25 mcg of vilanterol.

As you can see, the difference lies in the strength of fluticasone, the steroid ingredient of the medication. The lower dose contains 100 mcg of fluticasone, while the higher dose contains 200 mcg. The strengths of the other two ingredients, umeclidinium and vilanterol, are the same.

Trelegy 100 vs. 200: Key differences

While Trelegy 100 and 200 contain different dosages of fluticasone, they also differ slightly in their FDA-approved uses:

  • People with COPD can use Trelegy 100. The dose is one puff by mouth once a day (one daily dose). Trelegy 200 is not FDA-approved for people with COPD.
  • People with asthma can use Trelegy 100 or Trelegy 200. The dose for either inhaler is one puff by mouth once a day.

Considerations of Trelegy Ellipta dosing

As mentioned above, people with COPD will generally be prescribed a dose of Trelegy 100/62.5/25 mcg, one puff by mouth once daily. 

However, there are two options for people with asthma: Trelegy 100/62.5/25 mcg or Trelegy 200/62.5/25 mcg. The prescribing information notes that when determining the starting dose of Trelegy, there are several factors to consider. These include the severity of the condition, previous medications tried, current control of symptoms, and risk of future exacerbation of symptoms. Healthcare providers take all of these factors into consideration to determine the appropriate starting dosage of Trelegy Ellipta. 

For patients with asthma who start on the Trelegy 100/62.5/25 mcg dose but find they do not respond adequately, their healthcare provider may suggest increasing the dose to Trelegy 200/62.5/25 mcg daily for improved asthma control. If Trelegy 200/62.5/25 mcg is not effective, other options may be considered.

The table below summarizes important information about both inhalers.

Trelegy Ellipta 100 vs. Trelegy Ellipta 200
Trelegy 100 Trelegy 200
Dosage (fluticasone furoate/ umeclidinium/ vilanterol) 100/62.5/25 mcg 200/62.5/25 mcg
FDA-approved conditions COPD

Asthma

 Asthma
Dosage  Inhale 1 puff by mouth once daily  Inhale 1 puff by mouth once daily 

Trelegy Ellipta drug warnings and interactions

Warnings and drug interactions are the same, regardless of the Trelegy Ellipta dosage. 

Some important information about warnings and interactions follows below. You can read the full prescribing information to find out more about Trelegy side effects, warnings, precautions, results of clinical studies, and other important patient information.

  • Trelegy Ellipta is a dry powder inhaler and contains lactose. People with a severe milk protein allergy should not use this medicine.
  • Take Trelegy exactly as directed. If you feel like it is not working as well as it should or has in the past, consult your healthcare provider. 
  • After using the inhaler, patients should rinse the mouth with water, and spit (do not swallow). This helps lower the risk of yeast infections (thrush) of the mouth and throat.
  • Your healthcare provider will monitor for certain conditions such as cataracts, glaucoma, and osteoporosis—as well as growth in children and adolescents. 
  • Trelegy interacts with certain medications, including certain antibiotics and antifungals. Before you take Trelegy, tell your healthcare provider about all the medications you take, including prescription and over-the-counter drugs, vitamins, and supplements.